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食管癌是华北地区常见的恶性肿瘤之一。最近,我们在河南省林县和安阳地区的工作基础上,进一步发动群众,对华北地区太行山周围181个县(市)约五千万人口中1969～1971年食管癌死亡情况进行了调查,结果发现粗死亡率为53.96/10万人口,年令性别调整率为37.39/10万人口,其中年令性别调整死亡率最高的地区达139.80/10万人口,最低的地区为1.43/10万人口,死亡率较高的县(市)集中在太行山的南段,由此向四周逐渐减低,大体成一个不规则的同心圆分布。食管癌患者的男女两性比例为1.6:1,发病越高的地区其性别的比例越小,年令越高,死亡越多。高发区食管癌的发病比低发区提前十年,而且细胞学的对比普查发现,食管上皮增生的病人也较多。据林县1959～1970年的发病与死亡登记报告资料,年令性别调整发病率为108.56/10万人口,死亡率为99.76/10万人口,三十年来林县的食管癌死亡率始终在较高水平上,无明显的升高或减低趋势。在动物的流行病学调查方面,林县家鸡的咽～食管鳞癌患病率为175:78/10万只,而另一食管癌低发县为17.55/10万只,这些调查的初步结果说明,食管癌在华北地区的发生与地理环境有密切的关系。在病因学方面,我们正在开展食物中亚硝胺及其前身物的测定与分析,环境中某些微量元素的测定,以及霉菌等因素的研究,工作尚在进行中。此外,我们还在食管癌高发区现场开始了防治试点工作,探讨有效的予防措施。
Esophageal cancer is one of the common malignant tumors in North China. Recently, based on the work in Linxian County and Anyang County in Henan Province, we further mobilized people to investigate the deaths of esophageal cancer from 1969 to 1971 in approximately 50 million people in 181 counties (cities) around Taihang Mountain in North China. The crude mortality rate was 53.96 per 100 000 people, and the annual gender adjustment rate was 37.39 per 100,000 population. Among them, the highest annual gender-adjusted mortality rate was 139.80 per 100,000 population, and the lowest was 1.43 per 100,000 population. The counties (cities) with higher death rates are concentrated in the southern section of the Taihang Mountains, gradually decreasing from the surrounding area, and forming an irregular concentric distribution. The ratio of male to female patients with esophageal cancer is 1.6:1. The higher the incidence, the smaller the proportion of the sex, and the higher the age, the more deaths will occur. The incidence of esophageal cancer in high-incidence areas is ten years earlier than that in low-incidence areas, and a comparative cytological survey has found that there are more patients with esophageal epithelial hyperplasia. According to Lin County’s report on the incidence and death registration from 1959 to 1970, the annual incidence of gender adjustment was 108.56 per 100 000 population, and the mortality rate was 99.76 per 100 000. The death rate of esophageal cancer in Lin County for the past 30 years has been relatively high. At high levels, there is no significant increase or decrease in the trend. In the epidemiological survey of animals, the prevalence of pharyngeal-esophageal squamous cell carcinoma in Linxian chicken was 175:78 per 100,000, and another low incidence of esophageal cancer was 17.55 per 100,000, preliminary to these surveys. The results show that the occurrence of esophageal cancer in North China has a close relationship with the geographical environment. In terms of etiology, we are conducting the determination and analysis of nitrosamines and their predecessors in foods, the determination of certain trace elements in the environment, and the study of factors such as mold, and the work is still in progress. In addition, we also started trials on prevention and control at the scene of high incidence of esophageal cancer and explored effective preventive measures.