簡易檢索 / 詳目顯示

研究生: 王美純
Mei-Chuen Wang
論文名稱: 攝護腺癌相關危險因子研究─以某醫學中心攝護腺癌病患為例
Multiple Behavioral Risk Factors for Prostate Cancer at an Academic Teaching Hospital: A Case-Control Study.
指導教授: 陳政友
Chen, Cheng-Yu
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 109
中文關鍵詞: 攝護腺癌危險因子病例對照研究法
英文關鍵詞: Prostate cancer, risk factors, case control study
論文種類: 學術論文
相關次數: 點閱:350下載:70
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 本研究旨在探討攝護腺癌病患的相關危險因子,採病例對照研究法,以台灣地區40歲以上成年男子為研究對象,由95年05月01日至96年04月30日共12個月期間,自某醫學中心進行樣本收集,經泌尿外科主治醫師確定臨床診斷,且有攝護腺特異抗原(PSA)及肛門指診(DRE)檢查證實為攝護腺癌的病患共110名,另外在病例發現之同時於該醫學中心中排除有心臟血管疾病、新陳代謝疾病、腎臟病、泌尿系統疾病及血液腫瘤等疾病史之非攝護腺癌病患共126名為對照組,以上兩組研究對象均採面談方式,依結構式問卷進行回溯調查,收集研究對象之社會人口學及生活型態相關資料。資料經邏輯複迴歸分析後發現:高社經地位、高血脂家族病史、使用動物油烹調料理、高炒菜油量、喜食肥肉(含皮)、喜用滷汁拌飯或麵、高頻率的甜點攝取及低運動頻率等為攝護腺癌的主要危險因子,顯示高油脂飲食與某些生活飲食習慣確實與攝護腺癌有密切關係,建議採用低脂高纖的飲食方式,並配合適當且定期的運動,可有效減少攝護腺癌的罹患風險。

    A case-control study was conducted to investigate the multiple behavioral risk factors of prostate cancer in Taiwanese men ( >40 yr) from May 1st 2006 to April 30th 2007, including 110 cases and their age matched healthy 126 controls were included. Both of them were enrolled from the same hospital. Cases had diagnosed prostate cancer based on prostate specific antigen test and digital rectal examination. Controls with cardiovascular disease or metabolic disease or renal disease or urinary system disease or cancer were eliminated from the enrollment at first. Demographical data and risk factor related information were collected using a structured questionnaire. Subjects were interviewed in person to collect information regarding social demography variables, dietary factors and life-style factors. In a multiple logistic regression analysis, we found some significant variables including: high socioeconomic status, family history of hypertriglyceridemia, high dietary fat, high saturated fat, high fat meat and high sweets may increase the risk of prostate cancer. This beneficial effect presented for men with recreational physical activities but not for men with light physical activity. In conclusion, our study shows that high fat diet and some life-style factors may have associated with prostate cancer risk. It suggests that a low fat but high fiber diet and recreational physical activities have a protective effect against prostate cancer.

    目    錄 書名頁 i 論文口試委員審定書 ii 授權書 iii 誌謝 iv 中文摘要 v 英文摘要 vi 目錄 vii 表目錄 ix 圖目錄 x 第一章 緒 論 01 第一節 研究動機與重要性 01 第二節 研究目的 04 第三節 研究問題 04 第四節 研究假設 05 第五節 名詞操作型定義 06 第六節 研究限制 10 第二章 文獻探討 第一節 國人攝護腺癌之現況 11 第二節 國外攝護腺癌之情況 14 第三節 攝護腺癌的危險因子探討 18 第三章 研究方法 23 第一節 研究架構 23 第二節 研究對象 24 第三節 研究工具 24 第四節 研究步驟 26 第五節 資料處理與分析 29 第四章 研究結果與討論 31 第一節 研究對象社會人口學變項之分佈 31 第二節 研究對象生活型態相關因素之分析 37 第三節 攝護腺癌主要的危險因子探討 67 第四節 討論 71 第五章 結論與建議 第一節 結論 77 第二節 建議 78 參考文獻 中文部分 81 英文部分 86 附錄一 問卷內容效度考驗專家名單 98 附錄二 個案參與同意書 99 附錄三 問卷調查表 100

    中文部分
    三軍總醫院(1991)。中華民國八十年病歷統計年報,台北市:作者。
    三軍總醫院(1992)。中華民國八十一年病歷統計年報,台北市:作者。
    三軍總醫院(1993)。中華民國八十二年病歷統計年報,台北市:作者。
    三軍總醫院(1994)。中華民國八十三年病歷統計年報,台北市:作者。
    三軍總醫院(1995)。中華民國八十四年病歷統計年報,台北市:作者。
    三軍總醫院(1996)。中華民國八十五年病歷統計年報,台北市:作者。
    三軍總醫院(1997)。中華民國八十六年病歷統計年報,台北市:作者。
    三軍總醫院(1998)。中華民國八十七年病歷統計年報,台北市:作者。
    三軍總醫院(1999)。中華民國八十八年病歷統計年報,台北市:作者。
    三軍總醫院(2000)。中華民國八十九年病歷統計年報,台北市:作者。
    三軍總醫院(2001)。中華民國九十年病歷統計年報,台北市:作者。
    三軍總醫院(2002)。中華民國九十一年病歷統計年報,台北市:作者。
    三軍總醫院(2003)。中華民國九十二年病歷統計年報,台北市:作者。
    三軍總醫院(2004)。中華民國九十三年病歷統計年報,台北市:作者。
    三軍總醫院(2005)。中華民國九十四年病歷統計年報,台北市:作者。
    三軍總醫院(2006)。中華民國九十五年病歷統計年報,台北市:作者。
    于大雄、張聖原、馬正平(1990)。中華民國臺灣省泌尿道惡性腫瘤死亡率之變遷,中華泌尿醫誌,1,168-74。
    內政部統計處(2007)。世界各國平均壽命統計資料。2007年6月20日。摘自內政部統計處網址:httP://www.dgbas.gov.tw/ct.asP?xItem=1901&ctNode=2252.
    王秀伯(2006)血中高膽固醇與攝護腺癌有關。台北:健康世界,246:7-7。
    王約翰(1985)。攝護腺癌之臨床病理研究。未出版碩士論文,國防醫學院醫學研究所,台北市。
    行政院衛生署(1991)。中華民國八十年衛生統計年報,台北市:作者。
    行政院衛生署(1992)。中華民國八十一年衛生統計年報,台北市:作者。
    行政院衛生署(1993)。中華民國八十二年衛生統計年報,台北市:作者。
    行政院衛生署(1994)。中華民國八十三年衛生統計年報,台北市:作者。
    行政院衛生署(1995)。中華民國八十四年衛生統計年報,台北市:作者。
    行政院衛生署(1996)。中華民國八十五年衛生統計年報,台北市:作者。
    行政院衛生署(1997)。中華民國八十六年衛生統計年報,台北市:作者。
    行政院衛生署(1998)。中華民國八十七年衛生統計年報,台北市:作者。
    行政院衛生署(1999)。中華民國八十八年衛生統計年報,台北市:作者。
    行政院衛生署(2000)。中華民國八十九年衛生統計年報,台北市:作者。
    行政院衛生署(2001)。中華民國九十年衛生統計年報,台北市:作者。
    行政院衛生署(2002)。中華民國九十一年衛生統計年報,台北市:作者。
    行政院衛生署(2003)。中華民國九十二年衛生統計年報,台北市:作者。
    行政院衛生署(2003a)。中華民國癌症登記年報,台北市:作者。
    行政院衛生署(2004)。中華民國九十三年衛生統計年報,台北市:作者。
    行政院衛生署(2005)。中華民國九十四年衛生統計年報,台北市:作者。
    江漢聲(2002)。攝護腺癌的防治。台北市:陶聲洋防癌之聲,100,17-27。
    林生傳 ( 1990 )。教育社會學。臺北:五南。
    張進寶、張延驛(1992)。攝護腺肥大患者之潛伏攝護腺癌。臨床醫學,29,336-340。
    陳光國、江漢聲、張延驊(1999)。攝護腺癌,台北:九州。
    陳建仁(1993)。臺灣地區癌症死亡率地圖集-八十二年研究報告。台北市:行政院衛生署(DOH82-HP-123-4M17)。
    黃書彬(2004)。台灣南部地區攝護腺癌分子流行病學之研究,未出版博士論文,高雄醫學大學醫學研究所,高雄市。
    楊啟瑞、吳錫金(1990)。攝護腺癌之早期診斷。醫學繼續教育雜誌,1,293-299。
    蒲永孝(1997)。前列腺癌,外科醫學叢書。台北市:中華民國外科醫學會。
    蒲永孝(1999)。台灣地區之前列腺癌。台灣醫學,3(2),186-195。
    蒲永孝、黃昭淵(1997)。認識前列腺癌。醫學叢書系列,台北:正中書局。
    蒲永孝‧劉詩彬(2005)。男人的前列腺與生活、飲食。台北:健康文化事業股份有限公司。
    劉詩彬、余宏政、蒲永孝(2003):簡介台灣地區前列腺癌的診治共識,台灣醫學,7(2),284-289。

    英文部分
    American Cancer Society. (2003). Cancer facts &figures, GA:American Cancer Society.
    Andersson SO, Wolk A, Bergström R, Giovannucci E, Lindgren C, Baron J, Adami HO. (1996). Energy, nutrient intake and prostate cancer risk: a population-based case-control study in Sweden. Int J Cancer, 68(6),716-22.
    Armstrong B, Doll R. (1975). Environmental factors and cancer incidence and mortality in different countries with special reference to dietary practices. Int J Cancer, 15,617-31.
    Bairatil I, Meyer F, Fradet Y, Moore L (1998). Dietary fat and advanced prostate cancer. J Urol, 159,1271-5.
    Bennett C. L., Ferrevia M. R., Davis T. C. Kaplan J, Weinberger M, Kuzel T et al. (1998). Relation between literacy, race and stage of presentation among low-income patients with prostate cancer. J. Clin Oncol, 16(9),3101-4.
    Blair A, Fraumini JF. (1978). Geographic patterns of prostate cancer in the United States. J Natl Cancer Inst, 61,1379-84.
    Boring C.C., Squires T. S., Tong T. Montgomery S. (1994). Cancer statistics. CA Cancer J Clin, 44(1),7-26.
    Bostwick DG, Burke HB, Djakiew D, Euling S, Ho SM, Landolph J, Morrison H, Sonawane B, Shifflett T, Waters DJ, Timms B. (2004). Human prostate cancer risk factors.Cancer, 101(10 Suppl),2371-490.
    Boyle P, Zaridze DG. (1993). Risk factors for prostate and testicular cancer. Eur J cancer, 29A(7): 1048-55. Review.
    Brasso K., Friis S., Kjaer SK., Jorgensen T., Iversen P (1998). Prostate cancer in Denmark, a 50-year population-based study. Urology, 51(4),590.
    Breslow N., Cham C. E., Dhom G. (1977). Latent carcinoma of the Prostate at autoPsy in seven areas. Int J Cancer,20(5),680-8.
    Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003b). Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med, 348,625–1638.
    Carter BS, Beaty TH, Steinberg GD, Childs B, Bova GS, Isaacs WB et al, (1992a). Segregation and linkage analyses of human prostate cancer. Am Assoc Cancer Res Proc, 33,240.
    Carter BS, Beaty TH, Steinberg GD, Childs B, Walsh PC. (1992b). Mendelian inheritance of familial prostate cancer. Proc Natl Acad Sci USA, 89,3367-71.
    Carter BS, Carter HB, Isaacs JT. (1990). Epidemiologic evidence regarding predisposing factors to prostate cancer. Prostate, 16,187- 97.
    Catalona W. (1997). Early screening is important despite lack of data from trials. Brit. Med. J, 315.
    Chang CK, Yu HJ, Chan KW, Lai MK. (1997). Secular trend and age-period-cohort analysis of prostate cancer mortality in Taiwan. Journal Urol, 158,1845-8.
    Chang CK, Yu HJ, Chan KW, Lai MK: Secular trend and age-period-cohort analysis of prostate cancer mortality in Taiwan. J Urol,158,1845-8.
    Chiu TY, Huang HS, Jun Chen. (1993 ). Prostate Cancer : Retrospective Comparison of Digital Rectal Examination,Transrectal Ultrasonography and Prostate-Specific Antigen.
    Chodak G. W., Thisted R. B., Gerber G. S. (1994). Results of conservative managencent of clinical localized Prostate cancer. N. Engl. Medical Journal, 330.
    Chyou PH, Nomura AM, Stemmermann GN. ( 1994). A prospective study of weight, body mass index and other anthropometric measurements in relation to site-specific cancers. Int J Cancer, 57(3),313-7.
    Clinton SK, Emenhiser C, Schwartz SJ. ( 1996). cis-trans Iycopene isomers,carotenoids, and retinol in the human prostate. Cancer Epidemiol Biomar Prevent, 5,823-33.
    Coffey DS, Pienta KJ. (1987). New concepts in studying the control of normal and cancer growth of the prostate. In: Current Concepts and Approaches to the Study of Prostate Cancer. Alan R. Liss, Inc, 1-73.
    Dennis LK, Snetselaar LG, Smith BJ, Stewart RE, Robbins ME. (2004). Problems with the assessment of dietary fat in prostate cancer studies. Am J Epidemiol, 160(5),436-44. Review.
    Druet-Cabanac M., Colombeau P., Preux PM, Paulhac P., Vergnenegre A., Dumas JP. (2002). Epidemiology of prostate cancer in the Limousin area. Progres en Urologie, 12,226-31.
    Gann PH (1997). Interpreting recent trends in prostate cancer incidence and mortality. Epidemiol, 8 117-20.
    Gaziano JM, Hennekens CH (1995). Dietary fat and risk of prostate cancer. J Natl Cancer Inst, 87,1427-8.
    Ghafoor M. Schuyten R. Bener A. (2003). Epidemiology of prostate cancer in United Arab Emirates. Medical Journal of Malaysia, 58,712-6.
    Giovannucci E, Rimm EB, Golditz GA, Stampfer MJ, Ascherio A, Chute CC & Willett WC. (1993a). A prospective study of dietary fat and risk of prostate cancer. J Natl Cancer Inst, 85,1571–1579.
    Giovannuucei E., Rimm E. B., Golditz G. A. (1993b). A prospective study of dietary fat and risk of prostatic cancer. J Natl. Cancer. Inst, 85, 1571.
    Godley PA, Rathore SS, Kshirsagar AV, Amamoo MA, Schell MJ, Freeman J, Harris RP. (2001). Retrospective classification of prostate-specific antigen tests: differentiating screening from diagnostic clinical encounters. J Clin Epidemiol, 54(9),884-8.
    Graham S, Haughey B, Marshall J, Priore R, Byers T, & RzePka T. (1983). Diet in the epidemiology of carcinoma of the prostate gland. J Natl Cancer Inst, 70,687-92.
    Gronberg H, Damber L & Damber J-E. (1996). Total food consumption and body mass index in relation to prostate cancer risk: a case–control study in Sweden with prospectively collected exposure data. J Urol 155,969-974.
    Hackney AC. (1996). The male reproductive system and endurance exercise. Medicine & Science in Sports & Exercise, 28,180–9.
    Håheim LL, Wisløff TF, Holme I, Nafstad P. (2006). Metabolic syndrome predicts prostate cancer in a cohort of middle-aged Norwegian men followed for 27 years. Am J Epidemiol, 164,769-774.
    Hsing A. W., Devesa S. S., Jin F and Gao Y. T. (1998). Rising incidence of prostate cancer in Shanghi, China.(letter). Cancer Epidemiology, Biomarkers and Prevention.
    Hutchinson GB. (1976). Epidemiology of prostatic cancer. Semin Oncol, 3,151-9.
    IARC. IARC, (2002). Handbooks on Cancer Prevention: weight control and physical activity, Vol. 6. Lyon: IARC.
    Ilic M, Vlajinac H & Marinkovic J. (1996). Case–control study of risk factors for prostate cancer. Br J Cancer, 74, 1682–1686.
    J. Hammarsten and B. Högstedt, (2004). Clinical, haemodynamic, anthropometric, metabolic and insulin profile of men with high stage and high grade clinical prostate cancer, Blood Pressure 13, 47–55.
    Williams and Wilkins Co. (1982). Prostate Cancer, G. H. Jacobi, R. Hohenfellner(eds): Baltimore.
    Joorge E. Chavarro, Meir J. Stampfer, Haojie Li, Hannia Campos, Tobias Kurth, Jing Ma (2007). A prospective study of Fatty Acid Levels in Blood and Prostate Cancer Risk. Epidemiol. Biomarkers Prev, 16,164-1370.
    Pienta KJ, Esper PS. (1993). Risk Factors for Prostate Cancer. Ann Intern, 118(10),793-803.
    Kroes R., Beems R. B., Bosland M. C., Bunnik, GS, Sinkeldam EJ. (1986). Nutritional factors in lung, colon and Prostate cancer in animal model. Fed. Proc, 45(2),136-141.Review.
    La Rosa F, Stracci F, Minelli L, Mastrandrea V. (2003). EPidemiology of Prostate cancer in the Umbria region of Italy-evidencd of opportunistic screening effects. Urology, 62,1040-4.
    Lee IM, Sesso HD, Chen J, Paffenbarger RS. (2001). Does physical activity play a role in the prevention of prostate cancer? Epidemiologic Reviews, 23,132–7.
    Lee IM, Paffenbarger RS, Hsieh CC. (1992). Physical activity and risk of prostate cancer among college alumni. Am J Epidemiol, 135, 169–179.
    Meikle AW, Smith JA, West DW. (1985). Familial factors affecting prostatic cancer risk and plasma sex-steroid levels. Prostate,6(2),121-8.
    Merrill RM, Potosky AL, Feuer EJ. (1996). Changing trends in U.S. prostate cancer incidence rates. J Natl Cancer Inst, 88,1683-5.
    Mills P. K., Beeson W. L., Phillips R. L. (1989). Cohort study of diet, lifestyle, and prostate cancer in Adventist men. Cancer, 64,598-604.
    Ohno Y, Yoshida O, Oishi K, Okada K, Yamabe H, Schroeder FH. (1988). Dietary ß-carotene and cancer of the prostate: a case–control study in Kyoto, Japan. Cancer Res, 48,1331-6.
    Oliveria SA, Lee IM. (1997). Is exercise beneficial in the prevention of prostate cancer? Sports Medicine, 23,271–8.
    O'Malley RL, Taneja SS. (2006). Obesity and prostate cancer. Can J Urol, 13 Suppl 2,11-7.
    Onuma M, Bub JD, Rummel TL, Iwamoto Y (2003). Prostate cancer cell-adipocyte interaction. Leptin mediates androgen independent prostate cancer cell proliferation through c-jun NH2-terminal kinase. J Biol Chem, 278,42660-42667.
    Parkin D.M. Mriir C. S. Whelan S (1992). Cancer Incidence in five continents vol: VI, IARC.
    Payne CK, Babiarz JW, Raz S. (1994). Genitourinary problems in the eldly patient. Surg Clin North Am, 74(2),401-429.
    Pu YS, Hsieh TS, & Chiu TY, (1998). Comparison of the diagnostic efficiencies of transrectal sonography, digital rectal examination and prostatic specific antigen in prostate cancer. J Chi Oncol Soc, 7,19-24.
    Roermund JG, Witjes JA. (2007). The impact of obesity on prostate cancer. World J Urol, Epub ahead of print.
    Rose DP, Boyar AP, Wynder EL. (1986). International comparisons of mortality rates for cancer of the breast, ovary, prostate, and colon, and per capita food consumption. Cancer, 58,2363-71.
    Ross JK, Pusateri DJ, Schultz TD. (2003). Dietary and hormonal evaluation of men at different risks for prostate cancer: fiber intake, excretion, and composition, with in vitro evidence for an association between steroid hormones and specific fiber components. Am J Clin Nutr, 51,365-70.
    Ross R., Paganini-Hill, Henderson B. E. (1983). The etiology of Prostate cancer: what does the epidemiology suggest? Prostate,4(4),333-344.
    Ross RK, Deapen DM, Casagrande JT, Paganini-Hill A & Henderson BE. (1981). A cohort study of mortality from cancer of the prostate in Catholic priests. Br J Cancer, 43, 233–235.
    Setchall KD, Borriello SP, Hulme P, Kirk DN, Axelson M (1984). Non-steroidal estrogens of dietary origin: possible role in hormone-dependent disease. Am. J Clin. Nutr. 40(3),569-578.
    Severson RK, Nomura AM, Grove JS, Stemmermann GN. (1989). A prospective study of demographics, diet, and prostate cancer among men of Japanese ancestry in Hawaii. Cancer Res. 49,1857-60.
    Shankar S, Ganapathy S, Srivastava RK. (2007) Green tea polyphenols: biology and therapeutic implications in cancer. Front Biosci, 12,4881-99.
    Shimizu H, Ropp R. K., Bernstein L. (1991). Cancers of the brrast and prostate among Japanese and White immigrants in Los Angeles County. Brt. J. Cancer, 63(6),963-6.
    Slattery ML, Schumacher MC, West DW, Robison LM, French TK. (1990). Food-consumption trends between adolescent and adult years and subsequent risk of prostate cancer. Am J Clin Nutr, 52,752-7.
    Small EJ. (1998). Prostate cancer, Incidence,management and outcomes. Drugs aging, 13,71-81.
    Snowdon DA, PhilliPs RL, Choi W. (1984). Diet, obesity, and risk of fatal Prostate cancer. Am Journal Epidemiol, 120,244-50.
    Stamey TA, Kabalin JN, Mc Neal JE. (1989). Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. Radical prostatectomy treated patients. J Urol, 141(5),1076-83.
    Stattin P, Bylund A, Rinaldi S. (2000). Plasma insulin-like growth factor-I, insulin-like growth factor binding proteins, and prostate cancer risk: a prospective study. Journal of the National Cancer Institute, 92,1910–17.
    Steinberg GD, Carter BS, Beaty TH, Childs B, Walsh PC. (1990). Family history and the risk of prostate cancer. Prostate, 17,337-7.
    Strom SS, Wang X, Pettaway CA, Logothetis CJ, Yamamura Y, Do KA, Babaian RJ, Troncoso P. (2005). Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy.Clin Cancer Res, 11,6889-94.
    Tymchuk CN, Barnard RJ, Heber D, Aronson WJ. (2001). Evidence of an inhibitory effect of diet and exercise on prostate cancer cell growth. J Urol, 166(3),1185-9.
    Veierod MB, Laake P, Thelle DS (1997). Dietary fat intake and risk of prostate cancer: a prospective study of 25,708 Norwegian men. Int J Cancer; 73,634-8.
    Whittemore, Kolonel , Wu, John EM, Gallagher RP, Howe GR, Burch JD, Hankin J, Dreon DM, West DW, Tsh C-Z & Paffenbarger RS. (1995). Prostate cancer in relation to diet, physical activity, and body size in black, whites, and Asians in the United States and Canada. J Natl Cancer Inst, 87: 652–655.
    Wingo PA, Tong T, & Bolden S. (1995). cancer statistics. CA Cancer J Clin 45,(1),8-30.
    Wu TT, Chen KK, Chen MT, et al, (1993) : Distribution of Distant Metastases in Patients with Advanced Adeno-carcinoma of the Prostate. J Urol ROC .
    Wuermli L, Joerger M, Henz S, Schmid HP, Riesen WF, Thomas G, Krek W, Cerny T, Gillessen S. (2005) Hypertriglyceridemia as a possible risk factor for prostate cancer. Prostate Cancer Prostatic Dis. 8(4), 316-20.
    Yeong-Shiau Pu. (2000). Prostate Carcinoma in Taiwan:Epidemiology and risk factors; International journal of andrology, 23,Suppl. 2,34-36.
    Yu HJ, Lai MK. (1998). The usefulness of prostate-specific antigen (PSA) density in patients with intermediate serum PSA level in a country with low incidence of prostate cancer. Urology, 51,125-30.

    QR CODE