流行病學在家庭醫學的應用: 談結核病與肺癌間的關係

To explore the relationship between tuberculosis (TB) and lung cancer two descriptive and two analytic studies were done in Taiwan. It was found that the major factors influencing the trends of TB morbidity and mortality are 1) administration district: higher in aboriginal township than in other areas; 2) age: first peak of TB mortality was noted in the age group of 0-4 years with the lowest in the age group of 5-14 years; 3) gender: males had higher risk than females but increasing mortality risk among females was noted; 4) period: lower risk was noted in recent calendar period with slow decreasing tendency; 5) cohort: lower risk was noted in recent birth-cohort, the focus of TB mortality in Taiwan will be on the group born from 1895 to 1925. Rapid increase of lung cancer morbidity and mortality were noted in Taiwan in recent 25 years. Higher lung cancer mortality were noted in the prevalent areas of black foot disease and northeast of Taiwan. In addition to smoking, passive smoking and other environmental exposure such as arsenics, potential risk factors should be taken into account. As compared with the mortality of lung cancer in Taiwan in 1980,1985, and 1990, the cohort of active pulmonary TB cases registered between 1985 and 1990 had standard mortality ratios of 511, 413 and 410 for males, and 920, 844 and 806 for females for lung cancer. As compared with the hospital and community controls, males who had history of pulmonary TB had 21.0 and 9.5 times risk of lung cancer of those who did not; as compared with community controls, females who had history of pulmonary TB had 42.1 times risk of lung cancer of those who did not. It indicated that there is a significant association between pulmonary TB and lung cancer. The contribution of TB in lung cancer needs more investigations to clarify