| 摘要: | 目的：牙醫師常接觸病人體液及各類的化學物質，但鮮少牙醫師健康狀況之相關研究，本研究目的為了解牙醫師與一般民眾罹患癌症風險及相關因素之探討。
方法：資料來源為1997年到2010年之「全民健康保險學術研究資料庫」，研究母群體為2000年底前曾執業滿一年之牙醫師與2000年仍在保之一般民眾，利用Propensity Score以 1:1 將牙醫師與一般民眾配對取得17,396人之研究對象。分析方法使用Cox proportional hazard model探討牙醫師與一般民眾罹患癌症之相對風險及影響因素。
結果：配對前牙醫師比一般民眾有較低風險罹患癌症（HR=0.75; 95% CI= 0.65-0.85），但配對後發現，牙醫師比一般民眾罹患癌症之風險雖然較低但無統計顯著差異（HR=0.90; 95% CI= 0.76-1.07）。若僅探討牙醫師族群，男性罹患癌症的機率為女性的0.49倍（95%CI=0.39-0.69），年齡愈大罹患癌症的風險愈高（p<0.001），而具有新陳代謝症候群之醫師，有較低罹癌風險（HR=0.61; 95%CI=0.44-0.84）。牙醫師罹患癌症發生率依序為結直腸癌、肝癌與乳癌，一般民眾依序為肝癌、結直腸癌與肺癌。
結論：牙醫師相比一般民眾有較低風險罹患癌症，但配對後兩者並無統計顯著差異，而性別、年齡與是否罹患新陳代謝症候群為牙醫師罹患癌症之影響因素。另外，牙醫師在結腸直腸癌、肝癌、肺癌、胃癌、口腔癌及食道癌的發生率低於一般民眾（P<0.001），但在乳癌及其他類別的發生率則高於一般民眾（P<0.001）。
Objectives: Dentists very often need to be in contact with patient’s bodily fluids and chemical compounds; however, little research is done currently on the health of dentists. The purpose of the study is to understand the risk factors of cancer among dentists and general population by using National Health Insurance Research Database.
Methods: The data are derived from National Health Insurance Research database from 1997 to 2010, the studying population are those who practiced dentistry for more than an year prior to the end of year 2000 and general public who were still under national insurance of the same year. Furthermore, in order to eliminate the discrepancy among dentist and general population, the Propensity Score is employed with a 1:1 ratio between dentist and general population, and 17,396 research subjects were identified. The analysis methods also use Cox proportional hazard model to further study the cancer risk factors between dentist and general population.
Results: Before pairing, dentists have a lower risk of developing cancer when comparing to general population (HR = 0.75; 95% CI = 0.65-0.85). However, the result indicates that the difference is not statistically significant after pairing (HR = 0.90; 95% CI = 0.76-1.07). If only looking at the dentist population, the risk of developing cancer is at 0.49 fold (95% CI = 0.39-0.69), it also indicates a positive correlation between higher risk and aging (p <0.001), furthermore, for those with metabolic syndrome, the risk of developing cancer is considerably lower (HR = 0.61; 95% CI = 0.44-0.84). The cancer incidence order of dentist are colorectal cancer, liver cancer and breast cancer, but the order of the general public are liver cancer, colorectal cancer and lung cancer.
Conclusion: Although dentists have a lower risk of cancer comparing to general population, the result was not statistically significant after pairing. Furthermore, the results indicate that the gender, age and the presence of metabolic syndrome influence the risk of cancer among dentists. In addition, the cancer incidence of the dentists in colorectal cancer, liver cancer, lung cancer, stomach cancer, oral cancer and esophageal is lower than the general population (P <0.001), but the cancer incidence in the breast and other types is higher than the general population (P <0.001) |
