Kampman E, Slattery M L, Caan B, Potter J D
Fred Hutchinson Cancer Research Center, Cancer Prevention Research Program, Seattle, WA 98109-1024, USA.
Cancer Causes Control. 2000 May;11(5):459-66. doi: 10.1023/a:1008914108739.
Epidemiologic studies on calcium, vitamin D and colon cancer are inconsistent, whereas experimental studies more regularly show a protective effect. To evaluate potential sources of inconsistencies, data from a large case-control study were analyzed, stratifying on potential effect modifiers.
Data were collected by certified interviewers in Northern California, Utah and Minnesota. Analyses included 1993 incident colon cancer cases and 2410 population-based controls. Multivariate logistic regression models included age, sex, BMI, family history, physical activity, intake of energy, dietary fiber, aspirin and NSAIDs.
Dietary calcium was inversely associated with colon cancer risk in men (OR highest vs lowest quintile = 0.6, 95% CI = 0.5-0.9) and women (OR = 0.6, 95% CI = 0.4-0.9). No statistically significant associations were observed for dietary vitamin D or sunshine exposure. Consumption of total low-fat dairy products was associated with a statistically significantly decreased risk in men and women (ORs highest vs lowest category of intake = 0.8 and 0.7 respectively). Calcium supplement use was inversely associated with risk in both sexes (ORs use vs non-use = 0.8). Vitamin D supplements were inversely associated with risk in men (OR = 0.5) and women (OR = 0.6) but confidence limits included 1.0.
These data provide additional support of an inverse association between high levels of calcium intake and colon cancer risk.
关于钙、维生素D与结肠癌的流行病学研究结果并不一致，而实验研究更常显示出保护作用。为评估不一致性的潜在来源，对一项大型病例对照研究的数据进行了分析，并根据潜在效应修饰因素进行分层。
数据由北加利福尼亚、犹他州和明尼苏达州的认证访谈员收集。分析纳入了1993例结肠癌新发病例和2410例基于人群的对照。多变量逻辑回归模型纳入了年龄、性别、体重指数、家族史、身体活动、能量摄入、膳食纤维、阿司匹林和非甾体抗炎药。
膳食钙摄入量与男性（最高五分位数与最低五分位数相比，比值比=0.6，95%置信区间=0.5-0.9）和女性（比值比=0.6，95%置信区间=0.4-0.9）的结肠癌风险呈负相关。未观察到膳食维生素D或阳光照射与结肠癌风险之间存在统计学显著关联。食用低脂乳制品总量与男性和女性患癌风险的显著降低相关（摄入量最高类别与最低类别相比，比值比分别为0.8和0.7）。服用钙补充剂与男女患癌风险均呈负相关（服用与未服用相比，比值比=0.8）。维生素D补充剂与男性（比值比=0.5）和女性（比值比=0.6）的患癌风险呈负相关，但置信区间包含1.0。
这些数据为高钙摄入量与结肠癌风险之间的负相关提供了额外支持。
