Dukas L, Platz E A, Colditz G A, Willet W C, Giovannucci E L
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Cancer Causes Control. 2000 Dec;11(10):907-14. doi: 10.1023/a:1026559624330.
Infrequent bowel movements and use of laxatives have been hypothesized to increase risk of colorectal neoplasia. However, the few existing epidemiologic studies in humans have been inconclusive.
To investigate prospectively the associations of bowel movement frequency and laxative use with the occurrence of adenomatous colorectal polyps in women.
A total of 17,400 women 36-61 years of age, without previous diagnosis of cancer or polyps, responded to a mailed questionnaire in 1982 that assessed bowel movement frequency and use of laxatives and had an endoscopy between 1984 and 1996. Between 1984 and 1996, 906 cases of adenomatous polyps (496 classified as small (< 1 cm), 358 classified as large (> or = 1 cm) and 52 unclassified) were documented. Relative risks (RRs) of adenomas and 95% confidence intervals (CIs) were calculated using logistic regression.
After controlling for adenoma risk factors, the multivariate RRs associated with having bowel movements every third day or less compared to once daily were 0.9 (95% CI: 0.7-1.2) for total colorectal adenomas, 1.0 (95% CI: 0.7-1.5) for large adenomas and 1.0 (95% CI: 0.7-1.3) for adenomas of the colon only. The multivariate RRs associated with weekly to daily laxative use compared to never use were 0.9 (95% CI: 0.7-1.1) for total colorectal adenomatous polyps, 1.0 (95% CI: 0.7-1.5) for large adenomas and 0.8 (95% CI: 0.6-1.2) for colon adenomatous polyps only.
These findings do not support an association between infrequent bowel movement or laxative use and risk of colorectal adenomas.
排便次数少和使用泻药被认为会增加患结直肠肿瘤的风险。然而，现有的为数不多的关于人类的流行病学研究尚无定论。
前瞻性调查女性排便频率和泻药使用与结直肠腺瘤性息肉发生之间的关联。
1982年，共有17400名年龄在36至-61岁之间、既往未诊断出癌症或息肉的女性回复了一份邮寄问卷，该问卷评估了排便频率和泻药使用情况，并在1984年至1996年间接受了内镜检查。1984年至1996年间，记录了906例腺瘤性息肉病例（496例分类为小息肉（<1厘米），358例分类为大息肉（≥1厘米），52例未分类）。使用逻辑回归计算腺瘤的相对风险（RRs）和95%置信区间（CIs）。
在控制腺瘤风险因素后，与每天排便一次相比，每三天或更少排便一次的总结直肠腺瘤的多变量RRs为0.9（95%CI：0.7-1.2），大腺瘤为1.0（95%CI：0.7-1.5），仅结肠腺瘤为1.0（95%CI：0.7-1.3）。与从不使用泻药相比，每周至每天使用泻药的总结直肠腺瘤性息肉的多变量RRs为0.9（95%CI：0.7-1.1），大腺瘤为1.0（95%CI：0.7-1.5），仅结肠腺瘤性息肉为0.8（95%CI：0.6-1.2）。
这些发现不支持排便次数少或使用泻药与结直肠腺瘤风险之间存在关联。
