Sandhu M S, White I R, McPherson K
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, CB1 8RN, UK.
Cancer Epidemiol Biomarkers Prev. 2001 May;10(5):439-46.
The relation between meat consumption and colorectal cancer risk remains controversial. In this report, we quantitatively reviewed the prospective observational studies that have analyzed the relation between meat consumption and colorectal cancer. We conducted electronic searches of MEDLINE, EMBASE, and CANCERLIT databases through to the end of June 1999 and manual searches of references from retrieved articles. We used both fixed and random-effects meta-analytical techniques to estimate the overall association and to investigate possible sources of heterogeneity among studies. Thirteen studies were eligible for inclusion in the meta-analysis. Pooled results indicate that a daily increase of 100 g of all meat or red meat is associated with a significant 12-17% increased risk of colorectal cancer. The marginally significant between-study heterogeneity for all meat and red meat was explained by a number of study-level covariates. A significant 49% increased risk was found for a daily increase of 25 g of processed meat. The individual study estimates for processed meat showed no detectable heterogeneity. On the basis of this quantitative review of prospective studies, the overall association between meat consumption and risk of colorectal cancer appears to be positive, with marginal heterogeneity between studies. The finding for processed meat and data from experimental studies suggests that it may also be an important predictor of colorectal cancer risk. However, because only a few of the studies reviewed here attempted to examine the independent effect of meat intake on colorectal cancer risk, the possibility that the overall association may be confounded or modified by other factors cannot be excluded.
肉类消费与结直肠癌风险之间的关系仍存在争议。在本报告中，我们对分析肉类消费与结直肠癌关系的前瞻性观察性研究进行了定量综述。我们通过检索截至1999年6月底的MEDLINE、EMBASE和CANCERLIT数据库，并人工检索所获文章的参考文献。我们使用固定效应和随机效应荟萃分析技术来估计总体关联，并调查研究之间可能存在异质性的来源。13项研究符合纳入荟萃分析的条件。汇总结果表明，每天所有肉类或红肉摄入量增加100克与结直肠癌风险显著增加12% - 17%相关。所有肉类和红肉在研究间的异质性略有显著差异可由一些研究层面的协变量来解释。每天加工肉类摄入量增加25克，风险显著增加49%。各研究对加工肉类的估计未显示出可检测到的异质性。基于对前瞻性研究的这一定量综述，肉类消费与结直肠癌风险之间的总体关联似乎呈正相关，研究之间存在轻微异质性。加工肉类的研究结果以及实验研究的数据表明，它也可能是结直肠癌风险的一个重要预测因素。然而，由于这里综述的研究中只有少数尝试检验肉类摄入量对结直肠癌风险的独立影响，因此不能排除总体关联可能被其他因素混淆或改变的可能性。
