Medicare Endoscopy Centre, The University of Hong Kong, Hong Kong.
J Gastroenterol Hepatol. 2009 Dec;24(12):1810-6. doi: 10.1111/j.1440-1746.2009.06138.x.
The prevalence of colorectal cancer is increasing in Asia. However, the age-standardized rate has reached a plateau in some countries. Some studies have shown a male predominance difference and increasing risk in the elderly, but not in the younger population. 'Right shifting' of colorectal cancer, not accountable by difference in age or the indications for endoscopic examination, has also been noted. Westernized diet is associated with colorectal cancer, but controversy remains on how it causes colorectal cancer. Alcohol consumption, obesity, diabetes mellitus, consumption of red and processed meat and cigarette smoking are linked to bowel cancer epidemiologically. Only high dietary calcium has a consistent negative (or 'protective') effect. The efficacy of fish oil, vitamin D, soy, phytoestrogens, folate, methionine, riboflavin and vitamin B6 has not been established. Aspirin and non-steroidal anti-inflammatory drugs use decrease risk of colorectal cancer after 5-10 years of use. There is no evidence for a detrimental effect of proton pump inhibitors or benefit of statins in colorectal cancer. In conclusion, there is a rising trend and prevalence of colorectal cancer in Asia. Dietary modification or supplementation may not be effective in preventing colorectal cancer. Surveillance of colorectal cancer in high-risk groups, according to current recommendation, is probably most effective.
亚洲地区结直肠癌的发病率正在上升。然而，一些国家的年龄标准化发病率已经达到了一个平台期。一些研究表明，男性发病率更高，且老年人群的风险增加，但在年轻人群中并非如此。结直肠癌的“右移”，即不能用年龄或内镜检查指征来解释的现象，也已经被注意到。西方化的饮食与结直肠癌有关，但它如何导致结直肠癌仍存在争议。酒精摄入、肥胖、糖尿病、红色和加工肉类的摄入以及吸烟与结直肠癌在流行病学上有关联。只有高膳食钙具有一致的负面（或“保护”）作用。鱼油、维生素 D、大豆、植物雌激素、叶酸、蛋氨酸、核黄素和维生素 B6 的功效尚未得到证实。阿司匹林和非甾体抗炎药的使用在使用 5-10 年后可降低结直肠癌的风险。质子泵抑制剂没有损害作用，他汀类药物也不能预防结直肠癌。总之，亚洲地区结直肠癌的发病率呈上升趋势。饮食改变或补充可能对预防结直肠癌无效。根据目前的建议，对高危人群进行结直肠癌监测可能是最有效的。
