Department of Oncologic Surgery, Portuguese Oncology Institute-Porto, Portugal.
Eur J Cancer Prev. 2012 Jan;21(1):15-23. doi: 10.1097/CEJ.0b013e3283472241.
Studies on the association between single foods or nutrients and colorectal cancer have provided inconsistent results. Previous reviews did not conduct a quantitative synthesis of the relation with dietary patterns. We conducted a systematic review and meta-analysis of studies addressing the association between dietary patterns and colorectal cancer. Studies quantifying the association between dietary patterns (defined a posteriori) and colorectal cancer were identified in PubMed (until 01.08.2010) and through backward and forward citation tracking (ISI Web of Science and Scopus). Summary relative risk (RR) estimates and 95% confidence intervals (95% CI) were computed for highest versus lowest levels of exposure, for colon cancer (CC) and rectal cancer (RC), and for proximal and distal CC, by random effects meta-analysis. Heterogeneity was quantified using the I(2) statistic. Eight cohort and eight case-control studies defining patterns through principal components and factor analyses were included in the systematic review. Meta-analyses were conducted for three patterns: (i) 'drinker,' characterized by high alcohol consumption (CC: RR(combined)=0.96, 95% CI: 0.82-1.12, I(2)=0.6%; RC: RR(combined)=0.83, 95% CI: 0.47-1.45, I(2)=65.1%); (ii) 'healthy,' characterized by high fruit/vegetables consumption (CC: RR(combined)=0.80, 95% CI: 0.70-0.90, I(2)=55.1%; RC: RR(combined)=1.02, 95% CI: 0.89-1.17, I(2)=10.8%); (iii) 'western,' characterized by high red/processed meat consumption (CC: RR(combined)=1.29, 95% CI: 1.13-1.48, I(2)=31.7%; RC: RR(combined)=1.13, 95% CI: 0.92-1.39, I(2)=40.6%). Summary estimates for proximal and distal CC were similar. The risk of CC was increased with patterns characterized by high intake of red and processed meat and decreased with those labelled as 'healthy.' No significant associations were observed for RC.
关于单一食物或营养素与结直肠癌之间关联的研究结果并不一致。之前的综述并未对饮食模式与结直肠癌之间的关系进行定量综合分析。我们对评估饮食模式与结直肠癌之间关系的研究进行了系统性综述和荟萃分析。在 PubMed（截至 2010 年 8 月 1 日）和通过回溯和向前引用追踪（ISI Web of Science 和 Scopus）检索到了定量评估饮食模式（基于后验定义）与结直肠癌之间关系的研究。采用随机效应荟萃分析计算了最高暴露水平与最低暴露水平之间结直肠癌（CC）和直肠癌（RC）以及近端和远端 CC 的相对危险度（RR）估计值及其 95%置信区间（95%CI）。采用 I(2)统计量量化异质性。系统性综述纳入了八项队列研究和八项病例对照研究，这些研究通过主成分分析和因子分析来定义饮食模式。对以下三种模式进行了荟萃分析：（i）“饮酒者”模式，特点是大量饮酒（CC：RR（合并）=0.96，95%CI：0.82-1.12，I(2)=0.6%；RC：RR（合并）=0.83，95%CI：0.47-1.45，I(2)=65.1%）；（ii）“健康”模式，特点是大量摄入水果/蔬菜（CC：RR（合并）=0.80，95%CI：0.70-0.90，I(2)=55.1%；RC：RR（合并）=1.02，95%CI：0.89-1.17，I(2)=10.8%）；（iii）“西方”模式，特点是大量摄入红色/加工肉类（CC：RR（合并）=1.29，95%CI：1.13-1.48，I(2)=31.7%；RC：RR（合并）=1.13，95%CI：0.92-1.39，I(2)=40.6%）。近端和远端 CC 的汇总估计值相似。CC 风险随着高摄入量的红色和加工肉类饮食模式而增加，随着被标记为“健康”的饮食模式而降低。RC 与饮食模式之间无显著相关性。
