Analysis Group, Inc., Boston, MA, USA.
Aliment Pharmacol Ther. 2014 Jul;40(1):83-92. doi: 10.1111/apt.12789. Epub 2014 May 15.
Chronic constipation (CC) is a highly prevalent health problem, potentially associated with increased risk of colorectal cancer (CRCancer).
To investigate the association between CC, its severity, and CRCancer by estimating the relative risk of developing CRCancer and benign colorectal neoplasm (BCN) among severity-stratified patients with and without CC.
Chronic constipation patients from a large retrospective US claims database were matched 1:3 with CC-free controls by demographic characteristics. CRCancer and BCN prevalence were measured over 1 year. In pre-index CRCancer- and BCN-free patients, incidence rate ratios (IRRs) of new CRCancer and BCN were calculated. Multivariate regression models adjusted for comorbidities and family history. CC patients' disease severity was rated based on CC-related resource use. IRRs for new CRCancer and BCN were estimated for CC severity groups and controls.
Chronic constipation (N = 28,854) and CC-free (N = 86,562) patients had mean age 61.9 years; 66.7% were female. One-year CRCancer prevalence was 2.7% and 1.7%, and BCN prevalence was 24.8% and 11.9% for CC and CC-free patients, respectively. Adjusted IRRs between CC and CC-free patients were 1.59 [95% confidence interval (CI): 1.43-1.78] and 2.60 [95% CI: 1.51-2.70] for CRCancer and BCN, respectively. Patients with severe and very severe CC had significantly greater incidence of CRCancer and BCN. At ≥ 2 and ≥ 5 years of observation, CRCancer and BCN incidence remained consistently and significantly higher for CC patients.
Patients with chronic constipation are associated with significantly higher prevalence and incidence of colorectal cancer and benign colorectal neoplasm than matched chronic constipation-free patients. These risks increase with the severity of chronic constipation.
慢性便秘（CC）是一种高发的健康问题，可能与结直肠癌（CRCancer）风险增加有关。
通过估计 CC 严重程度分层患者与非 CC 患者中 CRCancer 和良性结直肠肿瘤（BCN）的相对风险，研究 CC、其严重程度与 CRCancer 之间的关系。
从大型美国回顾性索赔数据库中招募 CC 患者，并按人口统计学特征与 CC 无患者匹配 1:3。在 1 年内测量 CRCancer 和 BCN 的患病率。在指数前 CRCancer 和 BCN 无患者中，计算新 CRCancer 和 BCN 的发病率比值（IRR）。多变量回归模型调整了合并症和家族史。根据 CC 相关资源的使用情况对 CC 患者的疾病严重程度进行了评分。对 CC 严重程度组和对照组的新 CRCancer 和 BCN 发生率进行了估计。
CC（N=28854）和 CC 无（N=86562）患者的平均年龄为 61.9 岁，其中 66.7%为女性。CC 患者和 CC 无患者的 1 年 CRCancer 患病率分别为 2.7%和 1.7%，BCN 患病率分别为 24.8%和 11.9%。CC 患者与 CC 无患者相比，调整后的 CRCancer 和 BCN 的 IRR 分别为 1.59（95%置信区间：1.43-1.78）和 2.60（95%置信区间：1.51-2.70）。严重和非常严重 CC 患者的 CRCancer 和 BCN 发生率明显更高。在≥2 年和≥5 年的观察中，CC 患者的 CRCancer 和 BCN 发生率仍然显著更高。
与匹配的慢性便秘无患者相比，慢性便秘患者的结直肠癌和良性结直肠肿瘤的患病率和发病率明显更高。这些风险随着慢性便秘的严重程度而增加。
