Kashino Ikuko, Mizoue Tetsuya, Tanaka Keitaro, Tsuji Ichiro, Tamakoshi Akiko, Matsuo Keitaro, Wakai Kenji, Nagata Chisato, Inoue Manami, Tsugane Shoichiro, Sasazuki Shizuka
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo.
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
Jpn J Clin Oncol. 2015 Oct;45(10):973-9. doi: 10.1093/jjco/hyv111. Epub 2015 Jul 28.
The association between vegetable consumption and colorectal cancer risk remains unclear and may differ by region. We performed a systematic review and meta-analysis of epidemiologic studies on this issue among the Japanese population.
A systematic review and meta-analysis was performed by searching MEDLINE through PubMed and the Ichushi database for cohort and case-control studies that were published by the end of December 2014. Associations were evaluated based on their magnitude and the strength of the evidence. Meta-analysis was performed by using the random effects model to estimate the summary relative risk with 95% confidence interval according to the study design. The final judgment was made based on a consensus of the research group members with consideration for both epidemiological evidence and biological plausibility.
We identified six cohort studies and 11 case-control studies on vegetable intake and colorectal cancer among the Japanese population. Of the cohort studies, one study showed a weak inverse association with colon cancer and another study showed a weak positive association with rectal cancer in men, but other studies found no associations between vegetable consumption and colon and rectal cancers. With regard to case-control studies, one study found a strong inverse association with colon cancer, and three studies showed a weak-to-strong inverse association with rectal cancer. In meta-analysis, the summary relative risk (95% confidence interval) for the highest vs. the lowest categories of vegetable consumption were 1.00 (0.92-1.10) and 0.75 (0.59-0.96) for cohort and case-control studies, respectively.
There was insufficient evidence to support an association between intake of vegetables and the risk of colorectal cancer among the Japanese population.
蔬菜摄入量与结直肠癌风险之间的关联仍不明确,且可能因地区而异。我们对日本人群中关于此问题的流行病学研究进行了系统评价和荟萃分析。
通过检索PubMed中的MEDLINE以及Ichushi数据库,对截至2014年12月底发表的队列研究和病例对照研究进行系统评价和荟萃分析。根据关联的大小和证据强度进行评估。根据研究设计,采用随机效应模型进行荟萃分析,以估计汇总相对风险及95%置信区间。最终判断基于研究小组成员的共识,同时考虑流行病学证据和生物学合理性。
我们在日本人群中确定了六项关于蔬菜摄入量与结直肠癌的队列研究和十一项病例对照研究。在队列研究中,一项研究显示与结肠癌存在弱负相关,另一项研究显示在男性中与直肠癌存在弱正相关,但其他研究未发现蔬菜摄入量与结肠癌和直肠癌之间存在关联。在病例对照研究方面,一项研究发现与结肠癌存在强负相关,三项研究显示与直肠癌存在弱至强的负相关。在荟萃分析中,队列研究和病例对照研究中,蔬菜摄入量最高组与最低组相比的汇总相对风险(95%置信区间)分别为1.00(0.92 - 1.10)和0.75(0.59 - 0.96)。
没有足够的证据支持日本人群中蔬菜摄入量与结直肠癌风险之间存在关联。