Knudsen Markus D, de Lange Thomas, Botteri Edoardo, Nguyen Dung-Hong, Evensen Helge, Steen Chloé B, Hoff Geir, Bernklev Tomm, Hjartåker Anette, Berstad Paula
Markus D Knudsen, Thomas de Lange, Edoardo Botteri, Chloé B Steen, Geir Hoff, Paula Berstad, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
World J Gastroenterol. 2016 Jul 21;22(27):6276-86. doi: 10.3748/wjg.v22.i27.6276.
To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia (ACN) in colorectal cancer (CRC) screening.
A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero (poorest) to six (best). Odds ratios (ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ACN.
In all 6315 women and men completed the lifestyle questionnaire, 3323 (53%) in the FIT arm and 2992 (47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311 (5%) participants of which 25 (8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs (95%CI) for the probability of ACN detection were 0.82 (0.45-1.16), 0.43 (0.28-0.73), 0.41 (0.23-0.64), and 0.41 (0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53 (0.42-0.68) and 0.63 (0.43-0.93) respectively.
Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening.
探讨在结直肠癌（CRC）筛查中遵守健康建议与晚期结直肠肿瘤（ACN）检测之间的关联。
共有14832名男性和女性被邀请参加CRC筛查，其中6959人接受粪便免疫化学检测，7873人接受乙状结肠镜检查。他们还收到一份自我报告的生活方式问卷，需在首次CRC筛查前完成。创建了一个生活方式评分，以反映当前在吸烟、体重指数、身体活动、饮酒和食物消费方面对健康行为的遵守情况，范围从0（最差）到6（最佳）。使用多变量逻辑回归计算优势比（OR）和95%置信区间（CI），以评估单个生活方式变量和生活方式评分与检测到ACN的概率之间的关联。
共有6315名男性和女性完成了生活方式问卷，粪便免疫化学检测组有3323人（53%），乙状结肠镜检查组有2992人（47%）。这占参加筛查者的89%。311名（5%）参与者被诊断为ACN，其中25名（8%）被诊断为CRC。与生活方式评分为0 - 1的个体相比，生活方式评分为2、3、4以及5 - 6的个体检测到ACN的概率的OR（95%CI）分别为0.82（0.45 - 1.16）、0.43（0.28 - 0.73）、0.41（0.23 - 0.64）和0.41（0.22 - 0.73）。在单个生活方式因素中，与吸烟者或高酒精摄入量者相比，坚持不吸烟和适度饮酒与检测到ACN的概率降低相关，分别为0.53（0.42 - 0.68）和0.63（0.43 - 0.93）。
采用的健康行为与检测到ACN的概率呈负相关。生活方式评估可能有助于CRC筛查中的风险分层。
