Mikolasevic I, Orlic L, Stimac D, Hrstic I, Jakopcic I, Milic S
Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia.
Department of Nephrology, Dialysis and Kidney Transplantation, UHC Rijeka, Rijeka, Croatia.
Postgrad Med J. 2017 Mar;93(1097):153-158. doi: 10.1136/postgradmedj-2016-134383. Epub 2016 Nov 16.
As a significant cause of cancer death worldwide, colorectal cancer (CRC) is still one of the most common cancers in the world. The most efficient strategies to reduce CRC incidence include identifying risk factors for CRC and performing a preventive colonoscopy in high-risk populations. Some well-established risk factors for CRC development include hereditary syndromes and inflammatory bowel disease. Of note, in recent years, attention has been given to new evidence indicating that more than 75%-95% of CRC occurs in individuals with little or no genetic risk. For these individuals, the risk for CRC is associated with their lifestyle and dietary factors, including central obesity, overweight and physical inactivity. Recently, evidence demonstrated a connection between non-alcoholic fatty liver disease (NAFLD) and CRC. Insulin resistance and metabolic syndrome (MetS) are common risks that NAFLD and colorectal neoplasms share. The incidence of NAFLD is increasing in parallel with an increasing prevalence of MetS and obesity. Consequently, the question arises: will the incidence of CRC increase together with this dramatic increase in obesity, MetS and ultimately NAFLD prevalence? Recent studies of adenomatous polyps, CRC and NAFLD are discussed in this manuscript.
作为全球癌症死亡的一个重要原因，结直肠癌（CRC）仍然是世界上最常见的癌症之一。降低结直肠癌发病率的最有效策略包括识别结直肠癌的风险因素，并在高危人群中进行预防性结肠镜检查。一些已明确的结直肠癌发生风险因素包括遗传综合征和炎症性肠病。值得注意的是，近年来，人们开始关注新的证据，这些证据表明超过75%-95%的结直肠癌发生在遗传风险很小或没有遗传风险的个体中。对于这些个体，结直肠癌的风险与其生活方式和饮食因素有关，包括中心性肥胖、超重和缺乏身体活动。最近，有证据表明非酒精性脂肪性肝病（NAFLD）与结直肠癌之间存在联系。胰岛素抵抗和代谢综合征（MetS）是NAFLD和结直肠肿瘤共有的常见风险。NAFLD的发病率随着MetS和肥胖患病率的增加而平行上升。因此，问题来了：结直肠癌的发病率会随着肥胖、MetS以及最终NAFLD患病率的急剧上升而一起增加吗？本文讨论了最近关于腺瘤性息肉、结直肠癌和NAFLD的研究。
