Callahan Catherine L, Vena John E, Green Joseph, Swanson Mya, Mu Lina, Bonner Matthew R
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, United States.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, United States.
Environ Res. 2017 Apr;154:86-92. doi: 10.1016/j.envres.2016.12.029. Epub 2016 Dec 30.
Fish consumption is hypothesized to reduce the risk of colorectal cancer. Nonetheless, consuming sport fish from the Great Lakes increases exposure to certain persistent organic pollutants, namely polychlorinated biphenyls (PCBs) and organochlorine insecticides, which may increase the risk of cancer. Evidence that exposure to persistent organic pollutants is associated with colorectal cancer is sparse. We examined colorectal cancer incidence in the New York State Angler Cohort Study (NYSACS), a prospective cohort of 17,110 anglers and spouses age 18-40 years at enrollment. In 1991, participants completed a mailed self-administered questionnaire that ascertained the number of years that fish from Lake Ontario were consumed, as well as potential confounders. Forty-one histologically confirmed first primary incident colorectal cancers diagnosed as of December 31, 2008 were identified via the New York State Cancer Registry. Vital status was ascertained by linkage with the Social Security Administration Death File. Rate ratios (RR) and 95% confidence intervals (CI) were calculated with Poisson regression, adjusting for age, pack-years of smoking, and sex. Compared with never consumers, colorectal cancer incidence was statistically non-significantly lower among consumers of Lake Ontario sport fish (RR=0.66; 95% CI: 0.35; 1.24). Incidence of colon cancer was lower among Lake Ontario sport fish consumers (RR=0.45, 95%CI: 0.20; 1.00). We did not observe any evidence of effect measure modification by sex or age. Although consumption of Lake Ontario sport fish may have an inverse association with colorectal cancer risk, inferences are complicated by a small number of cases and a lack of information regarding potential confounders including other dietary factors. However, our results do not provide support for the hypothesis that consumption of contaminated sport fish increases the risk of colorectal cancer.
据推测，食用鱼类可降低患结直肠癌的风险。然而，食用来自五大湖的游钓鱼类会增加接触某些持久性有机污染物的机会，即多氯联苯（PCBs）和有机氯杀虫剂，这可能会增加患癌风险。关于接触持久性有机污染物与结直肠癌相关的证据很少。我们在纽约州垂钓者队列研究（NYSACS）中调查了结直肠癌发病率，该前瞻性队列由17110名年龄在18至40岁之间的垂钓者及其配偶组成，他们在入组时进行了登记。1991年，参与者完成了一份邮寄的自填问卷，该问卷确定了食用安大略湖鱼类的年数以及潜在的混杂因素。截至2008年12月31日，通过纽约州癌症登记处确定了41例经组织学确诊的首例原发性结直肠癌。通过与社会保障管理局死亡档案的关联确定了生命状态。使用泊松回归计算率比（RR）和95%置信区间（CI），并对年龄、吸烟包年数和性别进行了调整。与从未食用者相比，食用安大略湖游钓鱼类的人群中结直肠癌发病率在统计学上无显著降低（RR = 0.66；95% CI：0.35；1.24）。安大略湖游钓鱼类消费者的结肠癌发病率较低（RR = 0.45，95% CI：0.20；1.00）。我们没有观察到性别或年龄对效应测量产生修正作用的任何证据。尽管食用安大略湖游钓鱼类可能与结直肠癌风险呈负相关，但由于病例数量较少以及缺乏包括其他饮食因素在内的潜在混杂因素信息，使得推断变得复杂。然而，我们的结果并不支持食用受污染的游钓鱼类会增加结直肠癌风险这一假设。
