Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London.
Division of Biostatistics, Department of Public Health and General Practice, Faculty of Medicine, University of Leeds, Leeds, UK.
Ann Oncol. 2017 Aug 1;28(8):1788-1802. doi: 10.1093/annonc/mdx171.
As part of the World Cancer Research Fund International Continuous Update Project, we updated the systematic review and meta-analysis of prospective studies to quantify the dose-response between foods and beverages intake and colorectal cancer risk.
PubMed and several databases up to 31 May 2015.
Prospective studies reporting adjusted relative risk estimates for the association of specific food groups and beverages and risk of colorectal, colon and rectal cancer.
Dose-response meta-analyses using random effect models to estimate summary relative risks (RRs).
About 400 individual study estimates from 111 unique cohort studies were included. Overall, the risk increase of colorectal cancer is 12% for each 100 g/day increase of red and processed meat intake (95% CI = 4-21%, I2=70%, pheterogeneity (ph)<0.01) and 7% for 10 g/day increase of ethanol intake in alcoholic drinks (95% CI = 5-9%, I2=25%, ph = 0.21). Colorectal cancer risk decrease in 17% for each 90g/day increase of whole grains (95% CI = 11-21%, I2 = 0%, ph = 0.30, 6 studies) and 13% for each 400 g/day increase of dairy products intake (95% CI = 10-17%, I2 = 18%, ph = 0.27, 10 studies). Inverse associations were also observed for vegetables intake (RR per 100 g/day =0.98 (95% CI = 0.96-0.99, I2=0%, ph = 0.48, 11 studies) and for fish intake (RR for 100 g/day = 0.89 (95% CI = 0.80-0.99, I2=0%, ph = 0.52, 11 studies), that were weak for vegetables and driven by one study for fish. Intakes of fruits, coffee, tea, cheese, poultry and legumes were not associated with colorectal cancer risk.
Our results reinforce the evidence that high intake of red and processed meat and alcohol increase the risk of colorectal cancer. Milk and whole grains may have a protective role against colorectal cancer. The evidence for vegetables and fish was less convincing.
作为世界癌症研究基金会国际持续更新项目的一部分，我们更新了前瞻性研究的系统评价和荟萃分析，以量化食物和饮料摄入量与结直肠癌风险之间的剂量反应关系。
PubMed 和截至 2015 年 5 月 31 日的几个数据库。
报告特定食物组和饮料与结直肠、结肠和直肠癌风险关联的前瞻性研究，报告调整后的相对风险估计值。
使用随机效应模型进行剂量-反应荟萃分析，以估计汇总相对风险（RR）。
共纳入 111 项独特队列研究的约 400 项个体研究估计值。总体而言，结直肠癌风险增加 12%，与每天增加 100 克红肉和加工肉摄入量有关（95%CI=4-21%，I2=70%，ph<0.01），每天增加 10 克乙醇摄入（95%CI=5-9%，I2=25%，ph=0.21）。每天增加 90 克全谷物可使结直肠癌风险降低 17%（95%CI=11-21%，I2=0%，ph=0.30，6 项研究），每天增加 400 克乳制品摄入量可使结直肠癌风险降低 13%（95%CI=10-17%，I2=18%，ph=0.27，10 项研究）。蔬菜摄入量也呈负相关（每天每增加 100 克 RR=0.98（95%CI=0.96-0.99，I2=0%，ph=0.48，11 项研究），鱼类摄入量（每天每增加 100 克 RR=0.89（95%CI=0.80-0.99，I2=0%，ph=0.52，11 项研究），蔬菜摄入量较弱，鱼类摄入量仅由一项研究驱动。水果、咖啡、茶、奶酪、家禽和豆类的摄入量与结直肠癌风险无关。
我们的研究结果强化了高摄入量的红肉和加工肉以及酒精会增加结直肠癌风险的证据。牛奶和全谷物可能对结直肠癌有保护作用。蔬菜和鱼类的证据不太令人信服。
