Shaukat Aasma, Dostal Allison, Menk Jeremiah, Church Timothy R
Division of Gastroenterology, Minneapolis Veterans Affairs Health Care System, Department of Medicine, University of Minnesota, One Veterans Drive, 111-D, Minneapolis, MN, 55417, USA.
Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN, USA.
Dig Dis Sci. 2017 Sep;62(9):2511-2517. doi: 10.1007/s10620-017-4682-z. Epub 2017 Jul 21.
The relationship between dietary and lifestyle risk factors and long-term mortality from colorectal cancer is poorly understood. Several factors, such as obesity, intakes of red meat, and use of aspirin, have been reported to be associated with risk of colorectal cancer mortality, though these findings have not been replicated in all studies to date.
In the Minnesota Colon Cancer Control Study, 46,551 participants 50-80 years old were randomly assigned to usual care (control) or annual or biennial screening by fecal occult blood testing. Colon cancer mortality was assessed after 30 years of follow-up. Dietary intake and lifestyle risk factors were assessed by questionnaire at baseline.
Age [hazard ratio (HR) 1.09; 95% CI 1.07, -1.11], male sex (HR 1.25; 95% CI 1.01, 1.57), and higher body mass index (BMI) (HR 1.03; 95% CI 1.00-1.05) increased the risk of CRC mortality, while undergoing screening for CRC was associated with a reduced risk of colorectal cancer mortality (HR 0.76; 95% CI 0.61-0.94 and 0.67; 95% CI 0.53-0.83 for biennial and annual screening, respectively). Intakes of grains, meats, proteins, coffee, alcohol, aspirin, fiber, fruits, and vegetables were not associated with colorectal cancer mortality.
Our study confirms the relationship between BMI and long-term colorectal cancer mortality. Modulation of BMI may reduce risk of CRC mortality.
饮食和生活方式风险因素与结直肠癌长期死亡率之间的关系尚不清楚。据报道,肥胖、红肉摄入量和阿司匹林的使用等几个因素与结直肠癌死亡率风险相关,尽管这些发现至今尚未在所有研究中得到重复验证。
在明尼苏达结肠癌控制研究中,46551名年龄在50至80岁之间的参与者被随机分配至常规护理组(对照组)或接受每年或每两年一次的粪便潜血检测筛查。在随访30年后评估结肠癌死亡率。在基线时通过问卷调查评估饮食摄入量和生活方式风险因素。
年龄[风险比(HR)1.09;95%置信区间1.07,-1.11]、男性(HR 1.25;95%置信区间1.01,1.57)和较高的体重指数(BMI)(HR 1.03;95%置信区间1.00 - 1.05)会增加结直肠癌死亡率风险,而接受结直肠癌筛查与结直肠癌死亡率风险降低相关(两年一次和每年一次筛查的HR分别为0.76;95%置信区间0.61 - 0.94和0.67;95%置信区间0.53 - 0.83)。谷物、肉类、蛋白质、咖啡、酒精、阿司匹林、纤维、水果和蔬菜的摄入量与结直肠癌死亡率无关。
我们的研究证实了BMI与结直肠癌长期死亡率之间的关系。调节BMI可能会降低结直肠癌死亡率风险。