Turati Federica, Bravi Francesca, Di Maso Matteo, Bosetti Cristina, Polesel Jerry, Serraino Diego, Dalmartello Michela, Giacosa Attilio, Montella Maurizio, Tavani Alessandra, Negri Eva, La Vecchia Carlo
Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy.
Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Via G. La Masa 19, 20156 Milan, Italy.
Eur J Cancer. 2017 Nov;85:86-94. doi: 10.1016/j.ejca.2017.08.015. Epub 2017 Sep 9.
The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released in 2007 eight recommendations for cancer prevention on body fatness, diet and physical activity. Our aim is to evaluate the relation between adherence to these recommendations and colorectal cancer (CRC) risk.
We pooled data from two Italian case-control studies including overall 2419 patients with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated using multiple logistic regression models.
Higher adherence to the WCRF/AICR recommendations was associated with a significantly reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56-0.80 for a score ≥5 versus <3.5), with a significant trend of decreasing risk for increasing adherence (p < 0.001). Consistent results were found for colon (OR 0.67) and rectal cancer (OR 0.67). Inverse associations were observed with the diet-specific WCRF/AICR score (OR 0.71, 95% CI, 0.61-0.84 for ≥3.5 versus <2.5 points) and with specific recommendations on body fatness (OR 0.82, 95% CI, 0.70-0.97), physical activity (OR 0.86, 95% CI, 0.75-1.00), foods and drinks that promote weight gain (OR 0.70, 95% CI, 0.56-0.89), foods of plant origin (OR 0.56, 95% CI, 0.42-0.76), limiting alcohol (OR 0.87, 95% CI, 0.77-0.99) and salt intake (OR 0.63, 95% CI, 0.48-0.84).
Our study indicated that adherence to the WCRF/AICR recommendations is inversely related to CRC risk.
世界癌症研究基金会（WCRF）和美国癌症研究学会（AICR）于2007年发布了八项关于身体脂肪、饮食和身体活动的癌症预防建议。我们的目的是评估遵守这些建议与结直肠癌（CRC）风险之间的关系。
我们汇总了两项意大利病例对照研究的数据，共纳入2419例CRC患者和4723例对照。通过一个包含WCRF/AICR七项建议的评分来总结对WCRF/AICR指南的遵守情况，得分越高表明对指南的遵守程度越高。使用多重逻辑回归模型估计结直肠癌的比值比（OR）。
更高程度地遵守WCRF/AICR建议与CRC风险显著降低相关（得分≥5分与<3.5分相比，OR为0.67，95%置信区间[CI]为0.56 - 0.80），随着遵守程度增加风险降低的趋势显著（p < 0.001）。在结肠癌（OR 0.67）和直肠癌（OR 0.67）中发现了一致的结果。观察到与特定饮食的WCRF/AICR评分（≥3.5分与<2.5分相比，OR为0.71，95% CI为0.61 - 0.84）以及关于身体脂肪（OR 0.82，95% CI为0.70 - 0.97）、身体活动（OR 0.86，95% CI为0.75 - 1.00）、促进体重增加的食物和饮料（OR 0.70，95% CI为0.56 - 0.89）、植物性食物（OR 0.56，95% CI为0.42 - 0.76）、限制饮酒（OR 0.87，95% CI为0.77 - 0.99）和盐摄入（OR 0.63，95% CI为0.48 - 0.84）呈负相关。
我们的研究表明，遵守WCRF/AICR建议与CRC风险呈负相关。
