1Nutritional Epidemiology Group,School of Food Science and Nutrition,University of Leeds,Leeds LS2 9JT,UK.
Br J Nutr. 2018 Feb;119(3):340-348. doi: 10.1017/S0007114517003622. Epub 2018 Jan 21.
Evidence on adherence to diet-related cancer prevention guidelines and associations with colorectal cancer (CRC) risk is limited and conflicting. The aim of this cohort analysis is to evaluate associations between adherence to the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) 2007 recommendations and incident CRC. The UK Women's Cohort Study comprises over 35 372 women who filled in a FFQ at baseline in 1995. They were followed up for CRC incidence for a median of 17·4 years, an individual score linking adherence to eight of the WCRF/AICR recommendations was constructed. Cox proportional hazards regression provided hazard ratios (HR) and 95 % CI for the estimation of CRC risk, adjusting for confounders. Following exclusions, 444 CRC cases were identified. In the multivariate-adjusted model, women within the second and third (highest) categories of the WRCF/AICR score had HR of 0·79 (95 % CI 0·62, 1·00) and 0·73 (95 % CI 0·48, 1·10), respectively, for CRC compared with those in the lowest, reference category. The overall linear trend across the categories was not significant (P=0·17). No significant associations were observed between the WCRF/AICR score and proximal colon, distal colon and rectal cancers separately. Of the individual score components, a BMI within the normal weight range was borderline significantly protective only for rectal cancer in the fully adjusted model. In view of the likely different causes of CRC subtypes, further research is needed to identify the optimal dietary patterns associated with reducing colon and rectal cancer risk, respectively.
关于遵循与癌症预防相关的饮食指南与结直肠癌(CRC)风险之间的关联的证据有限且存在冲突。本队列分析的目的是评估遵循世界癌症研究基金会/美国癌症研究所(WCRF/AICR)2007 年建议与 CRC 发病之间的关联。英国女性队列研究包括 35372 名女性,她们于 1995 年在基线时填写了一份 FFQ。中位随访时间为 17.4 年,用于评估 CRC 发病率,构建了一个链接到 WCRF/AICR 八项建议的依从性的个体评分。Cox 比例风险回归提供了风险比(HR)和 95%置信区间(CI),用于估计 CRC 风险,调整了混杂因素。排除后,共确定了 444 例 CRC 病例。在多变量调整模型中,WRCF/AICR 评分处于第二和第三(最高)类别中的女性与最低参考类别的女性相比,CRC 的 HR 分别为 0.79(95%CI 0.62,1.00)和 0.73(95%CI 0.48,1.10)。类别之间的整体线性趋势没有统计学意义(P=0.17)。WCRF/AICR 评分与近端结肠癌、远端结肠癌和直肠癌之间没有显著关联。在个体评分成分中,只有在完全调整模型中,BMI 处于正常体重范围内与直肠癌的相关性才有边界显著保护作用。鉴于 CRC 亚型的可能病因不同,需要进一步研究以确定与降低结肠癌和直肠癌风险分别相关的最佳饮食模式。