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泰国孔敬府红肉消费与粪便免疫化学法结直肠癌筛查试验阳性之间缺乏关联:一项基于人群的随机对照试验。

Lack of Association between Red Meat Consumption and a Positive Fecal Immunochemical Colorectal Cancer Screening Test in Khon Kaen, Thailand: a Population- Based Randomized Controlled Trial.

作者信息

Pramual Putthikrai, Sarakarn Pongdech, Kamsa-ard Siriporn, Jirapornkul Chananya, Maneenin Naowarat, Thavondunstid Prasert, Juntarach Prachak, Promthet Supannee

机构信息

Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Thailand.

ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Thailand. Email:

出版信息

Asian Pac J Cancer Prev. 2018 Jan 27;19(1):271-278. doi: 10.22034/APJCP.2018.19.1.271.

DOI:10.22034/APJCP.2018.19.1.271
PMID:29374412
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5844630/
Abstract

Background: There is convincing evidence from epidemiological studies that meat consumption increases colorectal cancer (CRC) risk. However, assessment of any association with a positive fecal immunochemical test (FIT) in CRC screening has been limited. If a link could be shown this might be helpful for establishing a risk group for colonoscopy. Objective: This study aimed to assess any association between meat consumption and other lifestyle factors and a positive FIT result in a Thai population. Methods: A cross-sectional analytical study was conducted with 1,167 participants in a population-based randomized controlled trial. CRC was screened from May 2016 - February 2017. Subjects aged 45-74 years who met the eligibility criteria were randomly allocated to the study arm. A positive FIT was determined with cut-off 100 ng/mL. Multiple logistic regression was used to analyze any relationship between lifestyle factors and a positive FIT. Result: The total number of subjects was 1,060 (90.8% return rate of FIT). With FIT100, FIT150, and FIT200, positive tests were found in 92 (8.68%), 74 (6.98%), and 60 (5.66%), respectively. No significant associations were noted with any of the variables, except for being aged 60-74 years (ORadj = 1.62, 95% CI: 1.03-2.54) Borderline significance was observed for high consumption of vegetables (ORadj = 0.62, 95% CI: 0.36-1.07) and being male (ORadj = 1.39, 95% CI: 0.87-2.22). Conclusion: Despite the evidence from the literature, no association was here found between a positive FIT result and meat consumption or other well-established lifestyle parameters. Being aged 60-74 years was a risk factor which should be taken into account in CRC screening strategy in countries like Thailand with limited access to endoscopy.

摘要

背景

流行病学研究中有令人信服的证据表明,肉类消费会增加结直肠癌(CRC)风险。然而,在CRC筛查中评估与粪便免疫化学检测(FIT)呈阳性的任何关联一直很有限。如果能证明存在关联,这可能有助于建立结肠镜检查的风险组。目的:本研究旨在评估泰国人群中肉类消费及其他生活方式因素与FIT阳性结果之间的任何关联。方法:在一项基于人群的随机对照试验中,对1167名参与者进行了横断面分析研究。2016年5月至2017年2月期间进行了CRC筛查。符合入选标准的45 - 74岁受试者被随机分配到研究组。FIT阳性的判定阈值为100 ng/mL。采用多因素logistic回归分析生活方式因素与FIT阳性之间的关系。结果:受试者总数为1060人(FIT回收率为90.8%)。FIT阈值为100、150和200时,阳性检测分别为92例(8.68%)、74例(6.98%)和60例(5.66%)。除年龄在60 - 74岁之间(校正OR = 1.62,95% CI:1.03 - 2.54)外,未发现与任何变量有显著关联。蔬菜高摄入量(校正OR = 0.62,95% CI:0.36 - 1.07)和男性(校正OR = 1.39,95% CI:0.87 - 2.22)观察到临界显著性。结论:尽管有文献证据,但本研究未发现FIT阳性结果与肉类消费或其他已确定的生活方式参数之间存在关联。在泰国等内镜检查机会有限的国家进行CRC筛查策略时,60 - 74岁是一个应考虑的风险因素。

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本文引用的文献

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Asian Pac J Cancer Prev. 2017 Oct 26;18(10):2883-2889. doi: 10.22034/APJCP.2017.18.10.2883.
2
Joinpoint Analysis Trends in the Incidence of Colorectal Cancer in Khon Kaen, Thailand (1989 – 2012).泰国孔敬府结直肠癌发病率的Joinpoint分析趋势(1989 - 2012年)
Asian Pac J Cancer Prev. 2017 Apr 1;18(4):1039-1043. doi: 10.22034/APJCP.2017.18.4.1039.
3
Dietary Intake of Meat Cooking-Related Mutagens (HCAs) and Risk of Colorectal Adenoma and Cancer: A Systematic Review and Meta-Analysis.
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Nutrients. 2017 May 18;9(5):514. doi: 10.3390/nu9050514.
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Fecal immunochemical test-based colorectal cancer screening: The gender dilemma.基于粪便免疫化学检测的结直肠癌筛查:性别困境。
United European Gastroenterol J. 2017 Apr;5(3):448-454. doi: 10.1177/2050640616659998. Epub 2016 Jul 14.
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