Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait.
BMC Cancer. 2018 Dec 7;18(1):1227. doi: 10.1186/s12885-018-5132-9.
Cancer of colon and rectum (colorectal) is one of the most common cancers worldwide. There is a scarcity of published data on the risk factors for colorectal cancer (CRC) from the Middle-Eastern countries specifically in Kuwait. Therefore, this matched case-control study sought to examine the risk factors associated with CRC in Kuwait.
One hundred and three histopathologically confirmed colorectal cancer cases were recruited from Kuwait Cancer Control Centre Registry. Two hundred and six controls matched with cases (2:1 ratio) on age, gender and nationality were selected from medical, ophthalmology, orthopedic and/ or surgical out-patient clinics at three main general hospitals in Kuwait. A structured questionnaire was used to collect the data from cases and controls through face-to-face interview. Adjusted matched odds ratios (mOR) and their 95% confidence intervals (CI) were estimated using a multivariable conditional logistic regression model.
Multivariable conditional logistic regression model showed that cases were 4.3 times more likely to have had attainted obesity (BMI ≥ 30) in their lifetime compared to controls (mOR = 4.3; 95% CI: 1.6-11.4). Compared to controls, cases rarely consumed fruits and vegetable (mOR = 20.8; 95% CI: 4.4-99.5), tended to consume red meat 2-3 times a week (mOR = 3.8; 95% CI: 1.6-8.7) or more than 4 times a week (mOR = 9.4; 95% CI: 2.5-35.4). Reportedly cases compared to controls frequently (nearly every week) suffered from constipation (mOR = 5.6; 95% CI: 1.9-16.5). However, CRC cases were less likely than controls to have been diagnosed in the past with hypercholesterolemia (mOR = 0.3; 95% CI: 0.2-0.7) or diabetes mellitus type II (mOR = 0.4; 95% CI: 0.2-0.8).
Obesity, excessive red meat consumption and infrequent fruits/vegetables intake were associated with an increased CRC risk. Overcoming identified pitfalls in dietary pattern and maintenance of healthy weight may help minimize CRC risk in Kuwait and perhaps other countries in the region. Further studies on genetic basis in conjunction with life styles and dietary factors may unravel their joint contributions to CRC risk and furnish tools for curtailing CRC risk in this and other similar populations.
结肠癌和直肠癌（结直肠癌）是全球最常见的癌症之一。中东国家，特别是科威特，关于结直肠癌（CRC）危险因素的已发表数据稀缺。因此，这项匹配病例对照研究旨在探讨科威特 CRC 相关的危险因素。
从科威特癌症控制中心登记处招募了 103 例经组织病理学证实的结直肠癌病例。从科威特三家主要综合医院的医学、眼科、骨科和/或外科门诊中选择了 206 名与病例年龄、性别和国籍相匹配的对照（2:1 比例）。通过面对面访谈，使用结构化问卷从病例和对照中收集数据。使用多变量条件逻辑回归模型估计调整后的匹配比值比（mOR）及其 95%置信区间（CI）。
多变量条件逻辑回归模型显示，与对照组相比，病例一生中发生肥胖（BMI≥30）的可能性高 4.3 倍（mOR=4.3；95%CI：1.6-11.4）。与对照组相比，病例很少食用水果和蔬菜（mOR=20.8；95%CI：4.4-99.5），倾向于每周食用 2-3 次红肉（mOR=3.8；95%CI：1.6-8.7）或每周食用 4 次以上（mOR=9.4；95%CI：2.5-35.4）。与对照组相比，病例报告称经常（几乎每周）患有便秘（mOR=5.6；95%CI：1.9-16.5）。然而，与对照组相比，CRC 病例过去被诊断为高胆固醇血症（mOR=0.3；95%CI：0.2-0.7）或 II 型糖尿病（mOR=0.4；95%CI：0.2-0.8）的可能性较低。
肥胖、过量食用红肉和水果/蔬菜摄入不足与 CRC 风险增加相关。克服饮食模式中的已知陷阱并保持健康体重可能有助于降低科威特和该地区其他国家的 CRC 风险。进一步研究遗传基础与生活方式和饮食因素的结合可能会揭示它们对 CRC 风险的共同贡献，并为减少该人群和其他类似人群的 CRC 风险提供工具。
