Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand.
Int J Epidemiol. 2020 Feb 1;49(1):246-258. doi: 10.1093/ije/dyz064.
Most of the previous studies on diet and colorectal cancer were based on diets consumed during the 1990s.
We used Cox-regression models to estimate adjusted hazard ratios for colorectal cancer by dietary factors in the UK Biobank study. Men and women aged 40-69 years at recruitment (2006-10) reported their diet on a short food-frequency questionnaire (n = 475 581). Dietary intakes were re-measured in a large sub-sample (n = 175 402) who completed an online 24-hour dietary assessment during follow-up. Trends in risk across the baseline categories were calculated by assigning re-measured intakes to allow for measurement error and changes in intake over time.
During an average of 5.7 years of follow-up, 2609 cases of colorectal cancer occurred. Participants who reported consuming an average of 76 g/day of red and processed meat compared with 21 g/day had a 20% [95% confidence interval (CI): 4-37] higher risk of colorectal cancer. Participants in the highest fifth of intake of fibre from bread and breakfast cereals had a 14% (95% CI: 2-24) lower risk of colorectal cancer. Alcohol was associated with an 8% (95% CI: 4-12) higher risk per 10 g/day higher intake. Fish, poultry, cheese, fruit, vegetables, tea and coffee were not associated with colorectal-cancer risk.
Consumption of red and processed meat at an average level of 76 g/d that meets the current UK government recommendation (≤90 g/day) was associated with an increased risk of colorectal cancer. Alcohol was also associated with an increased risk of colorectal cancer, whereas fibre from bread and breakfast cereals was associated with a reduced risk.
大多数关于饮食与结直肠癌的既往研究都基于 20 世纪 90 年代的饮食摄入情况。
我们使用 Cox 回归模型，在英国生物库研究中，根据饮食因素估计结直肠癌的校正危险比。招募时年龄在 40-69 岁的男性和女性（2006-10 年）通过简短的食物频率问卷报告其饮食情况（n=475581）。在大量亚样本中重新测量饮食摄入量（n=175402），这些人在随访期间完成了在线 24 小时饮食评估。通过将重新测量的摄入量分配到基线类别中，以考虑测量误差和随时间的摄入量变化，计算风险的趋势。
在平均 5.7 年的随访期间，发生了 2609 例结直肠癌。与每天摄入 21 克相比，报告每天平均摄入 76 克红肉和加工肉的参与者结直肠癌风险增加 20%（95%置信区间：4-37）。从面包和早餐谷物中摄入纤维最多的五分位数参与者结直肠癌风险降低 14%（95%置信区间：2-24）。每增加 10 克/天，酒精与风险增加 8%（95%置信区间：4-12）相关。鱼、禽、奶酪、水果、蔬菜、茶和咖啡与结直肠癌风险无关。
以满足当前英国政府建议（≤90 克/天）的平均水平 76 克/天摄入红肉和加工肉与结直肠癌风险增加有关。酒精也与结直肠癌风险增加有关，而面包和早餐谷物中的纤维与风险降低有关。
