International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO). Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL). Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Mol Aspects Med. 2019 Oct;69:2-9. doi: 10.1016/j.mam.2019.06.005. Epub 2019 Jun 28.
Colorectal cancer (CRC) incidence changes with time and by variations in diet and lifestyle, as evidenced historically by migrant studies and recently by extensive epidemiologic evidence. The worldwide heterogeneity in CRC incidence is strongly suggestive of etiological involvement of environmental exposures, particularly lifestyle and diet. It is established that physical inactivity, obesity and some dietary factors (red/processed meats, alcohol) are positively associated with CRC, while healthy lifestyle habits show inverse associations. Mechanistic evidence shows that lifestyle and dietary components that contribute to energy excess are linked with increased CRC via metabolic dysfunction, inflammation, oxidative stress, bacterial dysbiosis and breakdown of gut barrier integrity while the reverse is apparent for components associated with decreased risk. This chapter will review the available evidence on lifestyle and dietary factors in CRC etiology and their underlying mechanisms in CRC development. This short review will also touch upon available information on potential gene-environment interactions, molecular sub-types of CRC and anatomical sub-sites within the colorectum.
结直肠癌(CRC)的发病率随时间和饮食及生活方式的变化而变化,这一点从历史上的移民研究和最近的广泛流行病学证据中可以得到证明。CRC 发病率的全球异质性强烈提示环境暴露的病因学参与,特别是生活方式和饮食。已经确定,身体活动不足、肥胖和一些饮食因素(红色/加工肉类、酒精)与 CRC 呈正相关,而健康的生活习惯则呈负相关。机制证据表明,导致能量过剩的生活方式和饮食成分通过代谢功能障碍、炎症、氧化应激、细菌失调和肠道屏障完整性的破坏与 CRC 风险增加有关,而与风险降低相关的成分则相反。本章将回顾 CRC 病因学中生活方式和饮食因素的现有证据及其在 CRC 发展中的潜在机制。这篇简短的综述还将涉及潜在的基因-环境相互作用、CRC 的分子亚型以及结直肠内的解剖亚部位的相关信息。