Post-Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, P.le L. Severi 1, 06122 Perugia, Italy.
Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
Nutrients. 2019 Jul 12;11(7):1579. doi: 10.3390/nu11071579.
The aim of this systematic review and meta-analysis was to evaluate the association between dietary fibre intake and rectal cancer (RC) risk. In January 2019, a structured computer search on PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus was performed for studies reporting the results of primary research evaluating dietary fibre intake in women and men as well as the risk of developing RC. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. Highest vs. lowest fibre concentrations was compared. The Egger test was used to estimate publication bias. Heterogeneity between studies was evaluated with I statistics. The search strategy identified 912 papers, 22 of which were included in our meta-analysis. Having evaluated a total of 2,876,136 subjects, the results suggest a protective effect of dietary fibre intake on RC prevention. The effect Size (ES) was [0.77 (95% CI = 0.66-0.89), -value = 0.001)]. Moderate statistical heterogeneity (Chi = 51.36, df = 21, I = 59.11%, -value = 0.000) was found. However, no publication bias was found, as confirmed by Egger's linear regression test (Intercept -0.21, t = -0.24, = 0.816). The findings suggest that dietary fibre intake could be protective against RC, with a clinically relevant reduction of RC risk. Identifying preventive measures to avoid the development of RC, especially by following a healthy lifestyle including healthy diet, is pivotal.
本系统评价和荟萃分析的目的是评估膳食纤维摄入量与直肠癌（RC）风险之间的关联。2019 年 1 月，对 PubMed/Medline、Excerpta Medica dataBASE（EMBASE）和 Scopus 进行了结构化计算机检索，以检索报告评估女性和男性膳食纤维摄入量以及发展为 RC 的风险的主要研究结果的研究。遵循了系统评价和荟萃分析的首选报告项目（PRISMA）建议。比较了最高与最低纤维浓度。使用 Egger 检验估计发表偏倚。使用 I 统计量评估研究之间的异质性。搜索策略确定了 912 篇论文，其中 22 篇被纳入我们的荟萃分析。总共评估了 2876136 名受试者，结果表明膳食纤维摄入量对 RC 预防具有保护作用。效应大小（ES）为 [0.77（95%CI=0.66-0.89），-值=0.001)]。发现存在中度统计学异质性（Chi=51.36，df=21，I=59.11%，-值=0.000）。然而，正如 Egger 的线性回归检验所证实的那样，没有发现发表偏倚（截距-0.21，t=-0.24，=0.816）。研究结果表明，膳食纤维摄入量可能对 RC 具有保护作用，RC 风险的临床相关降低。确定预防措施以避免 RC 的发展，特别是通过遵循健康的生活方式，包括健康的饮食，是至关重要的。
