Department of Gastroenterology Tel Aviv Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Clin Nutr. 2020 Feb;74(2):328-337. doi: 10.1038/s41430-019-0481-2. Epub 2019 Jul 30.
Colorectal cancer is associated with lifestyle characteristics such as diet, physical inactivity, obesity, and smoking, but these are not incorporated in screening recommendations. Moreover, the joint association of these factors with various colorectal polyps is not established.
A case-control study, among consecutive subjects aged 40-70 years, undergoing colonoscopy. Cases with colorectal polyps were compared with controls. Detailed information was gathered regarding polyp histology and anatomic location, demographics, medical history, anthropometrics, and lifestyle. The healthy lifestyle index was estimated as the sum of: non-smoking, maintaining a healthy weight, healthy diet, and physical activity.
A total of 788 participants were included (cases n = 403, controls n = 385). The healthy lifestyle index had a negative association with colorectal polyps (OR = 0.72, 95% CI 0.62-0.85, P < 0.001), both adenomas and serrated polyps (OR = 0.75, 0.64-0.89, and OR = 0.59, 0.44-0.79, respectively), and both proximal and distal adenomas (OR = 0.77, 0.62-0.95, and OR = 0.73, 0.59-0.90, respectively). Adherence to ≥ 2 healthy lifestyle components was strongly related with colorectal polyps (OR = 0.50, 0.34-0.75, P = 0.001). Abstinence from smoking, and a healthy diet were the factors most strongly associated with lower odds of colorectal polyps (OR = 0.58, 0.42-0.79, and OR = 0.61, 0.44-0.85, respectively).
Adherence to a healthy lifestyle (≥2 healthy lifestyle components) is inversely associated with colorectal polyps, especially serrated and distal polyps, with no dose-response association. Components most strongly associated with lower odds of colorectal polyps were maintaining a healthy diet and abstinence from smoking. Lifestyle-related characteristics may assist in risk stratification and are potential goals for colorectal neoplasia prevention.
结直肠癌与饮食、身体活动不足、肥胖和吸烟等生活方式特征有关，但这些因素并未纳入筛查建议中。此外，这些因素与各种结直肠息肉的联合关联尚未确定。
这是一项连续纳入年龄在 40-70 岁之间进行结肠镜检查的受试者的病例对照研究。将结直肠息肉患者与对照组进行比较。详细收集了息肉组织学和解剖位置、人口统计学、病史、人体测量学和生活方式等信息。健康生活方式指数的估计值为：不吸烟、保持健康体重、健康饮食和身体活动。
共纳入 788 名参与者（病例组 403 名，对照组 385 名）。健康生活方式指数与结直肠息肉呈负相关（OR=0.72，95%CI 0.62-0.85，P<0.001），包括腺瘤和锯齿状息肉（OR=0.75，0.64-0.89 和 OR=0.59，0.44-0.79），以及近端和远端腺瘤（OR=0.77，0.62-0.95 和 OR=0.73，0.59-0.90）。坚持≥2 项健康生活方式与结直肠息肉密切相关（OR=0.50，0.34-0.75，P=0.001）。戒烟和健康饮食是与结直肠息肉发生风险降低最相关的因素（OR=0.58，0.42-0.79 和 OR=0.61，0.44-0.85）。
坚持健康的生活方式（≥2 项健康生活方式因素）与结直肠息肉呈负相关，尤其是锯齿状和远端息肉，且不存在剂量反应关系。与结直肠息肉发生风险降低最相关的因素是保持健康的饮食和戒烟。与生活方式相关的特征可能有助于风险分层，并且是结直肠肿瘤预防的潜在目标。
