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无症状智利人群结直肠癌风险因素:日本与智利国际合作调查。

Colorectal cancer risk factors in asymptomatic Chilean population: a survey of international collaboration between Japan and Chile.

机构信息

Latin American Collaborative Research Center, Tokyo Medical and Dental University, Santiago, Chile.

Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Eur J Cancer Prev. 2020 Mar;29(2):127-133. doi: 10.1097/CEJ.0000000000000531.

Abstract

In Chile, the mortality from colorectal cancer has been on the rise. A national screening program based on a fecal immunochemical test was started in 2012 as an international collaboration with Japan. This case-control study was designed to identify the risk factors for colorectal cancer, with a goal of increasing the participation rate for colorectal cancer screening. In accordance with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, we conducted a case-control study from 2012 to 2017; 23 845 asymptomatic participants were enrolled in the study. Participants who were fecal immunochemical test-positive or had a family history of colorectal cancer underwent a colonoscopy. We analyzed the odds ratio of the risk factors for colorectal cancer, including sex, age, family history, BMI, hypertension, diabetes, regular use of nonsteroidal anti-inflammatory drugs, alcohol consumption, smoking, physical activity, and daily intake of certain food items. For the screening program, 202 cases of colorectal cancer were detected, and 195 of them were evaluated pathologically after resection. Of these, 173 cases (88.7%) had colorectal cancer stage 0/1, 151 (77.4%) of which were treated with endoscopic resection. In the multivariate analysis, male sex, family history of colorectal cancer, and low intake of cereals or fibers were closely related to a high colorectal cancer incidence. Moreover, participants in their 60s and 70s had a higher incidence of colorectal cancer than those in their 50s. These results suggest that intensive screening of the high-risk population can help in improving the detection of colorectal cancer, whereas higher consumption of cereals or fibers can be effective in preventing its onset.

摘要

在智利,结直肠癌的死亡率一直在上升。2012 年,一项基于粪便免疫化学试验的全国性筛查计划启动,这是与日本的一项国际合作。本病例对照研究旨在确定结直肠癌的危险因素,目的是提高结直肠癌筛查的参与率。根据《加强观察性研究的报告规范》,我们于 2012 年至 2017 年进行了一项病例对照研究;共纳入 23845 名无症状参与者。粪便免疫化学试验阳性或有结直肠癌家族史的参与者接受结肠镜检查。我们分析了结直肠癌的危险因素的比值比,包括性别、年龄、家族史、BMI、高血压、糖尿病、非甾体抗炎药的常规使用、饮酒、吸烟、身体活动和某些食物的日常摄入量。在筛查计划中,共发现 202 例结直肠癌病例,其中 195 例在切除后进行了病理评估。其中,173 例(88.7%)为结直肠癌 0/1 期,151 例(77.4%)采用内镜切除术治疗。多变量分析显示,男性、结直肠癌家族史和谷类或纤维摄入低与结直肠癌发病率高密切相关。此外,60 多岁和 70 多岁的参与者比 50 多岁的参与者结直肠癌发病率更高。这些结果表明,对高危人群进行强化筛查有助于提高结直肠癌的检出率,而增加谷类或纤维的摄入可能有效预防结直肠癌的发生。

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