Department of Family and Community Medicine, College of Medicine, Taibah University, Madinah 41541, Saudi Arabia.
Int J Environ Res Public Health. 2020 Jan 2;17(1):320. doi: 10.3390/ijerph17010320.
A rise in colorectal cancer (CRC) burden is expected around the globe. This study aimed to determine the population attributable fractions (PAFs) of CRC cases contributed by modifiable risk factors in Saudi Arabia. The PAF was calculated for modifiable risk factors with strong evidences of a causal association with CRC. CRC incidence was obtained from the National Cancer Registry, relative risks were retrieved from recent meta-analysis studies, and the prevalence of exposure to risk factors was obtained from national surveys. Conventional statistical formulas were used to calculate PAFs from registered CRC cases, stratified by sex. Three scenarios were proposed to make projections and present the expected effects of prevention interventions on the number of CRC cases in Saudi Arabia for 2025-2040. The results showed the largest fraction of attributable CRC cases among men and women was contributed by physical inactivity (16.13% and 16.45%), followed by excess weight (obesity: 9.71% and 6.93%; overweight: 6.05% and 1.9%); and tobacco smoking (current smoker: 3.04% and 0.18%; former smoker: 3.29% and 0.12%). We estimated that the number of projected cases attributable to physical inactivity, smoking, and excess weight in men and women would increase from 807 and 315 in 2025 to 1360 and 556 in 2040, respectively. In conclusion, physical inactivity, being overweight or obese, and tobacco smoking are major lifestyle factors affecting the incidence of CRC in Saudi Arabia. Prevention interventions and public health programs to reduce their prevalence are warranted.
预计全球结直肠癌（CRC）负担将增加。本研究旨在确定沙特阿拉伯可改变风险因素对 CRC 病例的人群归因分数（PAF）。对于与 CRC 有因果关系的强烈证据的可改变风险因素计算了 PAF。CRC 发病率来自国家癌症登记处，相对风险来自最近的荟萃分析研究，风险因素暴露的流行率来自国家调查。使用常规统计公式，根据性别对登记的 CRC 病例进行 PAF 分层计算。提出了三种方案来预测 2025-2040 年沙特阿拉伯 CRC 病例数量的预防干预效果。结果表明，男性和女性归因 CRC 病例的最大比例是由缺乏体力活动（16.13%和 16.45%）引起的，其次是超重（肥胖：9.71%和 6.93%；超重：6.05%和 1.9%）和吸烟（当前吸烟者：3.04%和 0.18%；前吸烟者：3.29%和 0.12%）。我们估计，2025 年男性和女性归因于缺乏体力活动、吸烟和超重的预计病例数将从 807 例和 315 例增加到 2040 年的 1360 例和 556 例。总之，缺乏体力活动、超重或肥胖以及吸烟是影响沙特阿拉伯 CRC 发病率的主要生活方式因素。需要采取预防干预和公共卫生计划来降低其流行率。
