Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
University of British Columbia Library, University of British Columbia, Vancouver, British Columbia, Canada.
Cancer Control. 2020 Jan-Dec;27(1):1073274820976670. doi: 10.1177/1073274820976670.
The risk of young-onset colorectal adenomas and cancer (yCRAC) in adults less than 50 years of age is increasing. We conducted a systematic review and meta-analysis of epidemiologic studies to identify lifestyle and clinical risk factors associated with yCRAC risk. We searched Medline, EMBASE, and Cochrane Database of Systematic Reviews for studies which: used an epidemiologic study design, involved individuals with yCRAC, evaluated at least 1 lifestyle or clinical factor, and applied multivariable regression approaches. We critically appraised the quality of included studies and calculated pooled measures of association (e.g. odds ratio [OR]) and 95% confidence intervals (CI) using random-effects models. We identified 499 articles in our search with 9 included in a narrative synthesis and 6 included in a meta-analysis. We found in the pooled analysis that smoking and alcohol consumption were lifestyle factors associated with yCRAC, as were clinical factors including obesity elevated blood glucose, elevated blood pressure, and elevated triglycerides. We identified lifestyle and clinical risk factors associated with risk of yCRAC, which have potential implications for informing preventive efforts and modifying screening to target at-risk populations.
年轻人结直肠腺瘤和癌症（yCRAC）在 50 岁以下成年人中的风险正在增加。我们进行了一项系统评价和荟萃分析，以确定与 yCRAC 风险相关的生活方式和临床危险因素。我们在 Medline、EMBASE 和 Cochrane 系统评价数据库中搜索了使用流行病学研究设计、涉及 yCRAC 患者、评估至少 1 种生活方式或临床因素以及应用多变量回归方法的研究。我们对纳入研究的质量进行了批判性评估，并使用随机效应模型计算了汇总的关联度量（例如比值比 [OR]）和 95%置信区间（CI）。我们在搜索中发现了 499 篇文章，其中 9 篇进行了叙述性综合分析，6 篇进行了荟萃分析。我们在汇总分析中发现，吸烟和饮酒是与 yCRAC 相关的生活方式因素，肥胖、血糖升高、血压升高和甘油三酯升高等临床因素也是如此。我们确定了与 yCRAC 风险相关的生活方式和临床危险因素，这可能对告知预防措施和修改筛查以针对高危人群具有重要意义。
