Department of Epidemiology, School of Public Health, Sun Yat-sen University.
Department of Colorectal Surgery, Department of Experimental Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Eur J Cancer Prev. 2022 Mar 1;31(2):137-144. doi: 10.1097/CEJ.0000000000000697.
The association between the educational level and colorectal cancer risk was controversial in developed countries and evidence was limited in Chinese population. This study aimed to investigate the association between the educational level and colorectal cancer risk in Guangdong Province, China.
From July 2010 to April 2019, 2502 newly diagnosed colorectal cancer patients and 2538 sex- and age-matched controls were recruited in this case-control study. Multivariable logistic regression models were used to examine the association between the educational level and colorectal cancer risk. Path analysis was used to investigate whether behavioral risk factors potentially mediated the association between the educational level and colorectal cancer risk.
Educational level was inversely associated with the colorectal cancer risk. People who graduated from the college or above had a lower risk of colorectal cancer than those from the primary school or below, with an adjusted odds ratio of 0.42 [95% confidence intervals (CI), 0.34-0.52]. The total, direct and indirect effects of the educational level for the colorectal cancer risk were statistically significant in the path diagram. Path analysis showed that lower red and processed meat intake and higher tea and coffee drinking among high educational participants contributed to the inverse association between the educational level and colorectal cancer risk.
The findings suggested that the educational level was inversely associated with the colorectal cancer risk. The association might be mediated by red and processed meat intake, household and leisure-time activities, and tea and coffee drinking.
在发达国家，教育水平与结直肠癌风险之间的关联存在争议，而中国人群的证据有限。本研究旨在探讨中国广东省教育水平与结直肠癌风险之间的关系。
本病例对照研究于 2010 年 7 月至 2019 年 4 月期间共纳入了 2502 例新诊断的结直肠癌患者和 2538 名性别和年龄匹配的对照。采用多变量逻辑回归模型来检验教育水平与结直肠癌风险之间的关联。路径分析用于调查行为风险因素是否潜在地调节了教育水平与结直肠癌风险之间的关联。
教育水平与结直肠癌风险呈负相关。与小学及以下学历者相比，大学及以上学历者结直肠癌的发病风险较低，调整后的比值比为 0.42（95%置信区间，0.34-0.52）。路径图中教育水平对结直肠癌风险的总效应、直接效应和间接效应均具有统计学意义。路径分析表明，高学历者中较低的红肉类和加工肉类摄入以及较高的茶和咖啡饮用可能导致了教育水平与结直肠癌风险之间的负相关关系。
研究结果表明，教育水平与结直肠癌风险呈负相关。这种关联可能是通过红肉类和加工肉类摄入、家庭和闲暇时间活动以及茶和咖啡饮用等因素介导的。
