成人身高与结直肠癌风险：队列研究、系统评价和荟萃分析。
Adult-Attained Height and Colorectal Cancer Risk: A Cohort Study, Systematic Review, and Meta-Analysis.
机构信息
Department of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Institute for Digestive Health and Liver Disease, Mercy Medical Center, Baltimore, Maryland.
出版信息
Cancer Epidemiol Biomarkers Prev. 2022 Apr 1;31(4):783-792. doi: 10.1158/1055-9965.EPI-21-0398.
BACKGROUND
The influence of anthropometric characteristics on colorectal neoplasia biology is unclear. We conducted a systematic review and meta-analysis to determine if adult-attained height is independently associated with the risk of colorectal cancer or adenoma.
METHODS
We searched MEDLINE, EMBASE, the Cochrane Library, and Web of Science from inception to August 2020 for studies on the association between adult-attained height and colorectal cancer or adenoma. The original data from the Johns Hopkins (Baltimore, MD) Colon Biofilm study was also included. The overall HR/OR of colorectal cancer/adenoma with increased height was estimated using random-effects meta-analysis.
RESULTS
We included 47 observational studies involving 280,644 colorectal cancer and 14,139 colorectal adenoma cases. Thirty-three studies reported data for colorectal cancer incidence per 10-cm increase in height; 19 yielded an HR of 1.14 [95% confidence interval (CI), 1.11-1.17; P < 0.001), and 14 engendered an OR of 1.09 (95% CI, 1.05-1.13; P < 0.001). Twenty-six studies compared colorectal cancer incidence between individuals within the highest versus the lowest height percentile; 19 indicated an HR of 1.24 (95% CI, 1.19-1.30; P < 0.001), and seven resulting in an OR of 1.07 (95% CI, 0.92-1.25; P = 0.39). Four studies reported data for assessing colorectal adenoma incidence per 10-cm increase in height, showing an overall OR of 1.06 (95% CI, 1.00-1.12; P = 0.03).
CONCLUSIONS
Greater adult attained height is associated with an increased risk of colorectal cancer and adenoma.
IMPACT
Height should be considered as a risk factor for colorectal cancer screening.
背景
人体测量特征对结直肠肿瘤生物学的影响尚不清楚。我们进行了一项系统评价和荟萃分析，以确定成人获得的身高是否与结直肠癌或腺瘤的风险独立相关。
方法
我们从建库到 2020 年 8 月在 MEDLINE、EMBASE、Cochrane 图书馆和 Web of Science 上搜索了关于成人获得的身高与结直肠癌或腺瘤之间关系的研究。还包括来自巴尔的摩约翰霍普金斯大学（MD）结肠生物膜研究的原始数据。使用随机效应荟萃分析估计身高增加与结直肠癌/腺瘤的总体 HR/OR。
结果
我们纳入了 47 项观察性研究，涉及 280644 例结直肠癌和 14139 例结直肠腺瘤病例。33 项研究报告了每增加 10cm 身高时结直肠癌发病率的数据；19 项研究得出 HR 为 1.14[95%置信区间（CI），1.11-1.17；P<0.001]，14 项研究得出 OR 为 1.09（95%CI，1.05-1.13；P<0.001）。26 项研究比较了最高和最低身高百分位个体之间的结直肠癌发病率；19 项研究表明 HR 为 1.24（95%CI，1.19-1.30；P<0.001），7 项研究得出 OR 为 1.07（95%CI，0.92-1.25；P=0.39）。四项研究报告了每增加 10cm 身高时评估结直肠腺瘤发病率的数据，总体 OR 为 1.06（95%CI，1.00-1.12；P=0.03）。
结论
成人获得的身高越高，结直肠癌和腺瘤的风险就越高。
意义
身高应被视为结直肠癌筛查的危险因素。
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