Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
J Cancer Surviv. 2023 Jun;17(3):836-847. doi: 10.1007/s11764-022-01288-8. Epub 2022 Nov 5.
We sought to determine whether adherence to the American Cancer Society (ACS) Nutrition and Physical Activity Guidelines was associated with better bowel function among colon cancer survivors.
This prospective cohort study included patients surgically treated for stage I-IV colon cancer enrolled in the Lifestyle and Outcomes after Gastrointestinal Cancer (LOGIC) study between February 2017 and May 2021. Participants were assigned an ACS score (0-6 points) at enrollment. Stool frequency (SF) was assessed every 6 months using the EORTC QLQ-CR29. Higher SF is an indication of bowel function impairment. ACS score at enrollment was examined in relation to SF at enrollment and over a 3-year period. Secondarily, we examined associations between the ACS score components (body mass index, dietary factors, and physical activity) and SF. Multivariable models were adjusted for demographic and surgical characteristics.
A total of 112 people with colon cancer (59% women, mean age 59.5 years) were included. Cross-sectionally, for every point increase in ACS score at enrollment, the odds of having frequent stools at enrollment decreased by 43% (CI 0.42-0.79; p < 0.01). Findings were similar when we examined SF as an ordinal variable and change in SF over a 3-year period. Lower consumption of red/processed meats and consuming a higher number of unique fruits and vegetables were associated with lower SF (better bowel function) at enrollment.
Colon cancer survivors who more closely followed the ACS nutrition and physical activity guidelines had lower SF, an indication of better bowel function.
Our findings highlight the value of interventions that support health behavior modification as part of survivorship care for long-term colon cancer survivors.
我们旨在确定遵守美国癌症协会（ACS）营养和身体活动指南是否与结肠癌幸存者更好的肠道功能有关。
这项前瞻性队列研究纳入了 2017 年 2 月至 2021 年 5 月期间参加生活方式与胃肠道癌后结局（LOGIC）研究的接受手术治疗的 I-IV 期结肠癌患者。患者在入组时被分配 ACS 评分（0-6 分）。使用 EORTC QLQ-CR29 每 6 个月评估一次粪便频率（SF）。较高的 SF 表明肠道功能受损。在入组时检查 ACS 评分与入组时和 3 年内的 SF 之间的关系。其次，我们检查了 ACS 评分组成部分（体重指数、饮食因素和身体活动）与 SF 之间的关联。多变量模型调整了人口统计学和手术特征。
共纳入 112 例结肠癌患者（59%为女性，平均年龄 59.5 岁）。在横截面上，ACS 评分每增加 1 分，入组时出现频繁排便的几率降低 43%（95%CI 0.42-0.79；p<0.01）。当我们将 SF 作为有序变量和 3 年内 SF 的变化进行检查时，结果相似。较低的红/加工肉类消耗和更多种类的独特水果和蔬菜的摄入与入组时较低的 SF（更好的肠道功能）相关。
更严格遵循 ACS 营养和身体活动指南的结肠癌幸存者 SF 较低，这表明肠道功能更好。
我们的研究结果强调了支持健康行为改变干预措施的价值，这些干预措施是长期结肠癌幸存者生存护理的一部分。
