Garabrant D H, Peters J M, Mack T M, Bernstein L
Am J Epidemiol. 1984 Jun;119(6):1005-14. doi: 10.1093/oxfordjournals.aje.a113805.
The authors studied 2,950 population-based colon cancer cases in males in Los Angeles County, California, that were diagnosed between 1972 and 1981. To determine if colon cancer risk is reduced by physical activity on the job in males aged 20-64 years, the authors first rated each occupation by judging the activity level as high, moderate, or sedentary. Men with sedentary jobs had a colon cancer risk at least 1.6 times that of men whose jobs required a high level of activity. Risk increased in a stepwise manner as activity level decreased. This gradient was consistently seen within each socioeconomic stratum, among whites, blacks, immigrant and native Hispanics, and for each subsection of the colon from the hepatic flexure to the sigmoid. The protective effect of physical activity was very strong in the descending colon and diminished in a gradient both proximally and distally. There was no such relationship between physical activity and risk for rectal cancer. Physical activity may play a major, previously unrecognized role in colon cancer etiology. Such a role is consistent with the known pattern of colon cancer occurrence and with our understanding of colon physiology and colon cancer pathogenesis. In addition to the implications for prevention, understanding the effects of physical activity on colon cancer risk may allow future studies to evaluate more accurately the role played by diet.
作者对1972年至1981年间在加利福尼亚州洛杉矶县确诊的2950例男性人群结肠癌病例进行了研究。为了确定20 - 64岁男性在工作中的体力活动是否能降低患结肠癌的风险,作者首先通过判断活动水平为高、中或久坐,对每个职业进行了评级。从事久坐工作的男性患结肠癌的风险至少是工作需要高活动水平男性的1.6倍。随着活动水平的降低,风险呈逐步上升趋势。在每个社会经济阶层、白种人、黑人、移民和本地西班牙裔中,以及从肝曲到乙状结肠的结肠各部分,都一致观察到这种梯度变化。体力活动对降结肠的保护作用非常强,且在近端和远端均呈梯度减弱。体力活动与直肠癌风险之间不存在这种关系。体力活动可能在结肠癌病因学中发挥了以前未被认识到的主要作用。这样的作用与已知的结肠癌发生模式以及我们对结肠生理学和结肠癌发病机制的理解是一致的。除了对预防的意义外,了解体力活动对结肠癌风险的影响可能使未来的研究能够更准确地评估饮食所起的作用。