Jain M, Cook G M, Davis F G, Grace M G, Howe G R, Miller A B
Int J Cancer. 1980 Dec 15;26(6):757-68. doi: 10.1002/ijc.2910260609.
A case-control study of cancer of the colon and rectum has been conducted in Calgary, Alberta and Toronto, Ontario, Canada. A total of 348 cases of cancer of the colon and 194 cases of cancer of the rectum were individually matched by age, sex and neighbourhood of residence to 542 population controls and frequency match to 535 hospital controls who had undergone an abdominal operation. Each subject received a personal medical history questionnaire and a quantitative diet history questionnaire. Data on a number of potential non-nutrient risk factors for bowel cancer and on the consumption of 9 nutrients in the 2-month period up to 6 months before interview were analysed. The dietary data thus refer to recent diet consumed in a period antedating the diagnosis of, and in most cases symptoms from, large-bowel cancer in the cases, and a corresponding time period in the controls. The major findings were an elevated risk for those with a history of bowel polyps, and for those with an elevated intake of calories, total fat, total protein, saturated fat, oleic acid and cholesterol. No association was seen with an elevated intake of crude fibre, Vitamin C and linoleic acid. The nutrients for which an increased risk was demonstrated were highly correlated, though multivariate analysis using logistic regression indicated highest risk for saturated fat, with evidence of a dose-response relationship. The findings in both cancer sites, both sexes and with both sets of controls were quantitatively very similar. The population-attributable risk for colon and rectal cancer combined was estimated from the neighbourhood controls to be 41% for males and 44% for females for saturated fat intake and 9.8% and 6.4% respectively for any history of polyps.
在加拿大艾伯塔省卡尔加里市和安大略省多伦多市开展了一项关于结肠癌和直肠癌的病例对照研究。总共348例结肠癌患者和194例直肠癌患者，按照年龄、性别和居住社区与542名人群对照进行个体匹配，并按照频率与535名接受过腹部手术的医院对照进行匹配。每位受试者都收到一份个人病史问卷和一份定量饮食史问卷。分析了一些潜在的结直肠癌非营养风险因素的数据，以及在访谈前6个月内直至2个月期间9种营养素的摄入量。因此，饮食数据指的是病例中在诊断出大肠癌（大多数情况下有症状）之前一段时间内近期摄入的饮食，以及对照中的相应时间段。主要发现是，有肠息肉病史的人以及热量、总脂肪、总蛋白、饱和脂肪、油酸和胆固醇摄入量较高的人风险升高。未发现与粗纤维、维生素C和亚油酸摄入量升高有关联。显示风险增加的营养素之间高度相关，尽管使用逻辑回归的多变量分析表明饱和脂肪风险最高，且有剂量反应关系的证据。在两个癌症部位、男女两性以及两组对照中的研究结果在数量上非常相似。根据社区对照估计，男性和女性因饱和脂肪摄入导致的结肠癌和直肠癌合并人群归因风险分别为41%和44%，因任何息肉病史导致的风险分别为9.8%和6.4%。
