Reddy B S
Division of Nutritional Carcinogenesis, American Health Foundation, Valhalla, New York 10595, USA.
Cancer Metastasis Rev. 1994 Dec;13(3-4):285-302. doi: 10.1007/BF00666099.
During the last two decades, substantial progress has been made in the understanding of the relationship between the dietary constituents and development of colon cancer in man. Unlike studies of cancer among smokers and nonsmokers, nutritional epidemiologic studies are confronted with the inherent difficulty of assessing reasonably precise exposures. The lack of consistency between international correlation studies and case-control studies does not necessarily negate a dietary etiology of colon cancer because these inconsistencies may have arisen, at least in part, from methodological limitations. Some of these deficiencies in epidemiological studies of diet and cancer have been corrected; recent case-control studies demonstrated that high dietary fat is a risk factor for colon cancer development and that an overall increase in intake of foods high in fiber might decrease the risk for colon cancer. The results of epidemiologic studies may be assumed to present conservative estimates of the true risk for cancer associated with diet. The populations with high incidence of colon cancer are characterized by high consumption of dietary fat, which may be a risk factor in the absence of factors that are protective, such as whole-grain cereals and of other high-fiber. Laboratory animal model studies have shown that certain dietary lipids and fibers influence tumorigenesis in the colon. The data of metabolic epidemiological and laboratory animal model studies are sufficiently convincing with respect to enhancement of colon cancer by type of fat and protection by certain dietary fibers.
在过去二十年中,人们对饮食成分与人类结肠癌发展之间的关系的理解取得了重大进展。与吸烟者和非吸烟者患癌研究不同,营养流行病学研究面临着合理精确评估暴露因素这一固有难题。国际相关性研究与病例对照研究之间缺乏一致性并不一定否定结肠癌的饮食病因,因为这些不一致至少部分可能源于方法学上的局限性。饮食与癌症流行病学研究中的一些缺陷已得到纠正;最近的病例对照研究表明,高膳食脂肪是结肠癌发展的一个危险因素,而高纤维食物摄入量的总体增加可能会降低患结肠癌的风险。流行病学研究结果可被认为是对与饮食相关的癌症真实风险的保守估计。结肠癌高发人群的特点是膳食脂肪摄入量高,在缺乏诸如全谷物和其他高纤维等保护因素的情况下,这可能是一个危险因素。实验动物模型研究表明,某些膳食脂质和纤维会影响结肠肿瘤的发生。关于脂肪类型对结肠癌的促进作用以及某些膳食纤维的保护作用,代谢流行病学和实验动物模型研究的数据具有足够的说服力。