Centonze S, Boeing H, Leoci C, Guerra V, Misciagna G
Laboratorio di Epidemiologia e Biostatistica, IRCCS S. De Bellis, Castellana, Italy.
Nutr Cancer. 1994;21(3):233-46. doi: 10.1080/01635589409514322.
Many epidemiological studies have focused on the relationships between diet and colorectal cancer, but only a few have been conducted in the Mediterranean area. A population-based case-control study was carried out from July 1987 to June 1989 in a low-risk area in Southern Italy. By means of an "ad hoc" tumor registry, 132 diagnosed colorectal cancers were detected during the two years of study. One hundred nineteen of these 132 colorectal cancer cases were interviewed about their personal dietary habits with use of a questionnaire concerning the frequency of consumption of 70 foods or beverages. An equal number of controls was randomly selected from the lists of general practitioners of the area during the same period and interviewed with the same food frequency questionnaire. In a multivariate analysis, the relative risks (RRs) of developing colorectal cancer were estimated according to the different levels of consumption of food groups and selected food items. All RRs were adjusted for age, sex, education, smoking status, and modifications in diet in the previous 10 years. The risk of colorectal cancer increased nearly threefold for the highest level of consumption of foods with a high content of refined sugar [RR = 2.75, 95% confidence interval (CI) 1.26-5.97] and for the consumption of wine (> 1 l/day) (RR = 3.22, 95% CI 1.05-9.88). An inverse relationship was revealed for the highest consumption of raw and cooked vegetables (RR = 0.51, 95% CI 0.25-1.04) and diary products (RR = 0.46, 95% CI 0.22-0.98) and for the consumption of more than two cups of coffee per day (RR = 0.38, 95% CI 0.16-0.89). In this Mediterranean area, the main source of calories, cereals, did not show a significant relationship with colorectal cancer. These findings support the hypothesis that the local Mediterranean dietary pattern could explain the low risk of colorectal cancer.
许多流行病学研究都聚焦于饮食与结直肠癌之间的关系，但在地中海地区开展的此类研究却为数不多。1987年7月至1989年6月，在意大利南部一个低风险地区进行了一项基于人群的病例对照研究。通过一个“特设”肿瘤登记处，在两年的研究期间共检测出132例经诊断的结直肠癌病例。在这132例结直肠癌病例中，有119例就其个人饮食习惯接受了访谈，使用的是一份关于70种食物或饮料消费频率的问卷。同期从该地区全科医生名单中随机选取了同等数量的对照，并使用相同的食物频率问卷进行访谈。在多变量分析中，根据食物组和选定食物项目的不同消费水平，估算了患结直肠癌的相对风险（RRs）。所有RRs均针对年龄、性别、教育程度、吸烟状况以及过去10年的饮食变化进行了调整。对于高糖食物的最高消费水平[RR = 2.75，95%置信区间（CI）1.26 - 5.97]以及葡萄酒消费（> 1升/天）（RR = 3.22，95% CI 1.05 - 9.88），患结直肠癌的风险增加了近三倍。对于生蔬菜和熟蔬菜的最高消费量（RR = 0.51，95% CI 0.25 - 1.04）、乳制品（RR = 0.46，95% CI 0.22 - 0.98）以及每天饮用超过两杯咖啡（RR = 0.38，95% CI 0.16 - 0.89），呈现出负相关关系。在这个地中海地区，热量的主要来源谷物与结直肠癌并未显示出显著关系。这些发现支持了这样一种假设，即当地的地中海饮食模式可以解释结直肠癌的低风险。
