Bostick R M, Potter J D, Kushi L H, Sellers T A, Steinmetz K A, McKenzie D R, Gapstur S M, Folsom A R
Department of Family Practice and Community Health, Medical School, University of Minnesota, Minneapolis 55454.
Cancer Causes Control. 1994 Jan;5(1):38-52. doi: 10.1007/BF01830725.
To investigate the relation of dietary intakes of sucrose, meat, and fat, and anthropometric, lifestyle, hormonal, and reproductive factors to colon cancer incidence, data were analyzed from a prospective cohort study of 35,215 Iowa (United States) women, aged 55-69 years and without a history of cancer, who completed mailed dietary and other questionnaires in 1986. Through 1990, 212 incident cases of colon cancer were documented. Proportional hazards regression was used to adjust for age and other risk factors. Risk factors found to be associated significantly with colon cancer included: (i) sucrose-containing foods and beverages other than ice cream/milk; relative risks (RR) across the quintiles = 1.00, 1.73, 1.56, 1.54, and 2.00 (95% confidence intervals [CI] for quintiles two and five exclude 1.0); (ii) sucrose; RR across the quintiles = 1.00, 1.70, 1.81, 1.82, and 1.45 (CI for quintiles two through four exclude 1.0); (iii) height; RR = 1.23 for highest to lowest quintile (P for trend = 0.02); (iv) body mass index; RR = 1.41 for highest to lowest quintile (P for trend = 0.03); and (v) number of livebirths, RR = 1.59 for having had one to two livebirths and 1.80 for having had three or more livebirths compared with having had none (P for trend = 0.04). These data support hypotheses that sucrose intake or being tall or obese increases colon cancer risk; run contrary to the hypothesis that increased parity decreases risk; support previous findings of no association with demographic factors other than age, cigarette smoking, or use of oral contraceptives or estrogen replacement therapy; and raise questions regarding previous associations with meat, fat, protein, and physical activity.
为研究蔗糖、肉类和脂肪的膳食摄入量以及人体测量学、生活方式、激素和生殖因素与结肠癌发病率之间的关系,对来自美国爱荷华州35215名55 - 69岁且无癌症病史女性的前瞻性队列研究数据进行了分析,这些女性在1986年完成了邮寄的饮食及其他问卷。截至1990年,记录了212例结肠癌新发病例。采用比例风险回归对年龄和其他风险因素进行校正。发现与结肠癌显著相关的风险因素包括:(i)除冰淇淋/牛奶外的含蔗糖食品和饮料;各五分位数的相对风险(RR)分别为1.00、1.73、1.56、1.54和2.00(第二和第五五分位数的95%置信区间[CI]不包括1.0);(ii)蔗糖;各五分位数的RR分别为1.00、1.70、1.81、1.82和1.45(第二至第四五分位数的CI不包括1.0);(iii)身高;最高五分位数与最低五分位数相比RR = 1.23(趋势P值 = 0.02);(iv)体重指数;最高五分位数与最低五分位数相比RR = 1.41(趋势P值 = 0.03);以及(v)活产数,与未生育相比,生育一至二胎的RR = 1.59,生育三胎及以上的RR = 1.80(趋势P值 = 0.04)。这些数据支持以下假设:蔗糖摄入量增加、身材高大或肥胖会增加患结肠癌的风险;与生育次数增加会降低风险的假设相反;支持先前关于除年龄、吸烟、使用口服避孕药或雌激素替代疗法外与人口统计学因素无关联的研究结果;并对先前关于与肉类、脂肪、蛋白质和体育活动的关联提出了疑问。