Sonnenberg A, Müller A D
Division of Gastroenterology, VA Medical Center, Milwaukee, Wisc.
Pharmacology. 1993 Oct;47 Suppl 1:224-33. doi: 10.1159/000139862.
Since individual case-control studies have failed to resolve the question whether constipation and use of cathartics represent significant risk factors of colorectal cancer, a meta-analysis was performed. The method by Peto was used to calculate pooled odds ratios of the cancer risk among exposed and unexposed subjects. The analysis of 14 previously published case-control studies revealed statistically significant risks for colorectal cancer associated with both constipation and use of cathartics, the pooled odds ratios and their 95 percent confidence intervals being 1.48 (1.32-1.66) and 1.46 (1.33-1.61), respectively. The increased risk applied similarly to both sexes, it was higher in cancer of the colon than rectum. Since constipation and cathartics are associated with much lower odds ratios than various dietary components, such as fat, meat, alcohol, and low-vegetable or low-residue diets, it appears that their risk reflects the confounding influence of underlying dietary habits.
由于个别病例对照研究未能解决便秘和使用泻药是否为结直肠癌重要危险因素的问题，因此进行了一项荟萃分析。采用佩托方法计算暴露组和非暴露组患癌风险的合并比值比。对14项先前发表的病例对照研究的分析显示，便秘和使用泻药与结直肠癌存在统计学上的显著风险，合并比值比及其95%置信区间分别为1.48（1.32 - 1.66）和1.46（1.33 - 1.61）。这种风险增加在男女中相似，在结肠癌中比直肠癌更高。由于便秘和泻药与各种饮食成分（如脂肪、肉类、酒精以及低蔬菜或低残渣饮食）相比，其比值比要低得多，因此它们的风险似乎反映了潜在饮食习惯的混杂影响。
