Steinmetz K A, Potter J D
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
Int J Cancer. 1993 Mar 12;53(5):720-7. doi: 10.1002/ijc.2910530503.
We conducted a case-control study in Australia, comparing 220 persons with histologically confirmed incident adenocarcinoma of the colon with 438 age- and gender-matched controls. Cases were identified via the South Australian Cancer Registry (1979-80); controls were randomly selected from the electoral roll. All participants completed a 141-item food-frequency questionnaire and were interviewed regarding demographic and other information. Consumption of 8 groups of foods from animal sources was investigated. Odds ratios (OR) for quartiles of consumption were obtained using conditional logistic regression. All analyses were conducted separately for females and males. The most striking finding was a positive association for egg consumption in females, with an unadjusted OR of 2.4 (1.1-5.3) for consumption in the uppermost quartile. The uppermost septile of egg consumption was associated with an unadjusted OR of 6.3 (1.5-26.1) and a dose-response pattern was suggested. Intakes of red meat, liver, seafood, and dairy foods were also weakly positively associated with risk in females. In males, intakes of red meat and poultry were weakly positively associated with risk with unadjusted ORs of 1.5 (0.8-2.8) and 1.4 (0.7-2.6) respectively. The ratio of intake of red meat to poultry and seafood was also positively associated with risk in males, with an unadjusted OR of 1.4 (0.8-2.6). Interpretation of analyses stratified by colon cancer subsite was limited by the low number of subjects in each sub-site stratum, yet the results were somewhat supportive of a stronger risk associated with animal foods in the proximal than in the distal colon. The results for egg consumption suggest a role for cholesterol in the etiology of colon cancer, particularly in proximal cancer for females. Results for vegetable and fruit consumption are presented in a companion report.
我们在澳大利亚开展了一项病例对照研究,将220例经组织学确诊的新发结肠癌患者与438例年龄和性别匹配的对照者进行比较。病例通过南澳大利亚癌症登记处(1979 - 1980年)确定;对照者从选民名单中随机选取。所有参与者都完成了一份包含141个条目的食物频率问卷,并接受了关于人口统计学和其他信息的访谈。对8组动物性食物的摄入量进行了调查。使用条件逻辑回归获得各四分位数摄入量的比值比(OR)。所有分析分别针对女性和男性进行。最显著的发现是女性食用鸡蛋与结肠癌呈正相关,最高四分位数的食用量未调整OR为2.4(1.1 - 5.3)。鸡蛋食用量最高的七分位数与未调整OR为6.3(1.5 - 26.1)相关,提示存在剂量反应模式。女性食用红肉、肝脏、海鲜和乳制品的摄入量也与患病风险呈弱正相关。在男性中,红肉和家禽的摄入量与患病风险呈弱正相关,未调整OR分别为1.5(0.8 - 2.8)和1.4(0.7 - 2.6)。男性红肉与家禽及海鲜的摄入量比值也与患病风险呈正相关,未调整OR为1.4(0.8 - 2.6)。按结肠癌亚部位分层的分析结果因各亚部位层的受试者数量较少而受限,但结果在一定程度上支持近端结肠癌比远端结肠癌与动物性食物的关联更强。鸡蛋摄入量的结果提示胆固醇在结肠癌病因中起作用,尤其是对女性近端结肠癌。蔬菜和水果摄入量的结果在一份配套报告中呈现。