Neugut A I, Terry M B, Hocking G, Mosca L, Garbowski G C, Forde K A, Treat M R, Waye J
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Int J Cancer. 1996 Dec 11;68(6):744-8. doi: 10.1002/(SICI)1097-0215(19961211)68:6<744::AID-IJC9>3.0.CO;2-3.
Multiple studies have shown a protective effect for physical activity on the incidence of colorectal cancer, but few have addressed its association with incident adenomas and none have investigated its association with metachronous adenomas. We interviewed 2,001 patients undergoing colonoscopy in 3 New York City practices between 1986-1988. Of these, 298 had a first diagnosis of adenomas, 506 had normal colonoscopies, 197 had metachronous adenomas and 345 had normal colonoscopies with a past history of adenomas. Subjects were queried regarding use of moderate amounts of recreational exercise (swimming, jogging, biking, racket sports and other sports) on a regular basis, and were also asked to estimate their level of physical activity. Occupational physical activity was assessed through a blinded coding of occupational titles. After adjusting for age, years of education, body mass index, total caloric intake, dietary fiber intake, dietary fat intake and years of cigarette smoking, protective effects of borderline significance were observed among males for leisure physical activity for metachronous and incident cases. Occupational physical activity was found to be significantly protective in male incident cases. Men with increased levels of either occupational or leisure activity showed a reduction for incident and metachronous cases. No effects were observed for females. Thus, in this study, both leisure and occupational physical activity were associated with a reduced risk of incident and metachronous adenomas among men but not women.
多项研究表明,体育活动对结直肠癌的发病率具有保护作用,但很少有研究探讨其与偶发性腺瘤的关联,且尚无研究调查其与异时性腺瘤的关联。我们在1986年至1988年间对纽约市3家医疗机构中接受结肠镜检查的2001例患者进行了访谈。其中,298例首次诊断为腺瘤,506例结肠镜检查结果正常,197例有异时性腺瘤,345例结肠镜检查结果正常但既往有腺瘤病史。研究对象被问及是否经常进行适量的休闲运动(游泳、慢跑、骑自行车、球拍运动和其他运动),并被要求估计自己的身体活动水平。通过对职业头衔进行盲法编码来评估职业体力活动。在调整年龄、受教育年限、体重指数、总热量摄入、膳食纤维摄入、膳食脂肪摄入和吸烟年限后,在男性中观察到休闲体力活动对异时性和偶发性病例具有临界显著的保护作用。发现职业体力活动对男性偶发性病例具有显著保护作用。职业或休闲活动水平较高的男性在偶发性和异时性病例中风险降低。未观察到女性有此效应。因此,在本研究中,休闲和职业体力活动均与男性而非女性偶发性和异时性腺瘤风险降低有关。