Jacobs E J, White E
Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98104 USA.
Epidemiology. 1998 Jul;9(4):385-91.
We examined the associations of colon cancer with constipation and the use of commercial laxatives in a case-control study among men and women ages 30-62 years. We based this analysis on 424 incident cases of colon cancer, diagnosed in the Seattle metropolitan area between 1985 and 1989, and 414 random-digit-dial controls. Frequent constipation during the 10 years before the reference data (2 years before diagnosis), as defined by "feeling constipated to the point of having to take something," was associated with substantially increased risk of colon cancer. The adjusted relative risk (RR) was 2.0 [95% confidence interval (CI) = 1.2-3.6] for constipation 12-51 times per year, and 4.4(95% CI = 2.1-8.9) for constipation 52 or more times a year. Cumulative lifetime use of commercial laxatives was also associated with increased risk of colon cancer. When constipation and commercial laxative use were adjusted for each other, the association with commercial laxative use disappeared, whereas the association with constipation remained strong. Although constipation has not consistently been associated in past studies with a large increase in risk of colon and rectal cancer combined, these results suggest that frequent constipation may be an important risk factor for colon cancer among middle-aged adults.
我们在一项针对30至62岁男性和女性的病例对照研究中，考察了结肠癌与便秘及使用商用泻药之间的关联。我们的分析基于1985年至1989年期间在西雅图都会区确诊的424例结肠癌新发病例，以及414名随机数字拨号选取的对照。在参考数据（诊断前2年）之前的10年里，频繁便秘（定义为“感觉便秘到必须服用某种药物的程度”）与结肠癌风险大幅增加相关。每年便秘12至51次时，调整后的相对风险（RR）为2.0 [95%置信区间（CI）= 1.2 - 3.6]，每年便秘52次或更多次时，调整后的相对风险为4.4（95% CI = 2.1 - 8.9）。商用泻药的累积终生使用也与结肠癌风险增加相关。当便秘和商用泻药的使用相互调整后，与商用泻药使用的关联消失，而与便秘的关联仍然很强。尽管在过去的研究中，便秘与结肠癌和直肠癌综合风险大幅增加之间的关联并不一致，但这些结果表明，频繁便秘可能是中年成年人患结肠癌的一个重要风险因素。
