Faivre J, Giacosa A
Registre des Cancers Digestifs (INSERM CRI 9505), Faculté de Médecine, Dijon, France.
Eur J Cancer Prev. 1998 May;7 Suppl 2:S29-32. doi: 10.1097/00008469-199805000-00006.
Epidemiological studies have emphasized the importance of diet in the etiology of large bowel cancer. A high intake of dietary fibre has been hypothesized to decrease the risk of colorectal cancer. This hypothesis is now being tested within the framework of intervention studies. Supplemental fibre is being used in four chemopreventive trials as wheat bran (22.5 g/day together with vitamins C and E, New York study; 25 g/day, Australian study; 50 g/day, Toronto study; 13.5 g/day, Arizona study) and in one trial as ispaghula husk (a mucilaginous substance) at 3.8 g/day (European Cancer Prevention Organization study). One study is evaluating the effect of fibre on adenoma size in patients with familial polyposis and an intact rectum, and the other four studies are focusing on the recurrence of adenoma in patients with previous adenomas. The results available so far provide some evidence for the inhibition of adenoma growth through a high-fibre and/or low-fat diet. Further results are expected within a year. If there is sufficient evidence for a protective effect of dietary fibre on colorectal carcinogenesis, a simple, safe and inexpensive prophylaxis for a very common cancer will be indicated.
流行病学研究强调了饮食在大肠癌病因学中的重要性。据推测，高膳食纤维摄入量可降低患结直肠癌的风险。目前正在干预研究的框架内对这一假设进行验证。在四项化学预防试验中，补充的纤维分别为麦麸（纽约研究中为每日22.5克，同时服用维生素C和E；澳大利亚研究中为每日25克；多伦多研究中为每日50克；亚利桑那研究中为每日13.5克），在一项试验中为每日3.8克的伊斯帕古勒壳（一种粘性物质，欧洲癌症预防组织研究）。一项研究正在评估纤维对家族性息肉病且直肠完整患者腺瘤大小的影响，另外四项研究则聚焦于既往有腺瘤患者腺瘤的复发情况。目前已获得的结果为通过高纤维和/或低脂肪饮食抑制腺瘤生长提供了一些证据。预计一年内会有进一步的结果。如果有足够的证据表明膳食纤维对结直肠癌发生有保护作用，那么对于一种非常常见的癌症来说，将有一种简单、安全且廉价的预防措施。
