Russo A, Franceschi S, La Vecchia C, Dal Maso L, Montella M, Conti E, Giacosa A, Falcini F, Negri E
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano (PN), Italy.
Int J Cancer. 1998 Oct 5;78(2):161-5. doi: 10.1002/(sici)1097-0215(19981005)78:2<161::aid-ijc7>3.0.co;2-x.
Individuals whose energy intake exceeds expenditure are at increased risk of colorectal cancer. To determine whether body-size measurements at different ages were risk factors for cancer of the colon-rectum, we carried out a hospital-based case-control study in 6 Italian areas, 2 of which were in the South. Interviews were conducted with 1,217 subjects of both genders with incident histologically confirmed cancer of the colon, 726 with cancer of the rectum, and 4,136 controls hospitalized for acute, non-neoplastic, non-digestive conditions. The questionnaire included information on sociodemographic factors, and physical activity, a validated dietary history, height, weight at diagnosis and at 12, 30 and 50 years of age and waist-to-hip ratio (WHR). After allowance for education, physical activity, energy intake, family history of colorectal cancer and recent change in weight, the body-mass index (BMI) was significantly associated with colorectal-cancer-risk in men (odds ratio, OR, in highest vs. lowest quintile = 1.7; 95% confidence interval, CI, 1.3-2.3), but not in women (corresponding OR = 0.9; 95% CI, 0.7-1.2). Cases of both gender tended to have higher BMI than controls in adolescence, young adulthood and middle age. Height appeared unrelated to risk. In women, but not in men, WHR was positively associated with risk, independently of BMI (OR for > or = 0.90 vs. < or = 0.81 = 1.6; 95% CI; 1.2-2.1). Thus, excessive weight predicts colorectal-cancer risk in men, whereas abdominal obesity (i.e., a high WHR) represents a more reliable risk indicator in women.
能量摄入超过消耗的个体患结直肠癌的风险会增加。为了确定不同年龄段的身体尺寸测量值是否为结直肠癌的危险因素，我们在意大利的6个地区开展了一项基于医院的病例对照研究，其中2个地区在南部。对1217名经组织学确诊为结肠癌的男女患者、726名直肠癌患者以及4136名因急性非肿瘤性非消化系统疾病住院的对照者进行了访谈。问卷内容包括社会人口学因素、身体活动情况、经过验证的饮食史、身高、确诊时以及12岁、30岁和50岁时的体重以及腰臀比（WHR）。在考虑了教育程度、身体活动、能量摄入、结直肠癌家族史和近期体重变化后，体重指数（BMI）在男性中与结直肠癌风险显著相关（最高五分位数与最低五分位数的比值比，OR，=1.7；95%置信区间，CI，1.3 - 2.3），但在女性中并非如此（相应的OR = 0.9；95% CI，0.7 - 1.2）。在青春期、青年期和中年期，男性和女性患者的BMI往往都高于对照者。身高似乎与风险无关。在女性中，而非男性中，WHR与风险呈正相关，独立于BMI（WHR≥0.90与≤0.81相比的OR = 1.6；95% CI；1.2 - 2.1）。因此，超重可预测男性患结直肠癌的风险，而腹部肥胖（即高WHR）在女性中是更可靠的风险指标。
