Fuchs C S, Giovannucci E L, Colditz G A, Hunter D J, Stampfer M J, Rosner B, Speizer F E, Willett W C
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
N Engl J Med. 1999 Jan 21;340(3):169-76. doi: 10.1056/NEJM199901213400301.
A high intake of dietary fiber has been thought to reduce the risk of colorectal cancer and adenoma.
We conducted a prospective study of 88,757 women, who were 34 to 59 years old and had no history of cancer, inflammatory bowel disease, or familial polyposis, who completed a dietary questionnaire in 1980. During a 16-year follow-up period, 787 cases of colorectal cancer were documented. In addition, 1012 patients with adenomas of the distal colon and rectum were found among 27,530 participants who underwent endoscopy during the follow-up period.
After adjustment for age, established risk factors, and total energy intake, we found no association between the intake of dietary fiber and the risk of colorectal cancer; the relative risk for the highest as compared with the lowest quintile group with respect to fiber intake was 0.95 (95 percent confidence interval, 0.73 to 1.25). No protective effect of dietary fiber was observed when we omitted, adjustment for total energy intake, when events during the first six years of follow-up were excluded, or when we excluded women who altered their fiber intake during the follow-up period. No significant association between fiber intake and the risk of colorectal adenoma was found.
Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer or adenoma.
一直以来，人们认为高膳食纤维摄入量可降低患结直肠癌和腺瘤的风险。
我们对88757名年龄在34至59岁之间、无癌症、炎症性肠病或家族性息肉病病史的女性进行了一项前瞻性研究，这些女性在1980年完成了一份饮食问卷。在16年的随访期内，记录了787例结直肠癌病例。此外，在随访期间接受内镜检查的27530名参与者中，发现了1012例远端结肠和直肠腺瘤患者。
在对年龄、既定风险因素和总能量摄入进行调整后，我们发现膳食纤维摄入量与结直肠癌风险之间无关联；与膳食纤维摄入量最低的五分位数组相比，最高五分位数组的相对风险为0.95（95%置信区间，0.73至1.25）。当我们省略对总能量摄入的调整、排除随访前六年的事件或排除随访期间改变膳食纤维摄入量的女性时，未观察到膳食纤维的保护作用。未发现膳食纤维摄入量与结直肠腺瘤风险之间存在显著关联。
我们的数据不支持膳食纤维对结直肠癌或腺瘤具有重要保护作用这一观点。
