阑尾炎史与结直肠癌发病关系的研究

目的研究阑尾炎与结直肠癌发病之间的关系.方法以1989年5月至1990年4月期间,参加浙江省嘉善县大肠癌筛查的10个乡镇30岁及以上人口为研究队列,按是否具有阑尾炎史分为暴露组和非暴露组,随访从1990年5月至2001年1月,应用回顾性队列研究的方法,对结直肠癌发病率进行分析,并作相对危险度(RR)估计.结果 Poisson回归分析表明,经控制年龄因素后,阑尾炎史仅在女性结肠癌中表现出有统计学意义(P＜0.05),有阑尾炎史者结肠癌的发病风险较之无阑尾炎史者高达近2倍,RR为1.9335,95%可信限为1.0456～3.5754.结论阑尾炎史与结肠癌的发病有关,阑尾炎史是结肠癌的重要危险因子.     

结肠癌和直肠癌危险因素的巢式病例对照研究

目的：探讨结肠癌和直肠癌的危险因素。方法：应用巢式病例对照研究方法,对一个6万余人队列随访10年队列中196例新发结、直肠癌病例作为病例组;从该队列中随机抽取980名正常人作为对照组,对有关暴露因素进行单因素分析和多因素非条件logistic回归分析,结果：年龄在病例组和对照之间差异有显著性,病例组年龄高于对照组,且结肠癌的发病年龄高于直肠癌。多因素分析表明,除年龄外,粘液血便中、肠息肉史与结肠癌关系密切,OR值分别为：2．961（95％CI：1．202－7．298）和8．941（95％CI：1．820－43．926）,饮用混合水与直肠癌的OR值为1．823（95％CI:1．024－3．247）。结论：结、直肠癌的危险因素不尽相同。除年龄是结、直肠癌发病的一个共同重要因素外,肠息肉史和粘液血便史与结肠癌有关联,而饮用混合水则与直肠癌关系密切。     

上海市区居民1973-2005年结直肠癌发病趋势分析

目的 了解1973-2005年上海市区居民结直肠癌发病率的时间变化趋势.方法 结直肠癌发病资料来自上海市肿瘤发病登记处,共采集32 962例结肠癌患者资料和24 662例直肠癌患者资料.根据人口普查资料中性别、年龄构成估算各年人口数,利用世界标准人口,采用直接法计算标化发病率.标化发病率年度变化百分比(APC)估算采用对数线性回归法,并用病例数进行加权.结果 1973-2005年男女性结直肠癌发病率均呈上升趋势,结肠癌的标化发病率分别从6.09/10万和5.70/10万上升至14.70/10万和14.35/10万,APC分别为3.03%(t=14.77,P<0.01)和3.21%(t=22.15,P<0.01).男女性直肠癌标化发病率分别从7.68/10万和6.51/10万上升至11.45/10万和8.28/10万,APC分别为1.34%(t=7.28,P<0.01)和0.93%(t=7.34,P<0.01).女性结直肠癌的APC在85岁～组达到最高,分别为5.86%和2.79%;而男性在80岁～组APC最高,分别为4.64%和2.38%.男女性45岁及以上各年龄组结肠癌的APC大于直肠癌.33年间,男女性结直肠癌的平均发病年龄由57～60岁推迟到66～70岁.结肠癌发病年龄较直肠癌略晚[2003-2005年,男性结肠癌平均发病年龄为(68.61±12.17)岁,男性直肠癌为(66.81±12.62)岁,t=4.90,P<0.01;女性结肠癌为(69.20±12.13)岁,女性直肠癌为(67.75±12.54)岁,t=3.81,P<0.01].结论 上海市区男女性结直肠癌的标化发病率在33年里稳步上升,其中结肠癌上升趋势更加明显,有必要进一步探讨导致这种变化的原因.     

遗传性非息肉性结直肠癌相关性子宫内膜癌的研究进展

子宫内膜癌是遗传性非息肉性结直肠癌综合征最常见的肠外肿瘤,发病率高和发病时间早是其显著的临床特征.本文就遗传性非息肉性结直肠癌综合征相关性子宫内膜癌的临床病理特征、筛查和预防性治疗作一综述.     

1990—2005年杭州市萧山区人群肠癌发病部位和年龄特点及生存率影响因素

目的研究1990—2005年杭州市萧山区人群结、直肠癌的发病部位和年龄特点及生存率影响因素。方法以杭州市萧山区恶性肿瘤发病与死亡监测系统为基础,采用寿命表法计算结、直肠癌的生存率,分析结、直肠癌的发病年龄、部位、生存率的变化趋势及其影响因素。结果 1990—2005年结、直肠癌病例共2450例,中位发病年龄65.3岁,1990—1995年、1996—2000年、2001—2005年中位发病年龄分别为63.2岁、65.3岁、66.8岁,结、直肠癌病例的发病年龄呈增高趋势。结肠癌中位发病年龄64.5岁,低于直肠癌病人中位发病年龄(65.8岁),差别有统计学意义(Z=2.06,P=0.039)。发病部位以直肠癌为主,占60.2%,60岁以下发病的病人中结肠癌的比例高于60岁以上年龄组。近年来结肠癌的比例呈增高趋势,2001—2005年已占全部结、直肠癌患者的46.6%。本组结、直肠癌病人的1年、3年、5年生存率分别为51.5%,45.6%和43.4%。影响结、直肠癌预后的主要因素有肿瘤部位[直肠癌相对危险度是结肠癌的1.453倍(95%CI:1.293～1.633)]、发病年龄[45～59岁组和≥60岁组的相对危险度分别为45岁组的1.071倍(95%CI:0.867～1.325)和1.847倍(95%CI:1.535～2.222)]、诊断时期[1996—2000年和2001年以后的相对危险度分别为1996年以前的0.901倍(95%CI:0.788～1.030)和0.691倍(95%CI:0.600～0.795)]。结论结、直肠癌病人有发病年龄增高、发病部位趋向近端、预后改善的趋势,须针对发病特征及相关影响因素采取积极有效的预防措施。     

1990—2019年中国肺结核发病趋势及年龄-时期-队列分析

目的 分析1990—2019年中国居民肺结核发病随年龄、时期及队列变化趋势,为肺结核研究提供参考依据。方法 收集并整理全球疾病负担(global burden of disease, GBD)数据库中1990—2019年中国居民肺结核发病数据,使用连接点回归模型(joinpoint regression, JPR)拟合肺结核发病趋势,建立年龄-时期-队列(age-period-cohort, APC)模型探讨影响肺结核发病风险的年龄效应、时期效应与出生队列效应。结果 1990―2019年中国男性和女性的肺结核发病率均呈下降趋势,年平均变化率分别为2.38%、3.89%;APC模型分析结果显示,1990—2019年我国肺结核发病风险随年龄的增加而上升[RR值(男性):0.22～2.08;RR值(女性):0.38～1.76]。时期发病风险随着年份的增加而降低[RR值(男性):1.11～0.80;RR值(女性):1.57～0.61]。队列发病风险随年代的增加而降低[RR值(男性):1.91～0.42;RR值(女性):1.38～0.55]。结论 1990―2019年中国肺结核发病率总体呈下降趋...     

中国结直肠癌健康风险评估模型研究

目的构建适用于中国人群的结直肠癌健康风险的评估模型,为结直肠癌高危人群筛查提供理论依据。方法通过收集结直肠癌发病相关风险因素的比值比、不同水平风险因素的人群暴露率和中国结直肠癌年龄别、性别发病率等参数,建立个体在未来5年内的结直肠癌风险分数转换表,计算组合风险分数,采用SAS 9.2软件建立个体风险评价模型,预测个体发病风险。结果本研究纳入了13个危险因素,大便潜血和黏液便史的风险分数最高,均在10分左右,其次为肠息肉史(6.86分)、慢性结直肠炎病史(4.14分)、慢性腹泻(3.82分)、一级亲属肠癌史(2.42分)、慢性阑尾炎或阑尾炎手术史(2.09分)、胆囊疾病或胆囊手术史(2.01分)、慢性便秘(2.01分)和消化道溃疡史(1.91分),而吸烟(1.09分)和饮酒(1.11分)的风险分数接近1。风险分数1的因素为吃蔬菜≥1次/d(0.78分),提示该因素为保护性因素。发病风险因素个数相同、种类不同的个体发病风险不同。相同发病风险组合分数者,年龄越高,发病风险越大;年龄相同时,男性发病风险高于女性。结论本研究建立的中国人群结直肠癌健康风险的个体化评估模型可为结直肠癌高危人群筛查提供理论依据。     

1990—2019年中国上呼吸道感染的年龄-时期-队列分析

目的 分析1990—2019年中国上呼吸道感染的发病、死亡和伤残调整寿命年(DALY)的情况及变化趋势。方法 利用Joinpoint回归分析1990—2019年中国发病、死亡和DALY的趋势变化,采用年龄-时期-队列模型估计上呼吸道感染发病和死亡的年龄、时期和队列效应RR值。结果 2019年上呼吸道感染的发病人数较1990年高,但发病率和标化发病率较1990年降低。1990—2019年,标化死亡率和标化DALY率呈逐年下降趋势,平均每年下降8.2%(95%CI:-8.7%～-7.8%)和2.4%(95%CI:-2.5%～-2.2%),且女性的下降趋势较男性明显。年龄-时期-队列模型结果显示,1990—2019年中国男性上呼吸道感染发病率的年龄效应RR值呈现逐年下降趋势,女性发病率的年龄效应RR值呈现上升趋势,死亡率的年龄效应RR值随着年龄的增加呈现下降趋势。发病率的时期效应在女性群体中的风险高于男性,死亡率的时期RR值随时间的推移而逐渐下降。发病率的出生队列RR值在男性中呈现下降趋势,在女性中相反,死亡率的出生队列RR值呈逐年下降的趋势。结论 1990—2019年中国上呼吸道感染的疾病...     

1990―2019年中国结核病发病趋势的年龄-时期-队列模型分析

目的 分析1990―2019年中国结核病发病趋势并探讨年龄、时期、队列对结核病发病风险的影响。方法 收集全球健康数据交换数据库中0～<95岁中国居民结核病发病数据,采用Joinpoint回归模型分析1990―2019年中国居民结核病发病率的变化趋势,采用年龄-时期-队列模型来分析影响中国结核病发病风险的年龄效应、时期效应和队列效应。结果 1990―2019年,全国、男性、女性的结核病标化发病率均呈下降趋势,男性、女性年龄标化发病率分别从1990年的120.56/10万和99.75/10万下降至2019年的56.08/10万和30.60/10万,年平均下降速度分别为2.60%和3.98%。年龄-时期-队列模型分析结果显示,1990―2019年中国结核病发病率的年龄效应总体上随年龄的增加而增加,在90～<95岁发病风险达到最大,男性和女性的RR值分别为2.50(95%CI:2.33～2.69)和1.93(95%CI:1.76～2.12);时期效应随着时间的推移发病风险逐渐下降,发病风险RR值从1990年的[男性：1.13(95%CI:1.08～1.17);女性：1.58(95%...     

非甾体类抗炎药对肠息肉及结、直肠癌保护作用的病例对照研究

目的　研究非甾体类抗炎药 (NSAIDs)对肠息肉、结肠癌及直肠癌的保护作用。方法　将 2 0 0 0年 5月至 2 0 0 1年 7月来医院进行结肠镜检查的病人中诊断为结肠癌 (10 5例 )、直肠癌 (14 2例 )及结直肠息肉 (37例 )的患者设为病例组 ,肠炎及未见异常者为对照组 (6 6例 )。对病例组和对照组采用会晤调查的方法回顾过去服用NSAIDs史 ,同时调查其家族史、生活行为及日常饮食情况。采用Egert软件进行logistic回归分析。结果　单因素分析结果表明 ,NSAIDs对肠息肉、结肠癌及直肠癌有明显的保护作用 ,经多变量logistic回归分析其保护作用增强 ,OR值分别 0 2 1(95 %CI为 0 0 7～ 0 6 5 ,P =0 0 0 7)、0 13(95 %CI为 0 0 5～ 0 35 ,P <0 0 0 1)及 0 15 (95 %CI为 0 11～ 0 5 8,P <0 0 0 1)。阿司匹林单因素分析结果表明 ,阿司匹林对肠息肉也有明显的保护作用。logistic回归分析结果显示 ,在控制其他因素的条件下 ,阿司匹林的保护作用加强 ,OR值分别为 0 2 7(95 %CI为 0 0 7～ 0 96 ,P =0 0 4 4 )、0 10 (95 %CI为 0 0 3～ 0 35 ,P <0 0 0 1)、0 ,15 (95 %CI为 0 0 4～ 0 4 9,P =0 0 0 2 )。对布洛芬单独分析结果表明 ,布洛芬对结肠癌和直肠癌均有明显的保护作用 ,但logistic回归分析结果显     

Alcohol drinking and colorectal cancer: A population-based prospective cohort study in China

Study objective: To asses the association between alcohol consumption and the risk of colorectal cancer (CRC) in the Chinese population. Design: A population-based prospective cohort study was initiated from the colorectal cancer screening population in Jiashan County in 1989–1990. The drinking habits of individuals were investigated with demographic information. Setting: A cohort study was followed-up from 1st May 1990 to 1st January 2001 and censored at the date of diagnosis of CRC, at death from any causes, or at 1st January 2001, whichever came first, and the person-time was computed. Participants: Two hundred and forty two CRC patients were diagnosed during the study period and 64,100 individuals finished the follow-up. Results: The distribution of sex, smoking status, occupation, education level and marital status were all significantly different among different drinking habits at baseline. When the above factors were adjusted, no significant association was observed between alcohol consumption and the risk of CRC. Exclusion of individuals diagnosed cancer less than 1 year after the examination date did not alter the strength of an alcohol–CRC relationship. Further analysis in sex strata also did not show a significant relationship. Conclusions: Alcohol drinking may not be associated with a higher risk of CRC in the Chinese population.This revised was published online in April 2005. In the previous version the article category was missing.     

Alcohol consumption and distinct molecular pathways to colorectal cancer

High alcohol consumption is related to colorectal cancer (CRC). Our objective was to study associations between alcohol consumption and risk of CRC according to characteristics of aetiological pathways: the chromosomal instability (CIN) and the microsatellite instability (MIN) pathway. We classified CIN+ tumours (tumours with either a truncating APC mutation, an activating K-ras mutation or overexpression of p53), MIN+ tumours (tumours lacking hMLH1 expression) and CIN- /MIN- tumours (tumours without these defects). In the Netherlands Cohort Study on diet and cancer, 120852 men and women, aged 55-69 years, completed a questionnaire on risk factors for cancer at baseline (1986). Case-cohort analyses were conducted using 573 CRC cases with complete data after 7 x 3 years of follow-up, excluding the first 2 x 3 years. Adjusted incidence rate ratios (RR) and 95 % confidence intervals (CI) were estimated. Compared with abstaining, alcohol consumption of >or=30 g/d was positively associated with the risk of CRC irrespective of genetic or molecular aberrations present, although statistical significance was not reached (RR 1 x 35 (95 % CI 0 x 9-2 x 0) for the CIN+ tumours, RR 1 x 59 (95 % CI 0 x 4-5 x 8) for the MIN+ tumours and RR 1.15 (95 % CI 0 x 5-2 x 7) for the CIN- /MIN- tumours). Beer, wine and liquor consumption were, independent of their alcoholic content, not consistently associated with the risk of CRC within the defined subgroups. In conclusion, our results indicate that a daily alcohol consumption of >or=30 g is associated with an increase in risk of CRC, independent of the presence or absence of the studied characteristics of different aetiological pathways.     

Meta-Analysis of the Association between Dietary Inflammatory Index (DII) and Colorectal Cancer

The Dietary Inflammatory Index (DII) was extensively used to examine the inflammatory potential of diet related to colorectal cancer (CRC). This meta-analysis aimed to update the evidence of the association between the DII and CRC across various culture-specific dietary patterns. Literature search was performed through online databases (Scopus, Web of Science, PubMed, and EBSCOHost). Observational studies exploring the association between the DII and CRC, published between 2017 and 2021, were included. The risk ratio (RR) and 95% confidence interval (CI) were separately computed for 12 studies comparing the highest and lowest DII scores and for 3 studies that presented continuous DII scores. A high DII score was associated with a higher risk of CRC (RR:1.16; 95% CI, 1.05–1.27). In the subgroup analysis, significant associations were seen in cohort design (RR: 1.24; 95% CI, 1.06–1.44), those lasting for 10 years or longer (RR: 2.95; 95% CI, 2.47–3.52), and in adjustment factor for physical activity (RR: 1.13; 95% CI, 1.07–1.20). An increase of one point in the DII score elevates the risk of CRC by 1.34 (95% CI: 1.15–1.55) times. The findings call for standardized measurement of the inflammatory potential of diet in future studies to enable the establishment of global guidelines for CRC prevention.     

他汀类药物与结直肠癌相关性的Meta分析

目的:探讨他汀类药物与结直肠癌间的关系,为结直肠癌的预防提供循证医学依据。方法:系统检索中国知网（CNKI）、万方数据知识服务平台（Wanfang data）、PubMed和Cochrane Library数据库中从2000年1月至2020年1月所有他汀类药物与结直肠癌研究的文献,按照纳入排除标准选择文献,并用纽卡斯尔...     

Dietary fibre and risk of colorectal cancer in the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort

BACKGROUND: The hypothesis that increased intake of dietary fibre lowers the risk of colorectal cancer (CRC) has recently been weakened by results from cohort and intervention studies that did not detect such an association. We investigated the association between dietary fibre intake and risk of CRC in a cohort of women that prospectively answered a food frequency questionnaire (FFQ). METHODS: We studied 45 491 women in the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort. A 62-item FFQ was administered from 1987 and 1989 to assess dietary intake. Participants received follow-up questionnaires (in 1992-1995 and 1995-1998) on which they reported incident cancers. Cases were also identified through searches of the National Death Index and state cancer registries. Cox proportional hazard regression was used to generate risk ratios and 95% CI for quintiles of total fibre intake and fibre subtypes. RESULTS: During a mean follow-up time of 8.5 years we identified 487 colorectal cancer cases. The 10th and 90th percentiles of dietary fibre intake were 5.4 g and 18.2 g respectively. For total fibre we observed no association with colorectal cancer (fifth versus first quintile, RR = 0.94, 95% CI: 0.71-1.23). Analyses by subgroup of fibre and by anatomical subsite did not reveal any stronger inverse associations. CONCLUSIONS: Within a cohort of older women characterized by a relatively low fibre intake, there was little evidence that dietary fibre intake lowers the risk of colorectal cancer.     

Coffee consumption and colorectal cancer risk: a dose-response meta-analysis on prospective cohort studies

Abstract

Evidence regarding the influence of coffee drinking on colorectal cancer (CRC) is limited, and it remains unclear whether coffee consumption is associated with the risk of the disease. To clarify this association, a comprehensive meta-analysis was performed. The risk of CRC was compared between the categories of coffee consumption, and a dose-response relationship was studied using restricted cubic splines. We did not find evidence for the association between coffee consumption and CRC risk. Among alternative study inclusions, when using pooled projects, coffee consumption was related with a decreased risk of colon cancer in a subgroup analysis of never-smokers and in Asian countries, and with an increased risk of rectal cancer in an analysis of the general population and after restriction to women, never-smokers, and European countries. In conclusion, the association between coffee consumption and CRC risk is controversial and should be clarified in further cohort studies.     

1990-2019年中国结直肠癌归因于各类危险因素的疾病负担分析与模型预测

目的 分析1990-2019年中国结直肠癌(colorectal cancer,CRC)归因于各类危险因素的疾病负担变化趋势并对其未来10年的变化进行预测,为CRC的精准防控提供参考依据.方法 利用2019年全球疾病负担(Globad Burden of Disease,GBD)研究数据,采用Joinpoint估算年度...     

Nitrogen-nitrate exposure from drinking water and colorectal cancer risk for rural women in Wisconsin, USA

One unintentional result of widespread adoption of nitrogen application to croplands over the past 50 years has been nitrate contamination of drinking water with few studies evaluating the risk of colorectal cancer. In our population-based case-control study of 475 women age 20–74 years with colorectal cancer and 1447 community controls living in rural Wisconsin, drinking water nitrate exposure were interpolated to subjects residences based on measurements which had been taken as part of a separate water quality survey in 1994. Individual level risk factor data was gathered in 1990–1992 and 1999–2001. Logistic regression models estimated the risk of colorectal cancer for the study period, separately and pooled. In the pooled analyses, an overall colorectal cancer risk was not observed for exposure to nitrate-nitrogen in the highest category (10 ppm) compared to the lowest category (<0.5 ppm). However, a 2.9 fold increase risk was observed for proximal colon cancer cases in the highest compared to the lowest category. Statistically significant increased distal colon or rectal cancer risk was not observed. These results suggest that if an association exists with nitrate-nitrogen exposure from residential drinking water consumption, it may be limited to proximal colon cancer.     

Consumption of Whole-Grain Bread and Risk of Colorectal Cancer among Norwegian Women (the NOWAC Study)

There is evidence that consumption of foods containing dietary fiber decreases the risk of colorectal cancer (CRC). Whole grains contain dietary fiber, as well as a range of micronutrients and bioactive compounds, but the association between the consumption of whole grains and the risk of CRC remains less studied. The aim of the present study was to investigate the association between whole-grain bread consumption and CRC incidence among Norwegian women, using data from a prospective cohort study (the Norwegian Women and Cancer Study). Dietary intake was estimated from the food-frequency questionnaires of 78,254 women in the cohort (median age: 55 years), and these women were then followed up for CRC incidence. During the 9 years of median follow-up, 795 women were diagnosed with CRC (316 proximal, 193 distal, 218 rectal). Associations between whole-grain bread consumption and the risk of CRC (including colorectal subsites) were investigated using Cox proportional hazards regression models. When compared to the low consumption group, the hazard ratio for CRC was 0.89 (95% confidence interval (CI): 0.72–1.09) for the high consumption group and 0.86 (95% CI: 0.72–1.02) for the medium consumption group in a multivariable model. Overall, no association between whole-grain bread consumption and CRC was found.