大肠癌高发区居民结肠癌危险因素研究

目的 研究我国结直肠癌最高发达地区浙江嘉善县结肠癌危险因素,为监测和预防结肠癌提供科学依据。方法 采用以全人群为基础的病例对照研究,用统一的调查表调查了109对结肠癌病例和对照（病例对照之比为1：7）,应用Logistic回归对结肠癌相关变量进行了单因素和多因素分析。结果 10年前猪肉月均消耗量高（OR＝1.723)、下消化系统疾病（OR＝4．163）和一级亲属结直肠癌史（OR＝3．421）是嘉善县结肠癌主要危险因素;10年前蔬菜月均消耗量高则为发生结肠癌的保护因素（OR＝0．422）。结论 嘉善县结肠癌与饮食因素有关。研究结果支持结肠癌发生的脂肪胆汁酸假说及纤维缺乏假说。精神压抑、遗传和下消化系统疾病也与结肠癌发病密切相关。     

上海市居民饮食与胃癌关系的病例对照研究

目的：探讨上海市居民饮食与胃癌发生的关系。方法：采用全人群病例对照研究，调查1999年4月－10月间诊断的上海市区新发胃癌病例311例（男性198例，女性113例），对照1579例（为“九五”课题中乳腺癌，肺癌及胃癌病例－对照研究之一，对照共用）。采用非条件logistic回归分析，调整可能的混杂因素，包括年龄，文化程度，吸烟（仅男性）慢性胃炎及一级亲属胃癌家族史等，分析饮食口味，热烫饮食，新鲜蔬菜和水果，豆及豆制品，蛋及蛋制品，家禽类，腌制食品，油炸食品，植物油等饮食因素，以估计胃癌发生的比数比和95％可信区间。结果：研究发现新鲜蔬菜（最高摄入量OR＝0．6），水果（OR＝0．6），新鲜豆类OR＝0．4），豆制品（OR＝0．4）和植物油（OR＝0．6）是男性胃癌的保护因素，而油面食（OR＝1．6）增加男性胃癌的危险性，新鲜蔬菜9OR＝0．3），水果（OR＝0．4），新鲜豆类（OR＝0．4，干豆类（OR＝0．5）和蛋及蛋制品（OR＝0．5）对妇性胃癌具有保护作用，而腌制食品（OR＝2．2）和油食品（包括油鱼／肉、油炸面食，油煎蛋和油煎花生米，OR＝2．6是女性胃癌主要的危险因素，重盐饮食和热烫饮食及早餐不规律增加胃癌发生的危险，未发现主食，新鲜肉类（包括鱼，家禽类，红肉类）等与胃癌妇生有联系，结论：高盐饮食，热烫饮食，腌制食品和油炸食品是上海市胃癌的重要危险因素，而新鲜蔬菜，水果，豆及豆制品和植物油等可降低胃癌的危险性。     

广州市结肠癌危险因素的病例对照研究

目的：研究广州市结肠癌患者发病的危险因素。方法：采取病例对照研究的方法,采用全国4个城市和地区统一的调查表调查结肠癌患者及健康人各150例,资料按统一数据库收录后,采用SAS软件包进行单因素及多因素统计学分析。建立主效应模型。结果：与结肠癌发病有关的主要危险因素有：长期精神压抑（OR=75）,一级亲属患结肠癌（OR=7.886),高血脂及高胆固醇血症（OR=3.443);保护因素有：目前玉米月用量（OR=0.219),目前蛋类月用量（OR=0.278),常吃大蒜（OR=0.352),常吃早餐（OR=0.115)。结论：精神压抑、一级亲属患结肠癌、高血脂及高胆固醇血症是患结肠癌的危险因素;常吃早餐、常吃大蒜、膳食纤维的高摄入是预防结肠癌的保护因素。     

上消化道肿瘤高发区胃癌、食管癌病例对照研究

目的：探索泰兴市胃癌,食管癌的高危因素,方法,选择1998年9月1日－1999年12月31日期间430例胃癌和591例食管癌新发病例,按年龄,性别和居住地进行以人群为基础1：1配对的病例对照研究,分别采用Epi-info(6.04版）和SAS（6．12版）统计软件进行单因素和多因素分析。结果：单因素分析发现,经济状况差,吸烟,进食速度快,三餐不按时和既往患胃炎和胃溃疡,以及平时经常忧郁,长期处于精神压抑状态是泰兴地区胃和食管癌的共同危险因素,而有良好的人际关系,黄绿蔬菜的大量摄入,则可降低两种癌症的危险性,而饮高度白酒9OR＝2．71）,口味嗜咸（OR＝1．42）,喜爱吃烫食）OR＝2．21）,食管病变（OR＝6．62）和一级亲属中有人患食管癌（OR＝1．98）是食管癌的危险因素,多吃水果（OR＝0．68）则可降低患癌的危险性,多因素条件Logistic回归分析结果显示,既往有胃,食管病变,平时经常忧郁是胃,食管癌共同危险因素,进食速度快,三餐不按时,喜食烫食,过量饮高度白酒,一级亲属中有人患食管癌均作为食管癌的危险因素,而经常摄入黄绿蔬菜则作为胃癌保护因素进入回归方程,结论：精神因素,饮食相关因素及相关的上消化道病变对上消化道癌的发生影响十分明显。     

消化道疾患与大肠癌关系的病例—对照研究

本文以3166例大肠癌新发病例与3003例人群对照的病例对照研究数据，分析部分消化系统疾病与结、直肠癌的关系．结果表明：1．大肠息肉患者发生大肠癌的超额危险度是非息肉人群的22倍，2．溃疡性结肠炎为大肠癌的危险因数（OR=2．6，P＜0．01），并相对与结肠癌联系较为密切；3．单因素分析结果显示血吸虫病患者发生结、直肠癌相对危险度增高，分别为1．7（P＜0．05）和1．5（P＜0．10）．在调整病程因素后，该联系性未达到显著性水平，4．胆囊切除、肝炎、糖尿病可能不是结直肠癌的危险因素．     

嘉善县结肠癌的危险因素

分别于1997年和1999年在浙江嘉善县进行了基于全人群的结肠癌病例对照研究,用Logistic回归方法对两次调查资料进行了结肠癌危险因素的单因素和多因素分析。结果表明：多吃新鲜蔬菜是结肠癌发生的保护因素,下消化系统疾病史,一级亲属结直肠癌史及精神心理因素是结肠癌的危险因素。     

中国女性乳腺癌危险因素的Meta分析

[目的]评价中国女性乳腺癌部分危险因素的作用,探讨乳腺癌的病因。[方法]运用Meta分析方法对我国1996～2006年间公开发表的有关乳腺癌危险因素病例对照研究的12篇文献资料进行定量综合分析。[结果]各因素合并OR值分别为：初潮年龄OR=1．5401（95％CI：1．3437～1．7654）;哺乳OR=0．6837（95％CI：0．4779—0．9782）;口服避孕药OR=1．3278（95％CI：1．0627—1．6589）;良性乳腺疾病史OR=2．6180（95％CI：2．0275—3．3804）;吸烟OR=1．8576（95％CI：1．5394—2．2415）;饮酒OR=0．8137（95％CI：0．6196～1．0686）;饮茶OR=0．8625（95％CI：0．7646～0．9728）。[结论]初潮年龄、口服避孕药、良性乳腺疾病史及吸烟是乳腺癌发生的危险因素,哺乳及饮茶则是乳腺癌的保护因素。     

恶性肿瘤家族史与子宫内膜癌关系的流行病学研究

目的 研究一级亲属恶性肿瘤家族史与子宫内膜癌的关系。方法 采用全人群病例对照研究的方法,收集1997年1月－2000年6月诊断的30－69岁,具有上海市区常住户口的子宫内膜癌病例及其对照一级亲属的恶性肿瘤家族史,分析恶性肿瘤史在病例与对照组一级亲属的恶性肿瘤家族史,分析恶性肿瘤史在病例与对照组一级亲属中的分布情况及其对子宫内膜癌发生的影响。结果 病例组中有较多的一级亲属患有恶性肿瘤（调整OR＝1．3,95％CI1．0－1．7）,尤其是结肠直肠癌（CRC）（调整OR6．1,95％CI1．8－21．1）和子宫内膜癌（调整OR4．8,95％CI1．0－22．1）。调整年龄、一级亲属人数、体质指数（BMI）、腰围 臀围比（WHR）、月经生育史和避孕药的使用、饮食等可能的混杂因素进行非条件Logistic回归分析发现,一级亲属中恶性肿瘤史、子宫内膜癌家施行史和CRC家族史的OR值仍有意义,且分别上升为1．4（95％CI1．1－1．9）,5．2（95％CI1．1－25．3）和8．9（95％CI2．5－31．3）,但家庭史和这些危险因素对子宫内膜癌的发生无交互作用。一级亲属中恶性肿瘤史、子宫内膜癌家庭史和CRC家族史的人群归因危险度分别为9．5％、1．6％和3．2％。结论 研究结果表明,子宫呐膜癌具有明显的家族聚集性。子宫内膜癌和结肠直肠癌家族史是子宫内膜癌发生的独立的危险因素。     

厦门市居民2005年－2014年结直肠癌死亡的流行病学分析

目的：探讨厦门市居民结直肠癌死亡变化趋势,为厦门市结直肠癌综合防治工作提供依据。方法：收集整理2005年－2014年厦门市居民结直肠癌死亡资料,计算死亡率等评价指标。多因素 Logistic 回归分析结直肠癌死亡的影响因素。结果：2005年－2014年,厦门市居民结直肠癌死亡率10．69／10万,年均上升9．35％,男性死亡率是女性的1．40倍。死亡率随着年龄的升高逐渐升高,死亡年龄中位数为70岁。男性（OR ＝1．67,95％CI：1．52～1．82）、生活在城市（OR ＝1．67,95％CI：1．50～1．85）和2010年－2014年时间段（OR ＝1．48,95％CI：1．35～1．63）、年龄越大（OR ＝1．52,95％CI：1．50～1．55）可能是结直肠癌死亡的危险因素。结论：厦门市居民结直肠癌死亡率呈上升趋势,应以城市、男性、老年人群作为重点关注对象,重视结直肠癌防治工作。     

克拉玛依市区女性乳腺癌危险因素的病例对照研究

 目的　探讨克拉玛依市区女性乳腺癌的危险因素。方法　用病例对照研究方法调查129例女性乳腺癌和对应的129名对照者,用Logistic回归模型进行乳腺癌危险因素分析。结果　乳腺癌的危险因素有乳腺癌家族史（OR＝2.744,95 % CI＝1.884～4.674）、乳腺增生症（OR＝1.423,95 % CI＝1.160～1.810）、 乳腺炎（OR＝2.363,95 % CI＝2.039～3.934）、子宫肌瘤（OR＝1.623,95 % CI＝1.263～2.024）、 流产（OR＝1.723,95 % CI＝1.143～2.600）、 饮酒（OR＝1.243,95 % CI＝1.040～1.483）、精神创伤（OR＝2.184,95 % CI＝1.753～3.025）、长期接触电离辐射（OR＝1.374,95 % CI＝1.152～1.699）; 保护因素有初潮年龄增大（OR＝0.773,95 % CI＝0.674～0.956）、累计哺乳时间（OR＝0.672,95 % CI＝0.480～0.941）、坚持运动（OR＝0.572,95 % CI＝0.391～0.837）。结论　以上11个因素为克拉玛依市区女性乳腺癌重要的危险因素和保护因素。     

Colon Cancer Risk Factors in Jiashan County of Zhe-jiang Province, the Highest Incidence Area in China

OBJECTIVE To investigate the risk factors of colon cancer in Jiashan county, the highest incidence area in China and to provide a scientific basis for monitoring and prevention. METHODS With a population-based case-control study, 109 colon cancer patients with 1:7 matched controls were interviewed with uniform questionnaires. Conditional logistic regression was used for univariate and multivariate analysis of colon cancer. RESULTS High monthly pork consumption (OR=1.608), and high monthly animal fat consumption (OR=1.391) over a ten-year period, psychological depression (OR=9.887), negative emotion (OR=1.723), lower digestivetract diseases (OR=4.163), and history of colorectal cancer in first-degree relatives (OR=3.421) were the main risk factors of colon cancer. During that time, high monthly vegetable consumption was a protective factor for colon cancer (OR=0.422).CONCLUSIONS Colon cancer in Jiashan county was related to dietary factors. The research results support the colon cancer etiological hypothesis of “fat-bile acid“ and “deficiency of dietary fibre“. Psychological depression, in heritance and lower digestive tract diseases were also correlated with colon cancer.     

Family history and colorectal cancer: predictors of risk

INTRODUCTION: While the association between family history of colorectal cancer in first-degree relatives and risk of developing colon cancer has been well defined, the association with rectal cancer is much less clear. The purpose of this study is to define rectal cancer risk associated with family history of colorectal cancer in first-degree relatives. We also evaluate diet and lifestyle factors associated with developing colorectal cancer among participants with a positive family history. METHODS: Data were available from two population-based case--control studies of colon and rectal cancer. Participants were members of the Kaiser Permanente Medical Care Program (KPMCP) or residents of the state of Utah. Cases were first primary colon cancer diagnosed between 1991 and 1994 (n = 1308 cases and 1544 controls) or rectal cancer diagnosed between 1997 and 2001 (n = 952 cases and 1205 controls). RESULTS: A family history of colorectal cancer in any first-degree relatives slightly increased risk of rectal cancer (OR: 1.37 95% CI: 1.02-1.85). Family history of colorectal cancer was associated with the greatest risk among those diagnosed at age 50 or younger (OR: 2.09 95% CI: 0.94-4.65 for rectal tumors; OR: 3.00 95% CI: 0.98-9.20 for distal colon tumors; and OR: 7.88 95% CI: 2.62-23.7 for proximal colon tumors). Factors significantly associated with cancer risk among those with a family history of colorectal cancer, included not having a sigmoidoscopy (OR: 2.81 95% CI: 1.86-4.24): a diet not Prudent, i.e. high in fruits, vegetables, whole grains, fish and poultry, (OR: 2.79 95% CI: 1.40-5.56); smoking cigarettes (OR: 1.68 95% CI: 1.12-2.53), and eating a Western diet, i.e. a diet high in meat, refined grains, high-fat foods, and fast foods, (OR: 2.15 95% CI: 1.06-4.35). Physical inactivity was not associated with increased cancer risk among those with a positive family history of colorectal cancer. SUMMARY: These results confirm observations reported by others that a family history of colorectal cancer increases risk of cancer among those diagnosed at a younger age. Associations with family history are weakest for rectal cancer and strongest for proximal colonic tumors. Since several diet and lifestyle factors influence development of cancer among those with a family history of the disease, there appears to be practical approaches for individuals with a family history of colorectal cancer to reduce their cancer risk.     

结肠癌危险因素的Meta分析

目的 运用系统评价方式探讨结肠癌危险因素,为更好地预防结肠癌提供循证依据。方法 计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普系列数据库、The Cochrane Library、PubMed、SpringerLink、EBSCO、MEDLINE等数据库,检索文献发表时间为2000年1月1日至2018年10月31日,检索词包括“结肠癌”、“结肠肿瘤”、“结肠组织癌性病变”、“危险因素”及其自由词的病例对照试验相关文献。在尽可能全面地收集相关病例对照试验数据资料的基础上,根据纳入和排除标准,并采用Newcastle Ottawa Scale(NOS)文献质量评价表的评价标准对所提取文献进行质量评价,将得分≥7分(高质量)的文献纳入研究,最后采用RevMan53对其进行Meta分析。结果 13篇文献符合纳入标准,累计病例数和对照数分别为该2 773例和8 117例,经Meta分析结果显示,结肠癌的危险因素为:结肠癌家族史(OR=213,95％CI:158～287)、精神心理问题(OR=150,95％CI:109～205)、低膳食纤维饮食(OR=117,95％CI:094～146)、高脂高蛋白饮食(OR=135,95％CI:111～164)、缺乏运动(OR=116,95％CI:097～138)、消化系统疾病(OR=182,95％CI:131～253)及饮酒(OR=138,95％CI:111～171)。结论 结肠癌家族史、精神心理问题、低食纤维饮食、高脂高蛋白饮食、缺乏运动、消化系统疾病及饮酒是结肠癌的独立危险因素,控制上述因素可以有效降低结肠癌患者的死亡风险。     

Relation of Family History of Cancer and Environmental Factors to the Risk of Colorectal Cancer: A Case-control Study

The relation of a family history of cancer and environmentalfactors to colorectal cancer was investigated in a case-controlstudy conducted from 1992 to 1994 at 10 medical institutionsin Japan using a self-administered questionnaire, and 363 casesof colorectal cancer were compared with 363 controls matchedfor sex and age. A family history of colorectal cancer was positivelyassociated with colon cancer (odds ratio (OR)=2.0, 95% confidenceinterval(Cl)1.03–3.87) and rectal cancer (OR=2.1 Cl 0.94–4.48),but a family history of other cancers did not increase the risk.The proportion of patients with a family history of colorectalcancer within first-degree relatives was 12.4% — appreciablyhigher than figures previously reported in Japan. On the otherhand, the incidence of hereditary non-polyposis colorectal cancerwas 1.4%, and lower than previous estimates. Among dietary factors,a western-style diet significantly increased the risk of bothcolon and rectal cancer (OR = 2.3 Cl 1.30–3.88 and OR=2.1Cl 1.26–3.63, respectively). Consumption of rice was protectiveagainst both colon and rectal cancer(OR=0.5 Cl 0.31–0.82and OR = 0.3 Cl 0.18–0.65, respectively). Animal meat,oily food, fish, vegetables and fruit were shown to affect therisk, but no statistically significant correlation was found.Among other factors, constipation increased the risk of coloncancer (OR= 2.0 Cl 1.02–3.76) and consumption of coffeeraised the risk of rectal cancer (OR =1.7 Cl 1.07–2.82).Our findings suggest that a family history of colorectal canceris an important risk factor for this disease, and does not contradictthe hypothesis that the risk of colorectal cancer in Japan maybe influenced by westernization of lifestyle. However, we wereunable to find conclusive evidence that familial clusteringof this disease is strongly affected by environmental factorsor genetic diseases such as hereditary non-polyposis colorectalcancer.     

Allergy and other selected diseases and risk of colorectal cancer

It has been reported that allergy and other diseases may be related to colorectal cancer risk. The aim of this study was to perform a systematic analysis using information about medical histories specifically to see if there was any relation between allergies or other medical conditions and colorectal cancer risk. A multicentric case-control study was conducted in six Italian areas between 1992 and 1996 on 1225 incident cases of colon cancer, 728 cases of rectal cancer and 4154 controls comparable with cases according to sex and age group, admitted for acute conditions to the same network of hospitals where cases had been identified. Unconditional logistic regression models including terms for sex, age, study centre, years of education, body mass index, physical activity, smoking, history of colorectal cancer in first-degree relatives and energy intake were used to estimate the odds ratios (OR) of colon and rectal cancer according to history of allergy and other selected diseases. The OR for history of allergy was 0.88 (95% confidence interval, CI, 0.67-1.14) for colon and 0.64 (95% CI, 0.44-0.92) for rectal cancer, and the inverse association was stronger when allergy was diagnosed at age 35 years or more, or less than 10 years before the cancer diagnosis. No clear pattern emerged in strata of age and sex. History of other selected diseases, including hypertension and cholelithiasis, was not related to colon or rectal cancer risk, though there was a moderate increase in the risk of colon cancer (OR = 1.18, 95% CI, 0.66-2.14) in patients with a history of intestinal polyps. This study lends support to the hypothesis that allergic individuals may be at a lower risk of developing colorectal cancer.     

Prevalence of Colorectal Cancer in Relatives of Iranian Patients Diagnosed with Colorectal Cancer

Background: A high rate of colorectal cancer occurrence is established in individuals with a positive familyhistory of this type of cancer. Objectives: The aim of this study was to investigate the prevalence of colorectalcancer in first degree and second degree relatives of colorectal cancer patients. Methods: Family medical historiesof 489 first degree relatives of colorectal cancer patients were obtained by a questionnaire. 249 average riskpatients with no family history of colorectal cancer were included as control patients. Results: In our study froma total of 489 case patients, 153 (31.3%) had at least one close relative affected by colon cancer. Case-controlanalysis showed an odd ratio of 3.1 (95% CI, 2.07 to 6.27) for one and 5.7 (CI, 2.39 to 13.56) for two affectedrelatives. Cases with a positive family history had a 3.006 times greater risk in developing colorectal cancer if afirst degree relative was affected comparing with a 4.898 time greater risk if a second degree family memberwas diagnosed with colorectal cancer .Our study indicated a higher risk for developing colorectal cancer in malefamily relatives 50 years and older. Rectal area was found the most tumor side affected in case and controlpatients. Conclusion: First-degree relatives of patients with colorectal cancer had an increased risk of developingthis type of cancer. The risk was greater when diagnosis was in male, elderly patients and other first-degreerelatives were affected.     

河南省林州市食管鳞癌及癌前病变的影响因素研究

[目的]探讨河南省林州市食管鳞癌及癌前病变的影响因素。[方法]按照性别、年龄进行1∶1∶1匹配的原则,选取2019年5~10月在林州市食管癌医院就诊的新发食管鳞癌患者、新发中重度食管鳞状上皮异型增生患者和正常对照匹配成33个区组作为研究对象。对入组的研究对象进行问卷调查,收集其人口学、生活方式等信息,采用多元有序Logistic回归对食管鳞癌及癌前病变的影响因素进行统计学分析。[结果]单因素分析结果显示,教育程度,饮用水来源,吸烟,饮酒,饮茶,食用西兰花、大蒜、酸菜、烟熏制品,劳动强度,消化道疾病史,食管癌家族史与食管鳞癌及癌前病变发生有关(P<0.05)。多元有序Logistic回归结果显示,教育程度(小学:OR=2.128,95%CI:1.116~3.187;中学及以上:OR=1.960,95%CI:1.080~2.759),饮用浅层地下水、井水(OR=3.595,95%CI:1.051~7.130),现在吸烟(OR=2.027,95%CI:1.435~5.193),经常食用酸菜(OR=2.520,95%CI:1.030~4.498),经常食用烟熏制品(OR=1.312,95%CI:1.089~1.739),有消化道疾病史(OR=2.277,95%CI:1.038~2.828)是食管鳞癌及癌前病变的独立危险因素,而经常食用西兰花(OR=0.520,95%CI:0.031~0.855)是独立保护因素。[结论]在林州市,生活方式、饮食习惯和消化道病史均可影响食管鳞癌及癌前病变的发生,有其地域特点,应针对相关影响因素采取相应的预防措施。     

Family history of cancer and the risk of cancer: a network of case–control studies

BackgroundThe risk of many cancers is higher in subjects with a family history (FH) of cancer at a concordant site. However, few studies investigated FH of cancer at discordant sites.Patients and methodsThis study is based on a network of Italian and Swiss case–control studies on 13 cancer sites conducted between 1991 and 2009, and including more than 12 000 cases and 11 000 controls. We collected information on history of any cancer in first degree relatives, and age at diagnosis. Odds ratios (ORs) for FH were calculated by multiple logistic regression models, adjusted for major confounding factors.ResultsAll sites showed an excess risk in relation to FH of cancer at the same site. Increased risks were also found for oral and pharyngeal cancer and FH of laryngeal cancer (OR = 3.3), esophageal cancer and FH of oral and pharyngeal cancer (OR = 4.1), breast cancer and FH of colorectal cancer (OR = 1.5) and of hemolymphopoietic cancers (OR = 1.7), ovarian cancer and FH of breast cancer (OR = 2.3), and prostate cancer and FH of bladder cancer (OR = 3.4). For most cancer sites, the association with FH was stronger when the proband was affected at age <60 years.ConclusionsOur results point to several potential cancer syndromes that appear among close relatives and may indicate the presence of genetic factors influencing multiple cancer sites.     

Food groups and risk of colorectal cancer in Italy

The proportion of colorectal cancer attributed to dietary habits is high, but several inconsistencies remain, especially with respect to the influence of some food groups. To further elucidate the role of dietary habits, 1,225 subjects with cancer of the colon, 728 with cancer of the rectum and 4,154 controls, hospitalized with acute non-neoplastic diseases, were interviewed between 1992 and 1996 in 6 different Italian areas. The validated food-frequency questionnaire included 79 questions on food items and recipes, categorised into 16 food groups. After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing risk of colorectal cancer with increasing intake emerged for bread and cereal dishes (odds ratio [OR] in highest vs. lowest quintile = 1.7), potatoes (OR = 1.2), cakes and desserts (OR = 1.1), and refined sugar (OR = 1.4). Intakes of fish (OR = 0.7), raw and cooked vegetables (OR = 0.6 for both) and fruit other than citrus fruit (OR = 0.7) showed a negative association with risk. Consumption of eggs and meat (white, red or processed meats) seemed uninfluential. Most findings were similar for colon and rectum, but some negative associations (i.e., coffee and tea, and fish) appeared stronger for colon cancer. Our findings lead us to reconsider the role of starchy foods and refined sugar in light of recent knowledge on the digestive physiology of carbohydrates and the insulin/colon cancer hypothesis. The beneficial role of most vegetables is confirmed, with more than 20% reduction in risk of colorectal cancer from the addition of one daily serving. Int. J. Cancer 72:56–61, 1997. © 1997 Wiley-Liss Inc.