在无症状个体中,晚期结肠瘤和高增殖性息肉的危险因素
David A Lieberman1, Sheila Prindiville, David G Weiss
1Division of Gastroenterology, Department of Veterans Affairs Medical Center, Portland, Ore 97207, USA. lieberma@ohsu.edu
JAMA
|December 11, 2003
概括
患有结直肠癌的家族史,目前的吸烟和大量饮酒增加了晚期结直肠瘤的风险. 增加谷物纤维,维生素D和NSAID的摄入量是保护因素.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 确定结直肠瘤的危险因素对于制定针对性降低无症状个体风险的策略至关重要.
- 有限的研究已经全面评估了无症状人群中晚期结直肠瘤的危险因素,比较了多与无多群体,并采用多变量分析.
研究的目的:
- 确定和量化与晚期结肠直肠瘤相关的风险因素,在一组接受全结肠镜检查的无症状个体中.
主要方法:
- 这是一项前性,横截面研究,涉及13个退伍军人事务医疗中心的50至75岁3121名无症状患者.
- 进行了全结肠镜检查,以确定晚期瘤 (大腺瘤,小腺瘤,高度生殖不良或癌症).
- 多变量逻辑回归分析被用来评估各种因素 (家族史,生活方式,饮食) 与晚期瘤之间的关联.
主要成果:
- 与晚期瘤的积极关联包括一级亲属与结直肠癌的病史 (OR,1.66),目前的吸烟 (OR,1.85),以及中度到重度的酒精使用 (OR,1.02).
- 对较高的谷物纤维摄入量 (OR,0.95),维生素D摄入量 (OR,0.94) 和使用非类固醇抗炎药物 (NSAID) (OR,0.66) 观察到不良关联 (保护因素).
- 吸烟也与患有多发性多的风险增加有关,而其他晚期瘤的风险因素也相似.
结论:
- 该研究证实了几种先进结直肠瘤的重大风险因素,支持实施有针对性的降低风险策略.
- 需要进一步的研究,以调查生活方式修改在减轻结直肠癌风险方面的潜力.
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