文章摘要
杨淞淳,申泽薇,余灿清,郭彧,卞铮,谭云龙,裴培,魏永越,陈峰,陈君石,陈铮鸣,吕筠,李立明.中国成年人排便频率与结直肠癌发病风险的前瞻性关联分析[J].中华流行病学杂志,2019,40(4):382-388
中国成年人排便频率与结直肠癌发病风险的前瞻性关联分析
Association between the frequency of bowel movements and the risk of colorectal cancer in Chinese adults
投稿时间:2018-09-04  
DOI:10.3760/cma.j.issn.0254-6450.2019.04.003
中文关键词: 结直肠肿瘤;排便频率;队列研究
英文关键词: Colorectal neoplasms;Bowel movement frequency;Cohort study
基金项目:国家重点研发计划精准医学研究重点专项(2016YFC0900500,2016YFC0900501,2016YFC0900504);国家自然科学基金(81530088);中国香港Kadoorie Charitable基金;英国Wellcome Trust(202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z)
作者单位E-mail
杨淞淳 北京大学公共卫生学院流行病与卫生统计学系 100191  
申泽薇 北京大学公共卫生学院流行病与卫生统计学系 100191  
余灿清 北京大学公共卫生学院流行病与卫生统计学系 100191  
郭彧 中国医学科学院, 北京 100730  
卞铮 中国医学科学院, 北京 100730  
谭云龙 中国医学科学院, 北京 100730  
裴培 中国医学科学院, 北京 100730  
魏永越 南京医科大学公共卫生学院生物统计学系 211166  
陈峰 南京医科大学公共卫生学院生物统计学系 211166  
陈君石 国家食品安全风险评估中心, 北京 100022  
陈铮鸣 英国牛津大学临床与流行病学研究中心纳菲尔德人群健康系 OX3 7LF  
吕筠 北京大学公共卫生学院流行病与卫生统计学系 100191
北京大学分子心血管学教育部重点实验室 100191 
lvjun@bjmu.edu.cn 
李立明 北京大学公共卫生学院流行病与卫生统计学系 100191  
摘要点击次数: 483
全文下载次数: 428
中文摘要:
      目的 分析排便频率与结直肠癌发病风险的前瞻性关联。方法 研究对象来自于中国慢性病前瞻性研究,基线调查开展的时间为2004年6月至2008年7月,在剔除基线时自报患有恶性肿瘤的个体后,最终有510 134人纳入分析。本研究使用的随访数据截止到2016年12月31日,采用Cox比例风险回归模型计算排便频率和结直肠癌发病的关联。结果 研究对象平均随访9.9年,随访期间3 056人发生结直肠癌;在分癌种分析时,纳入结肠癌1 548例,直肠癌1 475例。控制潜在混杂因素后,与排便频率基本1次/d者相比,排便频率>1次/d者发生结直肠癌、结肠癌和直肠癌的HR值分别为1.24(95% CI:1.12~1.39)、1.12(95% CI:0.95~1.31)和1.37(95% CI:1.18~1.59)。按随访时间进行亚组分析,随访前5年对应的HR值分别为1.59(95% CI:1.36~1.86)、1.43(95% CI:1.14~1.80)和1.76(95% CI:1.41~2.19);随访5年后,上述关联均无统计学意义(交互P<0.05)。与排便频率基本1次/d者相比,排便频率更低者的发病风险无统计学意义。结论 排便频率>1次/d者在随访前5年发生结直肠癌的风险升高。异常增加的排便频率作为一个容易识别的症状,应该在自我健康管理和结直肠癌早期筛检的实践工作中加以重视。
英文摘要:
      Objective To examine the association between the frequencies of bowel movement (BMF) and the risk of colorectal cancer (CRC). Methods In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included, after excluding those who reported as having been diagnosed with cancer at the baseline survey. The baseline survey was conducted from June 2004 to July 2008. The present study included data from baseline and follow-up until December 31, 2016. We used the Cox proportional hazards regression models to estimate the HR and the 95% CI of incident CRC with BMF. Results During an average follow-up period of 9.9 years, 3 056 participants were documented as having developed colorectal cancer. In the site-specific analysis, 1 548 colon cancer and 1 475 rectal cancer were included. Compared with participants who had bowel movements on the daily base, the multivariable-adjusted HR (95% CI) for those who had more than once of BMF were 1.24 (1.12-1.39) for CRC, 1.12 (0.95-1.31) for colon cancer, and 1.37 (1.18-1.59) for rectal cancer. We further examined the association between BMF and CRC, according to the stages of follow-up, the corresponding HR (95% CI) for CRC, colon and rectal cancer were 1.59 (1.36-1.86), 1.43 (1.14-1.80), and 1.76 (1.41-2.19) for the first five years, while such associations became statistically insignificant in the subsequent follow-up (P for all interactions were <0.05), as time went on. As for CRC, colon or rectal cancers among participants who had lower bowel movements, the risks were not significantly different from those who had bowel movements everyday. Conclusions Participants who had BMF more than once a day, appeared an increased risk of CRC in the subsequent five years. Since abnormal increase of bowel movements is easily recognizable, programs should be set up on health self-management and early screening for CRC.
查看全文   Html全文     查看/发表评论  下载PDF阅读器
关闭