Abstract：
This systematic review and meta-analysis were conducted to determine the effects of anthraquinone (AQ) laxatives on colorectal cancer (CRC). We searched PubMed, Embase, Google Scholar, and CENTRAL from inception until March 2021, for randomized controlled trials (RCTs) and observational studies. Through the systematic review, we identified 8 observational studies evaluating AQ laxatives use as a risk factor for CRC development, and 5 studies on CRC risk were included in the meta-analysis using a random-effects model. Through the meta-analysis, we found that a history of AQ laxatives use compared with \"other\" and \"no laxatives\" use was associated with CRC development (OR: 1.41; 95% CI: 0.94-2.11), although not at a statistically significant level. The possible association persists even after removal of the outlier studies (OR: 1.51; 95% CI: 0.97-2.34). Selection of cases and controls was judged at low or unclear risk of bias across almost all studies, and the quality of evidence was from moderate to low. In conclusion, it is not possible to associate the use of AQ laxatives with the development of CRC. However, the trend toward an increased risk of CRC provides a strong indication for investigating this issue by performing further high-quality studies.
摘要：
进行了系统评价和荟萃分析，以确定蒽醌（AQ）泻药对结直肠癌（CRC）的影响。我们搜索了PubMed,Embase,谷歌学者，和CENTRAL从开始到2021年3月，用于随机对照试验（RCT）和观察性研究。通过系统回顾,我们确定了8项观察性研究，评估AQ泻药的使用是CRC发展的危险因素，5项CRC风险研究采用随机效应模型纳入meta分析.通过荟萃分析,我们发现，与“其他”和“没有使用泻药”相比，使用AQ泻药的历史与CRC发展有关（OR：1.41;95％CI：0.94-2.11），虽然没有达到统计学上的显著水平。即使在删除异常研究后，可能的关联仍然存在（OR：1.51;95％CI：0.97-2.34）。在几乎所有研究中，病例和对照的选择都被认为存在低或不清楚的偏倚风险。证据质量从中等到低。总之,不可能将AQ泻药的使用与CRC的发展联系起来.然而,CRC风险增加的趋势为进一步开展高质量研究调查这一问题提供了强有力的指征.
