Abstract：
Colorectal cancer (CRC) is a major global health concern and represents a significant public health challenge in Hungary, where it exhibits some of the highest morbidity and mortality rates in the European Union. The Mediterranean diet has been suggested to reduce the incidence of CRC, but comprehensive evidence from diverse study designs is needed to substantiate this effect. A systematic literature search was conducted in PubMed, ClinicalTrials.gov, CENTRAL, and the Web of Science to identify randomized controlled trials and human clinical trials from 2008 to 2024 to identify relevant studies. Statistical analysis was performed using the https://metaanalysisonline.com web application using a random effects model to estimate the pooled hazard rates (HRs). Forest plots, funnel plots, and Z-score plots were utilized to visualize results. We identified 15 clinical trials and 9 case-control studies, encompassing a total of 2,217,404 subjects. The pooled analysis indicated that adherence to the Mediterranean diet significantly reduced the prevalence of CRC (HR = 0.84, 95% CI = 0.78-0.91, p < 0.01). This protective effect was consistent across sexes, with HRs of 0.85 (95% CI = 0.75-0.97, p = 0.01) for males and 0.88 (95% CI = 0.79-0.99, p = 0.03) for females. Case-control studies specifically showed a substantial effect (HR = 0.51, 95% CI = 0.38-0.68, p < 0.01). Notable heterogeneity was observed across studies, yet the a priori information size was substantially below the cumulative sample size, ensuring sufficient data for reliable conclusions. The findings from this meta-analysis reinforce the protective role of the Mediterranean diet against CRC. The results of this meta-analysis will inform dietary interventions designed to mitigate CRC risk, which are conducted within the framework of the Semmelweis Study, an ongoing comprehensive cohort study at Semmelweis University, designed to explore the multifaceted causes of unhealthy aging in Hungary. These interventions aim to explore the practical application of Mediterranean dietary patterns in reducing CRC incidence among the Hungarian population.
摘要：
结直肠癌（CRC）是一个重大的全球健康问题，在匈牙利是一个重大的公共卫生挑战。在欧盟，它的发病率和死亡率最高。地中海饮食已被建议减少CRC的发病率。但需要来自不同研究设计的综合证据来证实这种效应.在PubMed进行了系统的文献检索，ClinicalTrials.gov,中部,和WebofScience确定2008年至2024年的随机对照试验和人体临床试验，以确定相关研究。使用https://metaanalysisonline.comWeb应用程序使用随机效应模型进行统计分析，以估计合并危险率（HR）。森林地块，漏斗图,和Z分数图用于可视化结果。我们确定了15项临床试验和9项病例对照研究，包括总共2,217,404个科目。汇总分析表明，坚持地中海饮食显着降低了CRC的患病率（HR=0.84，95％CI=0.78-0.91，p<0.01）。这种保护作用在不同性别之间是一致的，男性的HR为0.85（95％CI=0.75-0.97，p=0.01），女性为0.88（95％CI=0.79-0.99，p=0.03）。病例对照研究显示了显著的效果(HR=0.51,95%CI=0.38-0.68,p<0.01)。在研究中观察到显著的异质性，然而，先验信息大小大大低于累积样本量，确保有足够的数据得出可靠的结论。这项荟萃分析的结果加强了地中海饮食对CRC的保护作用。这项荟萃分析的结果将为旨在减轻CRC风险的饮食干预提供信息。这是在Semmelweis研究的框架内进行的，Semmelweis大学正在进行的一项综合队列研究，旨在探索匈牙利不健康衰老的多方面原因。这些干预措施旨在探索地中海饮食模式在减少匈牙利人口中CRC发病率方面的实际应用。
