■早发性结直肠癌(EOCRC)的发病率,这意味着在50岁以下的患者中诊断出结直肠癌,在世界各地一直在增加。然而,病因尚不清楚。本研究旨在确定EOCRC的危险因素。
■这项系统评价是在PubMed,Embase,Scopus,和Cochrane图书馆数据库从成立到2022年11月25日。我们检查了EOCRC的危险因素,包括人口因素,慢性疾病,和生活方式行为或环境因素。采用随机效应/固定效应荟萃分析来结合已发表数据的效应估计。采用纽卡斯尔-渥太华量表(NOS)评价研究质量。进行了Revman5.3的统计分析。通过系统评价对不适合进行荟萃分析的研究进行了分析。
■本综述共确定了36项研究,30项研究纳入荟萃分析.EOCRC的重要危险因素包括男性(OR=1.20;95%CI,1.08-1.33),高加索人(OR=1.44;95%CI,1.15-1.80),有CRC家族史(OR=5.90;95%CI,3.67-9.48),炎症性肠病(OR=4.43;95%CI,4.05-4.84),肥胖(OR=1.52;95CI,1.20-1.91),超重(OR=1.18;95%CI,1.12-1.25),甘油三酯(OR=1.12;95%CI,1,08-1.18),高血压(OR=1.16;95%CI,1.12-1.21),代谢综合征(OR=1.29;95%CI,1.15-1.45),吸烟(OR=1.44;95%CI,1.10-1.88),饮酒(OR=1.41;95%CI,1.22-1.62),久坐不动的生活方式(OR=1.24;95%CI,1.05-1.46),红肉(OR=1.10;95%CI,1.04-1.16),加工肉(OR=1.53;95%CI,1.13-2.06),西方饮食模式(OR=1.43;95%CI,1.18-1.73)和含糖饮料(OR=1.55;95%CI,1.23-1.95)。然而,在高脂血症和高血糖方面无统计学差异.维生素D可能是一种保护因素(OR=0.72;95%CI,0.56-0.92)。研究之间存在相当大的异质性(I2>60%)。
■该研究概述了EOCRC的病因和危险因素。目前的证据可以为EOCRC特有的风险预测模型和风险定制的筛查策略提供基线数据。
UNASSIGNED: The incidence of early-onset colorectal cancer (EOCRC), which means colorectal cancer diagnosed in patients under 50 years, has been increasing around the world. However, the etiology remains unclear. This study aims to identify risk factors for EOCRC.
UNASSIGNED: This systematic
review was conducted in PubMed, Embase, Scopus, and Cochrane Library databases from inception to November 25, 2022. We examined risk factors for EOCRC, including demographic factors, chronic conditions, and lifestyle behaviors or environmental factors. Random-effects/fixed-effects meta-analysis was adopted to combine effect estimates from published data. Study quality was evaluated with the Newcastle-Ottawa Scale (NOS). Statistical analysis was performed Revman5.3. Studies not suitable for the meta-analysis were analyzed by a systematic
review.
UNASSIGNED: A total of 36 studies were identified for this
review, and 30 studies were included in the meta-analysis. Significant risk factors for EOCRC included male (OR=1.20; 95% CI, 1.08-1.33), Caucasian (OR=1.44; 95% CI, 1.15-1.80), a family history of CRC (OR=5.90; 95% CI, 3.67-9.48), inflammatory bowel disease (OR=4.43; 95% CI, 4.05-4.84), obesity (OR=1.52; 95%CI, 1.20-1.91), overweight (OR=1.18; 95% CI, 1.12-1.25), triglycerides (OR=1.12; 95% CI, 1, 08-1.18), hypertension (OR=1.16; 95% CI, 1.12-1.21), metabolic syndrome (OR=1.29; 95% CI, 1.15-1.45), smoking (OR=1.44; 95% CI, 1.10-1.88), alcohol consumption (OR=1.41; 95% CI, 1.22-1.62), a sedentary lifestyle (OR=1.24; 95% CI, 1.05-1.46), red meat (OR=1.10; 95% CI, 1.04-1.16), processed meat (OR=1.53; 95% CI, 1.13-2.06), Western dietary patterns (OR=1.43; 95% CI, 1.18-1.73) and sugar-sweetened beverages (OR=1.55; 95% CI, 1.23-1.95). However, no statistical differences were found for hyperlipidemia and hyperglycemia. Vitamin D may be a protective factor (OR=0.72; 95% CI, 0.56-0.92). There was considerable heterogeneity among studies (I2>60%).
UNASSIGNED: The study provides an overview of the etiology and risk factors of EOCRC. Current evidence can provide baseline data for risk prediction models specific to EOCRC and risk-tailored screening strategies.