目的:在50岁以下的年轻人中,结直肠癌(CRC)的发病率有惊人的增长,推动这种上升趋势的因素是未知的。这项研究调查了各种医学之间的关联,生活方式,饮食因素和早发性CRC(EO-CRC)的风险。
方法:在安大略省进行了一项基于人群的病例对照研究,2018-2019年加拿大。从安大略省癌症登记处发现20-49岁的EO-CRC病例(n=175);通过随机数字拨号招募性别和年龄组匹配的对照(n=253)。使用基于网络的自我报告问卷收集有关潜在先验风险因素的数据。使用多变量逻辑回归估计赔率(OR)和95%置信区间(CI)。
结果:一级或二级亲属的CRC家族史(OR2.37;95%CI1.47-3.84),久坐时间较长(≥10vs.<5小时/天,OR1.93;95%CI1.02-3.65),更多的含糖饮料消费量(≥7vs.<1杯/周,OR2.99;95%CI1.57-5.68),和更西化的饮食模式(四分位数4与1,OR1.92;95%CI1.01-3.66)均与EO-CRC风险增加相关。相反,补钙使用(OR0.53;95%CI0.31-0.92),过敏史或哮喘病史(OR0.62;95%CI0.39-0.98),和更大的性别(≥3vs.无效,OR0.29;95%CI0.11-0.76)均与风险降低相关。
结论:可修改的因素,特别是久坐的行为和不健康的饮食,包括含糖饮料的消费,可能与EO-CRC风险相关。我们的发现,如果复制,可能有助于为针对年轻人的预防策略提供信息。
OBJECTIVE: There has been an alarming increase in colorectal cancer (CRC) incidence among young adults aged < 50 years, and factors driving this upward trend are unknown. This study investigated associations between various medical, lifestyle, and dietary factors and risk of early-onset CRC (EO-CRC).
METHODS: A population-based
case-control study was conducted in Ontario, Canada during 2018-2019. EO-CRC cases aged 20-49 years (n = 175) were identified from the Ontario Cancer Registry; sex- and age group-matched controls (n = 253) were recruited through random digit dialing. Data on potential a priori risk factors were collected using a web-based self-reported questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression.
RESULTS: Family history of CRC in a first- or second-degree relative (OR 2.37; 95% CI 1.47-3.84), longer sedentary time (≥ 10 vs. < 5 h/day, OR 1.93; 95% CI 1.02-3.65), greater consumption of sugary drinks (≥ 7 vs. < 1 drinks/week, OR 2.99; 95% CI 1.57-5.68), and a more Westernized dietary pattern (quartile 4 vs. 1, OR 1.92; 95% CI 1.01-3.66) were each associated with an increased risk of EO-CRC. Conversely, calcium supplement use (OR 0.53; 95% CI 0.31-0.92), history of allergy or asthma (OR 0.62; 95% CI 0.39-0.98), and greater parity in females (≥ 3 vs. nulliparity, OR 0.29; 95% CI 0.11-0.76) were each associated with a reduced risk.
CONCLUSIONS: Modifiable factors, particularly sedentary behavior and unhealthy diet including sugary drink consumption, may be associated with EO-CRC risk. Our findings, if replicated, may help inform prevention strategies targeted at younger persons.