遵守世界癌症研究基金会(WCRF)/美国癌症研究所(AICR)的癌症预防建议与白人的结直肠癌(CRC)风险有关。但之前只有一项研究报道了非洲裔美国人的这种联系。这项研究评估了2018年WCRF/AICR指南与社区动脉粥样硬化风险前瞻性队列中非洲裔美国人(26.5%)和白人(73.5%)的CRC发病率之间的关联(n=13,822)。
在基线(1987年)和2012年之间,共发现368例CRC事件(白人268例,非洲裔美国人100例)。为7个WCRF/AICR指南创建了基线依从性评分(每个指南对评分贡献0、0.5或1分,分数越高,依从性越高)。粘附分数也被归类为三位数(0.0-3.0、3.5-4.0和4.5-7.0)。Cox比例风险回归用于计算总队列的风险比(HR)和95%置信区间(CI),并按种族进行分层。
经过年龄调整后,性别,种族,中心,吸烟,教育,阿司匹林的摄入量,钙,总卡路里,糖尿病状态,and,在女性中,激素替代疗法,更高的依从性与CRC风险降低相关.整个队列中每1个单位评分增量的HR为0.88(95%CI,0.80-0.97),非洲裔美国人0.89(95%CI,0.73-1.09),白人为0.88(95%CI,0.77-0.99)。在男性和女性以及结肠癌中观察到较高的依从性评分和降低的癌症风险之间的类似关联,但在直肠癌中没有。
对于非洲裔美国人和白人而言,对癌症预防建议的坚持似乎与降低CRC风险有关。
Adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations is associated with colorectal cancer (CRC) risk in whites, but only 1 previous study has reported on this link in African Americans. This study assessed the association between the 2018 WCRF/AICR
guidelines and CRC incidence in African Americans (26.5%) and whites (73.5%) in the Atherosclerosis Risk in Communities prospective cohort (n = 13,822).
A total of 368 incident CRC cases (268 among whites and 100 among African Americans) were identified between the baseline (1987) and 2012. A baseline adherence score was created for 7 WCRF/AICR
guidelines (each contributing 0, 0.5, or 1 point to the score, with higher scores corresponding to greater adherence). Adherence scores were also categorized as tertiles (0.0-3.0, 3.5-4.0, and 4.5-7.0). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the total cohort and with stratification by race.
After adjustments for age, sex, race, center, smoking, education, intake of aspirin, calcium, total calories, diabetes status, and, in women, hormone replacement therapy, greater adherence was associated with decreased CRC risk. The HRs per 1-unit increment in score were 0.88 (95% CI, 0.80-0.97) for the whole cohort, 0.89 (95% CI, 0.73-1.09) for African Americans, and 0.88 (95% CI, 0.77-0.99) for whites. Similar associations between higher adherence scores and decreased cancer risk were observed for men and women and for colon cancer but not for rectal cancer.
Greater adherence to the cancer prevention recommendations appears to be associated with decreased CRC risk for both African Americans and whites.