| 臧钊平,孙可欣,张 梅,等.基于大型数据库链接后队列的结直肠癌危险因素巢式病例对照研究[J].中国肿瘤,2023,32(3):226-233. |
| 基于大型数据库链接后队列的结直肠癌危险因素巢式病例对照研究 |
| A Nested Case-control Study of Risk Factors for Colorectal Cancer Based on a Large Database Linked Cohort |
| 投稿时间：2022-11-23 |
| DOI：10.11735/j.issn.1004-0242.2023.03.A010 |
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| 中文关键词: 结直肠癌 巢式病例对照 危险因素 |
| 英文关键词:colorectal cancer nested case-control study risk factors |
| 基金项目:中国医学科学院医学与健康科技创新工程项目（2021-I2M-1-061） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨我国结直肠癌发病相关影响因素及多种因素联合暴露与结直肠癌发病风险的关联。［方法］ 基于中国慢性病及其危险因素监测项目数据与中国肿瘤登记数据链接、匹配后的数据库开展巢式病例对照研究。共纳入结直肠癌病例755例，1∶4匹配对照共3 004例。采用条件Logistic回归模型计算各因素与结直肠癌发病风险的比值比（OR）和95%置信区间（CI），并基于弗明汉风险评分函数计算每个个体不同因素联合暴露评分。［结果］ 在校正多种混杂因素后，目前吸烟(OR=1.765，95%CI：1.408~2.211)、目前饮酒(OR=1.370，95%CI：1.122~1.674)、日均静坐时长超过4 h(OR=1.843，95%CI：1.382~2.456)、体质指数(body mass index，BMI)为超重(OR=1.241，95%CI：1.027~1.501)或肥胖(OR=1.564，95%CI：1.217~2.009)、每天吃红肉类食物(OR=1.445，95%CI：1.185~1.763)、不经常吃蔬菜(OR=1.650，95%CI：1.196~2.278)、患有高血压(OR=1.634，95%CI：1.350~1.978)和糖尿病(OR=1.749，95%CI：1.389~2.204)以及有癌症家族史(OR=1.880，95%CI：1.324~2.668)为结直肠癌发病危险因素。联合暴露评分结果显示，最高四分位数组发生结直肠癌的风险为第一四分位数组的4.186倍(95%CI：3.192~5.490)。［结论］ 目前吸烟、饮酒者、久坐、超重或肥胖且有不良饮食习惯者以及患有高血压、糖尿病、有癌症家族史者是结直肠癌的高危人群，应重点关注。此外，上述多种危险因素联合作用会更为显著地增加结直肠癌发病风险。 |
| 英文摘要: |
| Abstract： ［Purpose］ To investigate the influential factors associated with the development of colo-rectal cancer in China and the association between combined exposure to multiple factors and the risk of colorectal cancer development. ［Methods］ A nested case-control study was conducted based on data from the Chinese Chronic Disease and its Risk Factors Surveillance Program and a database matched with the linked Chinese cancer registry data. A total of 755 colorectal cancer cases and 3 004 matched control cases（at a ratio of 1∶4） were included. Conditional Logistic regression models were used to calculate the odds ratio(OR) and 95% confidence interval(CI) of each factor to the risk of colorectal cancer， and the combined exposure scores of different factors were calculated for each individual based on the Framingham risk score function. ［Results］ After correcting for multiple confounders， current smoking(OR=1.765， 95%CI： 1.408~2.211)， current alcohol consumption(OR=1.370， 95%CI： 1.122~1.674)， average daily sedentary time >4 h(OR=1.843， 95%CI： 1.382~2.456)， and overweight(OR= 1.241， 95%CI： 1.027~1.501) or obese(OR=1.564， 95%CI： 1.217~2.009)， daily consumption of red meat(OR=1.445， 95%CI： 1.185~1.763)， less vegetable consumption(OR=1.650， 95%CI： 1.196~2.278)， hypertension(OR=1.634， 95%CI：1.350~1.978)， diabetes(OR=1.749， 95%CI： 1.389~2.204) ， and family history of cancer(OR=1.880， 95%CI： 1.324~2.668) were risk factors for colorectal cancer development. The results of the combined exposure score showed that the risk of colorectal cancer in the highest quartile group was 4.186 folds(95%CI： 3.192~5.490) higher than that in the first quartile group. ［Conclusion］ Current smokers， alcohol drinkers， people who are sedentariness， overweight or obese and have poor dietary habits， as well as people with hypertension， diabetes and family history of cancer are high-risk groups for colorectal cancer and should be given priority attention. In addition， the combined effect of multiple risk factors mentioned above could significantly increase the risk of colo-rectal cancer. |
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