Plos Med:坚持健康的生活方式,可极大降低结直肠癌患病风险

2021-02-20 MedSci原创 MedSci原创

据数据显示,结直肠癌(CRC)是美国第三大最常被诊断的癌症和第三大癌症死亡原因。既往研究显示,坚持健康的生活方式可预防20%到70%的CRC死亡率。然而,健康生活方式很难长期坚持,特别是对于内窥镜检查

据数据显示,结直肠癌CRC)是美国第三大最常被诊断的癌症和第三大癌症死亡原因。既往研究显示,坚持健康的生活方式可预防20%70%CRC死亡率。然而,健康生活方式很难长期坚持,特别是对于内窥镜检查筛查呈现阴性的人群。那么,对于已经接受过内镜筛查的人群来说,健康的生活方式是否与没有接受内镜筛查的人群一样,目前还不得而知。与单纯的内镜筛查相比,将健康的生活方式与内镜筛查结合起来是否可以预防CRC的也是未知的。

近日,发表在Plos Med杂志的一项研究,在两个大型的前瞻性队列研究中,无论是否进行内窥镜筛查,坚持健康的生活方式可降低CRC发生率和死亡率。仅通过内窥镜筛查就能预防大约32%的CRC发病率和34CRC死亡率,而与健康的生活方式相结合,预防CRC发病率和死亡率的比率分别增加到61%和55%,对近端结肠癌尤为明显。

在这项研究中,研究人员对美国两个大型队列研究,护士健康研究(NHS)和卫生专业人员随访研究(HPFS)进行健康生活方式与接受/未接受内镜筛查对CRC发病率和死亡率影响的评估。其中,包含75873名女性和42875名男性,平均年龄为54岁。研究人员根据体重指数、吸烟、体力活动、饮酒和饮食来定义健康生活方式评分,进而评估CRC发病率和死亡率与健康生活方式评分相关的危险比(HRs)和人群归因危险度(PAR)

结果显示,随访26年后,共记录了2836CRC病例和1013CRC死亡病例。无论是否进行内镜检查,健康的生活方式评分与较低的CRC发生率存在关联。单纯通过内镜筛查可能预防的CRC病例的比率(PAR)为32%95% CI31%33%),与健康生活方式相结合时(得分=5),增加到61%95% CI42%75%)。对于近端结肠癌,相应的PAR15%13%16%)增加到51%17%74%),对于远端结肠癌,从47%45%50%)增加到75%61%84%)。CRC死亡率的结果相似。

健康生活方式评分与CRC发病率(A组)和死亡率(B组)的关系,以及相应的年龄调整后的发病率和死亡率

与内窥镜筛查和健康生活方式相关的CRC发病率和死亡率

总而言之,该研究结果为加强预防结直肠癌的公共卫生措施提供了有力的证据, 健康的生活方式与较低的CRC发生率和死亡率相关,而与内窥镜检查无关。与单纯的内窥镜检查相比,将健康的生活方式与内窥镜检查相结合可以显著增强对CRC的预防,特别是对近端结肠癌的预防。

原始出处

Kai Wang.et al.Healthy lifestyle, endoscopic screening, and colorectal cancer incidence and mortality in the United States: A nationwide cohort study. Plos Med.https://doi.org/10.1371/journal.pmed.1003522

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