THE ROLE OF CHRONIC CONSTIPATION, DIARRHEA, AND LAXATIVE USE IN THE ETIOLOGY OF LARGE-BOWEL CANCER - DATA FROM THE MELBOURNE COLORECTAL-CANCER STUDY
THE ROLE OF CHRONIC CONSTIPATION, DIARRHEA, AND LAXATIVE USE IN THE ETIOLOGY OF LARGE-BOWEL CANCER - DATA FROM THE MELBOURNE COLORECTAL-CANCER STUDY
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DOI：
10.1007/bf02553722
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发表时间：
1988-07-01
影响因子：
3.9
通讯作者：
WATSON, LF
中科院分区：
文献类型：
--
作者：
KUNE, GA;KUNE, S;WATSON, LF
作为一项大型、综合性、基于人群的结直肠癌发病率、病因学和生存率研究的一部分，研究了685例结直肠癌病例和723例年龄/性别频率匹配的社区对照的终生排便习惯，该研究名为墨尔本结直肠癌研究。病例组自我报告的慢性便秘在统计学上显著高于对照组（P= 0.05）。每天排便三次或三次以上的病例比对照组多，但这一子集中的应答者总数仅包括10例病例和2例对照组。另外，排便的频率和一致性在病例组和对照组中分布相似。当同时调整先前确定的饮食风险因素时，便秘作为一个显著的风险消失了，这表明与大肠癌风险相关的是饮食而不是便秘。此外，在报告便秘和高脂肪摄入的人群中，发现与结直肠癌风险具有高度统计学显著性相关性（P= 0.02），这一发现与目前的结直肠癌发生假说一致。它的结论是，慢性便秘，腹泻，排便的频率和一致性，以及泻药的使用，是不太可能的病因因素在发展中的结直肠癌。自我报告的慢性便秘是大肠癌的过度风险的一个轻微的显着指标，并可用作筛选这种癌症的个体的指标之一。
Life-long bowel habits of 685 colorectal cancer cases and 723 age/sex frequency matched community controls were investigated as one part of a large, comprehensive, population-based study of colorectal cancer incidence, etiology, and survival, The Melbourne Colorectal Cancer Study. Self-reported chronic constipation was statistically significantly more common in cases than in controls (P=.05). Three or more bowel actions per day were reported by more cases than controls but the total number of respondents in this subset consisted of only ten cases and two controls. Otherwise, the frequency and consistency of bowel motions was similarly distributed among cases and controls. Constipation disappeared as a significant risk when simultaneously adjusted for previously determined dietary risk factors, indicating that it is the diet and not the constipation that is associated with the risk of large-bowel cancer. Additionally, a highly statistically significant association (P=.02) was found with the risk of colorectal cancer in those who reported constipation and also had a high fat intake, a finding consistent with current hypotheses of colorectal carcinogenesis. It is concluded that chronic constipation, diarrhea, and the frequency and consistency of bowel motions, as well as laxative use, are unlikely to be etiologic factors in the development of colorectal cancer. Self-reported chronic constipation is a marginally significant indicator of excess risk of large-bowel cancer and may be used as one of the indices in the screening of individuals for this cancer.