Primary prevention of colorectal cancer.
Primary prevention of colorectal cancer.
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DOI：
10.1053/j.gastro.2010.01.057
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发表时间：
2010-06
期刊：
影响因子：
29.4
通讯作者：
Giovannucci EL
中科院分区：
文献类型：
--
作者：
Chan AT;Giovannucci EL
结直肠癌与西方生活方式密切相关。在过去几十年中，人们对这种恶性肿瘤的饮食、生活方式和药物风险因素有了很多了解。尽管对于特定营养因素的作用存在争议，但从整体上考虑饮食模式似乎有助于制定相关建议。例如，几项研究表明，大量摄入红肉和加工肉类、高度精制的谷物和淀粉以及糖类与结直肠癌风险增加有关。用家禽、鱼类和植物来源作为蛋白质的主要来源，不饱和脂肪作为脂肪的主要来源，以及未精制的谷物、豆类和水果作为碳水化合物的主要来源来替代这些因素，可能会降低结直肠癌的风险。尽管包括维生素D、叶酸和维生素B6在内的补充剂的作用仍不确定，但钙补充剂可能至少有一定的益处。在生活方式方面，有力的证据表明，避免吸烟和大量饮酒、防止体重增加以及保持合理的身体活动水平与结直肠癌风险显著降低有关。阿司匹林和非甾体抗炎药等药物以及女性绝经后使用的激素与结直肠癌风险显著降低有关，尽管它们的效用受到相关风险的影响。综上所述，饮食和生活方式的改变应大幅降低结直肠癌的风险，并可在降低结直肠癌发病率方面对筛查起到补充作用。
Colorectal cancer has been strongly associated with a Western lifestyle. In the past several decades, much has been learned about the dietary, lifestyle, and medication risk factors for this malignancy. Although there is controversy about the role of specific nutritional factors, consideration of the dietary pattern as a whole appears useful for formulating recommendations. For example, several studies have shown that high intake of red and processed meats, highly refined grains and starches, and sugars is related to increased risk of colorectal cancer. Replacing these factors with poultry, fish, and plant sources as the primary source of protein; unsaturated fats as the primary source of fat; and unrefined grains, legumes and fruits as the primary source of carbohydrates is likely to lower risk of colorectal cancer. Although a role for supplements, including vitamin D, folate, and vitamin B6, remains uncertain, calcium supplementation is likely to be at least modestly beneficial. With respect to lifestyle, compelling evidence indicates that avoidance of smoking and heavy alcohol use, prevention of weight gain, and the maintenance of a reasonable level of physical activity are associated with markedly lower risks of colorectal cancer. Medications such as aspirin and non-steroidal anti-inflammatory drugs and post-menopausal hormones for women are associated with significant reductions in colorectal cancer risk, though their utility is affected by associated risks. Taken together, modifications in diet and lifestyle should substantially reduce the risk of colorectal cancer and could complement screening in reducing colorectal cancer incidence.
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影响因子：
158.5
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