Chronic Constipation as a Risk Factor for Colorectal Cancer: Results From a Nationwide, Case-Control Study.
Chronic Constipation as a Risk Factor for Colorectal Cancer: Results From a Nationwide, Case-Control Study.
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DOI：
10.1016/j.cgh.2021.10.024
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发表时间：
2022-08
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--
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结肠通过时间延长可能会增加粪便中潜在致癌物与结肠粘膜之间的接触时间。尽管如此，以前的研究得出了相互矛盾的结果，将慢性便秘与CRC的风险联系起来。我们研究了慢性便秘和后来的CRC之间的关系。在这项全国性的病例对照研究中，我们在2007年7月至2016年12月期间在瑞典通过结直肠活检确定了41，299例CRC病例，并将其与来自普通人群的203，181例年龄和性别匹配的对照进行了匹配。我们使用logistic回归分析比较了CRC病例和对照组之间早期慢性便秘（定义为处方药注册表中≥2次泻药处方，首末次处方之间≥6个月）的几率。在单独的分析中，我们比较了CRC病例和同胞对照者之间早期便秘的几率，但也检查了在CRC之前有慢性便秘住院/门诊专科诊断的早期风险。总体而言，3，943例CRC患者在CRC之前符合我们的慢性便秘标准。CRC患者中慢性便秘的粗比例为9.5%，而对照组为8.8%。多变量校正后，慢性便秘与晚期结直肠癌之间存在中度相关性（OR=1.10，95%CI =1.06-1.14），使用同胞对照品控制剩余混杂因素后，这种相关性消失（OR=1.04，95%CI =0.97-1.13）。在对1989-2016年诊断的126，650名CRC患者进行的敏感性分析中，我们发现与住院/门诊专科诊所诊断的早期慢性便秘无关（OR=0.88，95% CI=0.75-1.04）。在一项全国性的病例对照研究中，慢性便秘与晚期CRC无关。
Prolonged colon transit times may increase contact time between potential carcinogens in the stool and the colonic mucosa. Nonetheless, previous studies have yielded conflicting results connecting chronic constipation with risk of CRC. We examined the association between chronic constipation and later CRC. In this nationwide case-control study, we identified 41,299 CRC cases by colorectal biopsy in Sweden between July 2007 and December 2016 and matched them to 203,181 age- and sex-matched controls from the general population. We compared odds of earlier chronic constipation (defined as ≥2 laxative prescriptions in the Prescribed Drug Register with ≥6 months between first-last prescription) between CRC cases and controls using logistic regression. In separate analyses, we compared odds of earlier constipation between CRC cases and sibling comparators, but also examined earlier risk of having an inpatient/outpatient specialty diagnosis of chronic constipation prior to CRC. Overall, 3,943 patients with CRC met our criteria for chronic constipation prior to CRC. The crude proportion of chronic constipation in CRC patients was 9.5% compared to 8.8% in controls. After multivariable adjustment, there was a modest association between chronic constipation and later CRC (OR=1.10, 95% CI=1.06–1.14) that vanished using sibling comparators to control for residual confounding (OR=1.04, 95% CI=0.97–1.13). In a sensitivity analysis of 126,650 CRC patients diagnosed 1989–2016, we found no association with earlier chronic constipation diagnosed in inpatient/outpatient specialty clinics (OR=0.88, 95% CI=0.75–1.04). In a nationwide case-control study, chronic constipation was not associated with later CRC.
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影响因子：
6.2
作者：
Doubeni CA;Laiyemo AO;Major JM;Schootman M;Lian M;Park Y;Graubard BI;Hollenbeck AR;Sinha R
通讯作者：
Sinha R
影响因子：
3.8
作者：
McQueen, A;Vernon, SW;Rakowski, W
通讯作者：
Rakowski, W
影响因子：
29.4
作者：
CUMMINGS, JH;BINGHAM, SA;EASTWOOD, MA
通讯作者：
EASTWOOD, MA
影响因子：
3.9
作者：
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通讯作者：
Lashkariani, Mariam
影响因子：
3.9
作者：
KUNE, GA;KUNE, S;WATSON, LF
通讯作者：
WATSON, LF