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Favorable lifestyle before diagnosis associated with lower risk of screen-detected advanced colorectal neoplasia

World Journal of Gastroenterology 2016年第27期22卷 6276-6286页

作者： Markus D Knudsen Thomas de Lange Edoardo Botteri Dung-Hong Nguyen helge evensen Chloé B Steen Geir Hoff Tomm Bernklev Anette Hjartaker Paula Berstad Department of bowel cancer screening Cancer Registry of Norway Majorstuen 0304 Oslo Norway Department of Research and Development Telemark Hospital 3710 Skien Norway Department of Nutrition Institute of Basic Medical Sciences University of Oslo 0317 Oslo Norway Department of Medicine aerum Hospital Vestre Viken Hospital Trust 3004 Drammen Norway Division of Epidemiology and Biostatistics European Institute of Oncology 20141 Milan Italy Department of Gastroenterology фstfold Hospital Trust 1714 Gralum Norway Department of Health Management and Health Economics Institute of Health and Society University of Oslo 0317 Oslo Norway Institute of Clinical Medicine University of Oslo Blindern P.O. Box 1171 0318 Oslo Norway

AIM: To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia(ACN) in colorectal cancer(CRC) ***: A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero(poorest) to six(best). Odds ratios(ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ***: In all 6315 women and men completed the lifestyle questionnaire, 3323(53%) in the FIT arm and 2992(47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311(5%) participants of which 25(8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs(95%CI) for the probability of ACN detection were 0.82(0.45-1.16), 0.43(0.28-0.73), 0.41(0.23-0.64), and 0.41(0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53(0.42-0.68) and 0.63(0.43-0.93) ***: Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening.

关键词： Screening Colorectal neoplasia Lifestyle Prevention Health recommendations

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