南阳地区居民生活方式与结直肠癌相关因素分析

Analysis of the related factors between lifestyle and colorectal cancer in Nanyang area

目的探讨饮食习惯、生活方式与结直肠癌的相关性,为南阳地区结直肠癌制定病因阻断和预防措施提供一定的科学依据。方法选取2013-06-01-2018-06-01南阳医学高等专科学校第一附属医院(248例)、第二附属医院(75例)及第三附属医院(33例)行根治性手术的356例结直肠癌患者为病例组,按照与病例组年龄相差≤3岁、相同性别1∶1匹配的原则,选择同期在南阳医学高等专科学校第一附属医院体检中心体检的356名健康人群为对照组。通过条件Logistic回归分析结直肠癌生活方式等的相关因素。结果单因素分析结果显示,婚姻状况(χ2=13.62,P<0.01)、家庭人均年收入(χ2=4.27,P=0.04)、文化程度(χ2=1.80,P=0.18)、新鲜蔬菜摄入频率(χ2=31.56,P<0.01)、水果摄入频率(χ2=28.01,P<0.01)、肉类摄入频率(χ2=17.25,P<0.01)、豆制品摄入频率(χ2=26.14,P<0.01)、腌菜摄入频率(χ2=82.12,P<0.01)、体育锻炼(χ2=22.77,P<0.01)、每日静坐时间(χ2=19.74,P<0.01)和肿瘤家族史(χ2=13.10,P<0.01)与结直肠癌发生相关。多因素条件Logistic回归分析结果显示,除已婚外的其他婚姻状况(OR=1.57,95%CI为1.05~2.36,P=0.03)、家庭人均年收入≥10000元(OR=2.14,95%CI为1.35~3.42,P<0.01)、肉类摄入频率>7次/周(OR=2.28,95%CI为1.55~3.35,P<0.01)、腌菜摄入频率≥3次/周(OR=4.34,95%CI为2.98~6.33,P<0.01)、每日静坐时间≥8h(OR=3.52,95%CI为1.77~7.03,P<0.01)和肿瘤家族史(OR=5.33,95%CI为2.39~11.86,P<0.01)为结直肠癌的危险因素;新鲜蔬菜摄入频率>7次/周(OR=0.35,95%CI为0.23~0.53,P<0.01)、水果摄入频率≥3次/周(OR=0.58,95%CI为0.38~0.90,P=0.02)、豆制品摄入频率≥3次/周(OR=0.33,95%CI为0.22~0.48,P<0.01)和经常饮茶(OR=0.39,95%CI为0.27~0.58,P<0.01)为结直肠癌的保护因素。结论南阳地区结直肠癌的患病可能与饮食习惯和生活方式等因素有关,应针对地区全人群、高危人群积极开展健康教育,并提倡全人群平衡膳食和增加体育锻炼预防结直肠癌的发病。

OBJECTIVE To explore the relationship between dietary habits,lifestyle and colorectal cancer,and to provide a scientific basis for the prevention of colorectal cancer in Nanyang area.METHODS A total of 356 patients with colorectal cancer who underwent radical surgery in the First Affiliated Hospital,the Second Affiliated Hospital and the Third Affiliated Hospital of Nanyang Medical College from June 1,2013 to June 1,2018 were selected as the case group.According to the principle of age difference≤3 years and the same gender 1∶1 matching,healthy people who had physical examination in the physical examination center of the First Affiliated Hospital of Nanyang Medical College in the same period were selected as the control group.The related factors of colorectal cancer lifestyle were analyzed by conditional logistic regression.RESULTS The results of univariate analysis showed that marital status(χ~2=13.62,P<0.01),annual income per capita(χ~2=4.27,P=0.04),education level(χ~2=1.80,P=0.18),fresh vegetable intake frequency(χ~2=31.56,P<0.01),fruit intake frequency(χ~2=28.01,P<0.01),meat intake frequency(χ~2=17.25,P<0.01),soybean products intake frequency(χ~2=26.14,P<0.01),pickled vegetables intake frequency(χ~2=82.12,P<0.01),physical exercise(χ~2=22.77,P<0.01),daily sedentary time(χ~2=19.74,P<0.01)and family history of cancer(χ~2=13.10,P<0.01)were associated with colorectal cancer.The results of multivariate conditional logistic regression analysis showed that other marital status except married(OR=1.57,95%CI:1.05-2.36,P=0.03),family average annual income≥10000 yuan(OR=2.14,95%CI:1.35-3.42,P<0.01),intake frequency of meat>7 times/week(OR=2.28,95%CI:1.55-3.35,P<0.01),intake frequency of pickles≥3 times/week(OR=4.34,95%CI:2.98-6.33,P<0.01),daily sitting time≥8 h(OR=3.52,95%CI:1.77-7.03,P<0.01),and family history of tumor(OR=5.33,95%CI:2.39-11.86,P<0.01)were the risk factors of colorectal cancer.The protective factors of colorectal cancer were intake frequency of fresh vegetables>7 times/week(OR=0.35,95%CI:0.23-0.53,P<0.01),intake frequency of fruit≥3 times/week(OR=0.58,95%CI:0.38-0.90,P=0.02),intake frequency of bean products≥3 times/week(OR=0.33,95%CI:0.22-0.48,P<0.01)and the rate of drinking tea frequently(OR=0.39,95%CI:0.27-0.58,P<0.01).CONCLUSIONS The prevalence of colorectal cancer in Nanyang area may be related to dietary habits,lifestyle and other factors.Health education should be carried out for the whole population and high-risk population,and the whole population should be encouraged to balance diet and increase physical exercise to prevent the incidence of colorectal cancer.