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肉类亚型及其与结直肠癌的关联:系统评价与荟萃分析。

Meat subtypes and their association with colorectal cancer: Systematic review and meta-analysis.

作者信息

Carr Prudence R, Walter Viola, Brenner Hermann, Hoffmeister Michael

机构信息

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.

German Cancer Consortium (DKTK), Heidelberg, Germany.

出版信息

Int J Cancer. 2016 Jan 15;138(2):293-302. doi: 10.1002/ijc.29423. Epub 2015 Feb 24.

Abstract

Associations between specific red meat subtypes and risk of colorectal cancer (CRC) have been investigated in a number of epidemiological studies. However, no publication to date has summarised the overall epidemiological evidence. We conducted a systematic review and meta-analysis of prospective studies (cohort, nested case-control or case-cohort studies), which reported relative risk (RR) estimates and 95% confidence intervals (CI) for the association between intake of meat subtypes with colorectal, colon or rectal cancer or colorectal adenoma risk. PubMed and ISI Web of Science were searched up until August 1, 2014. Nineteen studies examined meat subtypes (5 beef, 5 pork, 2 lamb, 1 veal and 19 poultry) and associations with colorectal, colon or rectal cancer risk and 4 studies examined associations with adenoma risk (1 beef and 4 poultry). Comparing highest versus lowest intake, beef consumption was associated with an increased risk of CRC (RR = 1.11, 95% CI = 1.01 to 1.22) and colon cancer (RR = 1.24, 95% CI = 1.07 to 1.44), but no association was found with rectal cancer (RR = 0.95, 95% CI = 0.78 to 1.16). Higher consumption of lamb was also associated with increased risk of CRC (RR = 1.24, 95% CI = 1.08 to 1.44). No association was observed for pork (RR = 1.07, 95% CI = 0.90 to 1.27), but some between study heterogeneity was observed. No association was observed for poultry consumption and risk of colorectal adenomas or cancer. This meta-analysis suggests that red meat subtypes differ in their association with CRC and its sub sites. Further analysis of data from prospective cohort studies is warranted, especially regarding the role of pork.

摘要

一些流行病学研究探讨了特定红肉亚型与结直肠癌(CRC)风险之间的关联。然而,迄今为止尚无出版物总结整体流行病学证据。我们对前瞻性研究(队列研究、巢式病例对照研究或病例队列研究)进行了系统评价和荟萃分析,这些研究报告了肉类亚型摄入量与结直肠癌、结肠癌或直肠癌风险或结直肠腺瘤风险之间关联的相对风险(RR)估计值和95%置信区间(CI)。截至2014年8月1日,检索了PubMed和科学引文索引数据库。19项研究考察了肉类亚型(5项牛肉、5项猪肉、2项羊肉、1项小牛肉和19项家禽)与结直肠癌、结肠癌或直肠癌风险的关联,4项研究考察了与腺瘤风险的关联(1项牛肉和4项家禽)。比较最高摄入量与最低摄入量,牛肉消费与CRC风险增加(RR = 1.11,95% CI = 1.01至1.22)和结肠癌风险增加(RR = 1.24,95% CI = 1.07至1.44)相关,但未发现与直肠癌有关联(RR = 0.95,95% CI = 0.78至1.16)。较高的羊肉消费量也与CRC风险增加相关(RR = 1.24,95% CI = 1.08至1.44)。未观察到猪肉与CRC风险有关联(RR = 1.07,95% CI = 0.90至1.27),但研究间存在一定异质性。未观察到家禽消费与结直肠腺瘤或癌症风险有关联。这项荟萃分析表明,红肉亚型与CRC及其亚部位的关联存在差异。有必要对前瞻性队列研究的数据进行进一步分析,尤其是关于猪肉的作用。

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