大腸直腸癌之風險預測模式與風險指標

The Risk Prediction Model and Risk Index for Colorectal Cancer

劉易承(Yi-Cheng Liu) ； 宋鴻樟(Fung-Chang Sung) ； 謝玲玲(Ling-Ling Hsieh) ； 唐瑞平(Rei-Ping Tang) ； 葉志清(Chih-Ching Yeh)

《台灣公共衛生雜誌》 27卷1期 (2008/02) Pp. 1-12

https://doi.org/10.6288/TJPH2008-27-01-01

摘要

目標：國外早已有許多健康風險預測模式的研究，在台灣則不多見。大腸直腸癌（簡稱大腸癌）為台灣地區癌症十大死因的第三位，有必要建立一個預測模式或指標，以為預防大腸癌的參考。方法：本研究藉由病例對照研究(Case-control study)探討有關大腸癌的危險因子，利用多變項邏輯斯迴歸(multivariate logistic regression)建立風險預測模式，進一步將其個別危險因子的危險對比值(odds ratio, OR)轉換為風險值(risk points)，藉由加總每一個危險因子的風險值，便可求得總風險值，最後將指標分成七個風險等級。結果：在此風險預測模式中，男性與女性有顯著影響的變項各有10個和9個。女性除缺少飲酒變項，與男性相同的危險因子有族裔、職業、運動、咖啡、白肉、海鮮、蔬菜、水果和肉類烹煮方法等9個變項。依照各個變項的危險對比值，民眾只要加總各個危險因子的風險值就可以獲得個人的總風險值，再比對風險指標的區分，即可了解本身罹患大腸癌的風險程度。結論：本研究建立一個台灣地區民眾大腸癌的風險預測模式與風險指標，提供民眾一個簡單、方便的風險評估方法。進一步地，此風險預測模式與風險指標則需要藉由世代研究來確認其準確性。

關鍵字

大腸直腸癌 ； 風險預測模式 ； 風險指標 ； 台灣

並列摘要

Objectives: Various prediction models or indices for cancer risk have been developed in Western countries, but no such instruments are available in Taiwan. Colorectal cancer is the third leading cause of cancer deaths in Taiwan, thus it is essential to establish a prediction model or risk index for the prevention of colorectal cancer. Methods: The risk prediction model was established by a case-control study using multivariate logistic regression. Individual odds ratios (OR) for each risk factor were transformed into a risk point. An overall risk point was calculated as an index by summing all risk points for the related risk factors. The risk index was divided into seven categories according to the distribution of the total risk points. Results: In the risk prediction models, ten and nine significant risk factors were identified for males and females, respectively. With the exception of alcohol consumption in females, nine risk factors were identical in both genders, including race. occupation, physical activity, coffee intake, and the consumption of white meat, seafood, vegetables, and fruits, and the method of cooking of meat. After checking the strata for the selected risk factors, individuals can acquire their total risk points using the sum of the risk points for each risk factor. Referring to tire level of tire risk index by matched total risk points, individuals can recognize their risk level for the development of colorectal cancer. Conclusions: This study has established a risk prediction model and risk index for colorectal cancer in Taiwan. It is a simple and convenient method to assess colorectal cancer risk for the population in Taiwan. A prospective cohort study. however, is needed to help validate the accuracy of this risk prediction model and risk index.

並列關鍵字

colorectal cancer ； risk prediction model ； risk index ； Taiwan

參考文獻

Ahmed FE(2004).Effect of diet, life style, and other environmental/chemopreventive factors on colorectal cancer development, and assessment of the risks.J Environ Sci Health C Environ Carcinog Ecotoxicol Rev.22,91-147.

Butler LM,Sinha R,Millikan RC(2003).Heterocyclic amines, meat intake, and association with colon cancer in a population-based study.Am J Epidemiol.157,434-445.

Colditz GA,Atmood KA,Emmons K(2000).Harvard report on cancer prevention volume 4: Harvard Cancer Risk Index.Rink Index. Working Group, Harvard Center for Cancer Prevention Cancer Causes Control.11,477-488.

Coleman MP,Esteve J,Damiecki P,Arsian A,Renard H.(1993).Trends in cancer incidence and mortality.IARC Set Publ.121,1-806.

Costantino JP,Gail MH,Pee D(1999).Validation studies for models projecting the risk of invasive and total breast cancer incidence.J Natl Cancer Inst.91,1541-1548.