A Case-control Study On Risk Factors Of Colorectal Cancer Under Bio-psycho-social Medical Model

objeetive : To explore the risk factors of colorectal cancer under the bio-psycho-social medical model,and to understand the effects of biological factors,social factors and psychological factors on the occurrence and development of colorectal cancer,and so as to provide scientific evidence for the prevention of colorectal cancer.Methods:A case-control study was conducted to select 70 patients with colorectal cancer from Tianyou Hospital,Wuchang Hospital and Wuhan General Hospital of the Chinese peopleundefineds Liberation Army(PLA)as the case group,and 215 healthy subjects with similar sex and age were selected as the control group.Using the self-made questionnaire on risk factors of Colorectal Cancer and Yang tingzhong's version of perceived stress scale,a one-to-one questionnaire survey was conducted to investigate and analyze the social factors(general conditions,lifestyle habits,diet and physical exercise),biological factors(previous disease history and family history),and psychological factors(history of mental stimulation,life stress and psychological stress)in the study.Descriptive statistical analysis,chi-square test,t-test and conditional logisitic regression were used to analyze the risk factors of colorectal cancer.Result: 1.In the case group of 70 subjects,the incidence of colon cancer and rectal cancer was 1:1.12,and the ratio of male to female was 1.59:1.2.Social factors and colorectal cancer : 1)The patients in the case group and the control group were matched equally in age and gender,and there were significant differences in marital status and education level(P<0.05).The risk of colorectal cancer increased in the divorced and widowed people and those with junior middle school education or below.In terms of economic income,there was no significant difference in average annual income between the two groups(P>0.05).In terms of body mass index,there were significant differences between the two groups(P<0.05),and the risk of colorectal cancer of obese subjects was 6.122 times that of non-obese subjects(OR=6.122,95%CI: 3.146-11.915).2)Smoking and alcohol consumption were risk factors for colorectal cancer and are proportional to the amount of daily smoking and drinking time.The OR of smoking was 3.857(95%CI:2.125-7.000),for 10-20 cigarettes smoking per day the OR was 4.500(95% CI: 2.216-9.136),the OR of smoking above 20 cigarettes per day was 15.750(95% CI: 3.153-78.667).The OR of drinking was 2.574(95%CI:1.465-4.521),the OR of drinking time among 10 and 20 years was 3.197(95%CI:1.397-7.315),and the OR of drinking above 20 years was 5.575(95%CI:2.495-12.456).The difference was statistically significant(P < 0.05).3)Single-factor conditional logisitic regression analysis of dietary status about the two groups showed that: greasy diet(OR = 3.563,95% CI: 1.626-7.805),spicy diet(OR = 3.748,95% CI: 1.633-8.606),bacon(OR = 26.554,95% CI: 1.838-6.386),pickles(OR = 79.500,95% CI: 17.043-370.849),salted fish and meat(OR = 14.763,95%CI: 5.127-45.512)were risk factors for colorectal cancer,while fruit(OR = 0.177,95% CI: 0.67-0.68)was the protective factor for colorectal cancer,with statistically significant differences(P<0.05).There was no significant difference in dietary temperature,intake of vegetables,red meat and poultry between the two groups(P > 0.05).There was significant difference in physical exercise between the two groups(P < 0.05).Regular exercise was a protective factor for colorectal cancer.3.Biological factors and colorectal cancer : History of intestinal polyps(OR=4.667,95%CI: 1.432-15.212),history of chronic diarrhea(OR=19.810,95%CI: 8.118-48.342),History of chronic constipation(OR=3.426,95%CI: 1.838-6.386),history of mucinous blood stool(OR=13.061,95%CI: 6.785-25.141),history of chronic colorectal inflammation(OR=7.000,95%CI: 2.304-21.266),history of hemorrhoids(OR=2.556,95%CI: 1.450-4.505),history of helicobacter pylori infection(OR=3.589,95%CI: 1.616-7.971),history of chronic hepatitis(OR=5.540,95%CI: 2.057-14.920),history of chronic cholecystitis OR cholecystectomy(OR=13.175,95%CI: 3.559-48.770)and cancer history of first-degree relatives(OR=6.659,95%CI: 3.118-14.223)were risk factors for colorectal cancer,and the differences were statistically significant(P<0.05).There was no significant difference in the use of aspirin or non-steroidal anti-inflammatory drugs,metformin and female contraceptives between the two groups(P>0.05).4.Psychological factors and colorectal cancer : There was statistically a significant difference in life stress and mental stimulation between the two groups in the last 10 years(P < 0.05),and the risk of colorectal cancer was increased in those who had experienced mental stimulation and frequently felt stress.The tension score,loss of control score and total score of the case group were higher than the control group(P < 0.05).In the case group,The tension score,loss of control score and total score of the younger patients were higher than the olders(P<0.05).According to the CPSS score,we found that there was a significant difference in the stress between the two groups.The greater the stress,the greater the risk of colorectal cancer(P<0.05).There was no significant difference in the stress scores between colon cancer patients and rectal cancer patients in the case group(P>0.05).Conclusion:This case-control study showed that the occurrence of colorectal cancer is the result of a combination of biological,social and psychological factors.Therefore,we can effectively prevent the occurrence of colorectal cancer from cultivating a healthy lifestyle,getting rid of bad habits,exercising more regularly,performing regular physical examinations,Staying optimistic,regulating and releasing psychological pressure and timely excreting bad emotions.