【摘要】 目的 通过系统检索和归纳现有有关前瞻性研究的文献，探讨早发性结直肠癌(EOCRC)的危险因素及其保护因素。方法 以“early-onset colorectal cancer、risk factors、prospective study、cohort study、nested case-control study、case-cohort study”为英文关键词，以“早发性结直肠癌、危险因素、前瞻性研究、队列研究、巢式病例对照研究、病例-队列研究”为中文关键词，检索PubMed、Web of Science、Embase及中国知网数据库截至2024年6月发表的相关文献。排除回顾性研究后，最终纳入12篇文献进行分析。结果 研究显示，重度吸烟、定期饮酒、含糖饮料和鱼的较高摄入量可能是EOCRC的危险因素，而较高的维生素D和钙的摄入可能有助于降低该风险。具有一级亲属结直肠癌病史的人群发生EOCRC的风险显著增加。肥胖、炎症性肠病、自身免疫疾病、代谢综合征和糖尿病均与EOCRC风险升高有关。基于特定部位的筛查风险评估模型可以更精确地识别高危人群，但需更多病因学研究来优化筛查策略。结论 通过改善生活方式和合理膳食等措施，有望有效降低EOCRC的发生率。这些措施有助于识别和管理高危人群，为构建更加完善的结直肠癌防控体系奠定基础。更多还原

【Abstract】 Objective To review the risk and protective factors for early-onset colorectal cancer(EOCRC) by systematically searching and summarizing the existing prospective literature. Methods Using the keywords of "early-onset colorectal cancer, risk factors, prospective study, cohort study, nested case-control study, case-cohort study", we searched relevant literature in the PubMed, Web of Science, Embase and CNKI databases up to June 2024. After excluding retrospective studies, a total of 12 articles were included in the study. Results The results indicate that heavy smoking, regular alcohol consumption, sugar-sweetened beverages and a higher intake of fish may be risk factors for EOCRC, whereas higher intakes of vitamins D and calcium may be protective. People with a history of colorectal cancer in a first-degree relative have a significantly increased risk of EOCRC. Obesity, inflammatory bowel disease, autoimmune disease, metabolic syndrome, and diabetes are all associated with an increased risk of EOCRC. Site-specific screening risk assessment models can more accurately identify high-risk populations, but further etiological studies are needed to optimize screening strategies. Conclusion Improving lifestyle and rational diet could effectively reduce the incidence of EOCRC, which can help identify and manage high-risk groups and lay the foundation for prevention of EOCRC.更多还原