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Том 18, № 1, 2026 / Страницы 157-179

Факторы риска и профилактика заболеваний толстого кишечника: современные подходы и перспективы (обзор литературы)

Нурымжан Мурзагулов*Жансая ТельмановаИван ШишкинКульсара РустемоваНурбек Игисин

nmurzagulov29061995@gmail.com

Получено 18.11.2025
Доработано 16.01.2026
Принято 27.02.2026

Аннотация

Заболевания толстого кишечника продолжают вносить значительный вклад в структуру заболеваемости и смертности населения, что обусловливает их высокую медико-социальную значимость. С начала XXI века отмечается рост распространённости колоректальной патологии, а также смещение возрастной структуры пациентов в сторону более молодых групп, что усиливает актуальность анализа факторов, влияющих на развитие данных заболеваний, и подходов к их предупреждению. Целью настоящей обзорной работы было обобщение и систематизация современных научных данных о детерминантах риска и мерах снижения бремени основных заболеваний толстого кишечника. Проведён анализ 52 публикаций, включающих систематические обзоры, метаанализы, крупные когортные и рандомизированные исследования, представленные в базах PubMed, Scopus, Web of Science и Google Scholar. В обзор включены работы, опубликованные в период с 1990 по 2025 годы, при этом 53,8% источников относятся к периоду 2020-2025 годов. Анализ литературы показал, что ведущую роль в формировании заболеваний толстого кишечника играют особенности питания, избыточная масса тела, низкий уровень физической активности, курение и злоупотребление алкоголем. Существенное значение имеют нарушения состава кишечной микробиоты и хроническое воспаление, рассматриваемые как ключевые патогенетические механизмы. Эффективность снижения заболеваемости и смертности подтверждена для скрининговых стратегий, основанных на эндоскопических и неинвазивных методах, а также для отдельных медикаментозных и технологических подходов, включая системы компьютерной поддержки эндоскопии. Результаты обзора могут быть использованы при клиническом ведении пациентов, планировании программ скрининга и разработке профилактически ориентированных мероприятий в системе общественного здравоохранения

Ключевые слова

колоректальный рак; воспалительные заболевания кишечника; дивертикулярная болезнь; полипоз; образ жизни; скрининг

ЦИТИРОВАНИЕ

APA Style
Murzagulov, N., Telmanova, Zh., Shishkin, I., Rustemova, K. & Igissin, N. (2026). Risk factors and prevention of colonic diseases: Modern approaches and perspectives (literature review). Eurasian Health Journal, 18(1), 157-179. https://doi.org/10.54890/1694-8882-2026-1-157
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Vancouver Style
Murzagulov, N., Telmanova, Zh., Shishkin, I., Rustemova, K., Igissin, N.. Risk factors and prevention of colonic diseases: Modern approaches and perspectives (literature review). Eurasian Health J. 2026;18(1):157-79. https://doi.org/10.54890/1694-8882-2026-1-157
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Использованные источники

  1. Keum N, Giovannucci E. Global burden of colorectal cancer: Emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019;16(12):713–32. DOI: 10.1038/s41575-019-0189-8
  2. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683–91. DOI: 10.1136/gutjnl-2015-310912
  3. Humphrey HN, Sibley P, Walker ET, Keller DS, Pata F, Vimalachandran D, et al. Genetic, epigenetic and environmental factors in diverticular disease: Systematic review. BJS Open. 2024;8(3):zrae032. DOI: 10.1093/bjsopen/zrae032
  4. Hua H, Jiang Q, Sun P, Xu X. Risk factors for early-onset colorectal cancer: Systematic review and meta-analysis. Front Oncol. 2023;13:1132306. DOI: 10.3389/fonc.2023.1132306
  5. Feuerstein JD, Cheifetz AS. Crohn disease: Epidemiology, diagnosis, and management. Mayo Clin Proc. 2017;92(7):1088–103. DOI: 10.1016/j.mayocp.2017.04.010
  6. Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies. Lancet. 2017;390(10114):2769–78. DOI: 10.1016/s0140-6736(17)32448–0
  7. Zamani M, Alizadeh-Tabari S. Does elderly-onset inflammatory bowel disease increase risk of colorectal cancer? A systematic review and meta-analysis. J Clin Med. 2023;13(1):148. DOI: 10.3390/jcm13010148
  8. Adams SM, Close ED, Shreenath AP. Ulcerative colitis: Rapid evidence review. Am Fam Physician. 2022;105(4):406–11.
  9. Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology. 2019;156(5):1282–98.e1. DOI: 10.1053/j.gastro.2018.12.033
  10. Jacobsson M, Wagner V, Kanneganti S. Screening for colorectal cancer. Surg Clin North Am. 2024;104(3):595–607. DOI: 10.1016/j.suc.2023.11.009
  11. Monreal-Robles R, Jáquez-Quintana JO, Benavides-Salgado DE, González-González JA. Serrated polyps of the colon and rectum: a concise review. Rev Gastroenterol Mex (Engl Ed). 2021;86(3):276–86. DOI: 10.1016/j.rgmxen.2021.06.001
  12. Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366(8):687–96. DOI: 10.1056/NEJMoa1100370
  13. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. DOI: 10.3322/caac.21660
  14. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599–600. DOI: 10.1016/s1470-2045(15)00444-1
  15. Ungvari Z, Fekete M, Varga P, Lehoczki A, Munkácsy G, Fekete JT, et al. Association between red and processed meat consumption and colorectal cancer risk: A comprehensive meta-analysis of prospective studies. GeroScience. 2025;47(3):5123–40. DOI: 10.1007/s11357-025-01646-1
  16. Diet, nutrition, physical activity and colorectal cancer [Internet]. [cited 2025 November 2]. Available from: https://www.wcrf.org/wp–content/uploads/2024/10/Colorectal–cancer–report.pdf
  17. Eyl RE, Xie K, Koch-Gallenkamp L, Brenner H, Arndt V. Quality of life and physical activity in long–term (≥5 years post–diagnosis) colorectal cancer survivors – systematic review. Health Qual Life Outcomes. 2018;16(1):112. DOI: 10.1186/s12955-018–0934-7
  18. Crowe FL, Appleby PN, Allen NE, Key TJ. Diet and risk of diverticular disease in Oxford cohort of European prospective investigation into cancer and nutrition (EPIC): Prospective study of British vegetarians and non-vegetarians. BMJ. 2011;343:d4131. DOI: 10.1136/bmj.d4131
  19. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet. 2014;384(9945):755–65. DOI: 10.1016/s0140-6736(14)60892-8
  20. Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis. Cell. 1990;61(5):759–67. DOI: 10.1016/0092-8674(90)90186-i
  21. Nguyen LH, Goel A, Chung DC. Pathways of colorectal carcinogenesis. Gastroenterology. 2020;158(2):291–302. DOI: 10.1053/j.gastro.2019.08.059
  22. Ogura Y, Bonen DK, Inohara N, Nicolae DL, Chen FF, Ramos R, et al. A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease. Nature. 2001;411(6837):603–6. DOI: 10.1038/35079114
  23. Baretti M, Le DT. DNA mismatch repair in cancer. Pharmacol Ther. 2018;189:45–62. DOI: 10.1016/j.pharmthera.2018.04.004
  24. Kostic AD, Gevers D, Pedamallu CS, Michaud M, Duke F, Earl AM, et al. Genomic analysis identifies association of Fusobacterium with colorectal carcinoma. Genome Res. 2012;22(2):292–8. DOI: 10.1101/gr.126573.111
  25. Louis P, Flint HJ. Formation of propionate and butyrate by the human colonic microbiota. Environ Microbiol. 2017;19(1):29–41. DOI: 10.1111/1462-2920.13589
  26. Arayici ME, Mert-Ozupek N, Yalcin F, Basbinar Y, Ellidokuz H. Soluble and insoluble dietary fiber consumption and colorectal cancer risk: A systematic review and meta-analysis. Nutr Cancer. 2022;74(7):2412–25. DOI: 10.1080/01635581.2021.2008990
  27. Simillis C, Taylor B, Ahmad A, Lal N, Afxentiou T, Powar MP, et al. A systematic review and meta–analysis assessing the impact of body mass index on long-term survival outcomes after surgery for colorectal cancer. Eur J Cancer. 2022;172:237–51. DOI: 10.1016/j.ejca.2022.05.020
  28. Gagnière J, Raisch J, Veziant J, Barnich N, Bonnet R, Buc E, et al. Gut microbiota imbalance and colorectal cancer. World J Gastroenterol. 2016;22(2):501–18. DOI: 10.3748/wjg.v22.i2.501
  29. Garrett WS. Cancer and the microbiota. Science. 2015;348(6230):80–6. DOI: 10.1126/science.aaa4972
  30. Tabowei G, Gaddipati GN, Mukhtar M, Alzubaidee MJ, Dwarampudi RS, Mathew S, et al. Microbiota dysbiosis a cause of colorectal cancer or not? A systematic review. Cureus. 2022;14(10):e30893. DOI: 10.7759/cureus.30893
  31. Avuthu N, Guda C. Meta-analysis of altered gut microbiota reveals microbial and metabolic biomarkers for colorectal cancer. Microbiol Spectr. 2022;10(4):e0001322. DOI: 10.1128/spectrum.00013-22
  32. Gethings-Behncke C, Coleman HG, Jordao HWT, LongleyDB, Crawford N, Murray LJ, et al. Fusobacterium nucleatum in the colorectum and its association with cancer risk and survival: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2020;29(3):539–48. DOI: 10.1158/1055–9965.Epi-18-1295
  33. Costello SP, Hughes PA, Waters O, Bryant RV, Vincent AD, Blatchford P, et al. Effect of fecal microbiota transplantation on 8-week remission in patients with ulcerative colitis: A randomized clinical trial. Jama. 2019;321(2):156–64. DOI: 10.1001/jama.2018.20046
  34. Zhang XF, Guan XX, Tang YJ, Sun JF, Wang XK, Wang WD, et al. Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: A systematic review and meta-analysis. Eur J Nutr. 2021;60(5):2855–75. DOI: 10.1007/s00394-021-02503-5
  35. Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Am J Gastroenterol. 2017;112(7):1016–30. DOI: 10.1038/ajg.2017.174
  36. Coughlin SS. Social determinants of colorectal cancer risk, stage, and survival: A systematic review. Int J Colorectal Dis. 2020;35(6):985–95. DOI: 10.1007/s00384-020-03585-z
  37. Hull MA. Nutritional prevention of colorectal cancer. Proc Nutr Soc. 2021;80(1):59–64. DOI: 10.1017/s0029665120000051
  38. Holme Ø, Løberg M, Kalager M, Bretthauer M, Hernán MA, Aas E, et al. Effect of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality: a randomized clinical trial. Jama. 2014;312(6):606–15. DOI: 10.1001/jama.2014.8266
  39. Drew DA, Chan AT. Aspirin in the prevention of colorectal neoplasia. Annu Rev Med. 2021;72:415–30. DOI: 10.1146/annurev-med-060319-120913
  40. Chia JWK, Segelov E, Deng Y, Ho GF, Wang W, Han S, et al. Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): an international, multicentre, phase 3, randomised, double-blind, placebo-controlled trial. Lancet Gastroenterol Hepatol. 2025;10(3):198–209. DOI: 10.1016/S2468-1253(24)00387-X
  41. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370(14):1287–97. DOI: 10.1056/NEJMoa1311194
  42. Kasapoglu M, Yadavalli R, Nawaz S, Althwanay A, AlEdani EM, Kaur H, et al. The Impact of microbiome interventions on the progression and severity of inflammatory bowel disease: A systematic review. Cureus. 2024;16(5):e60786. DOI: 10.7759/cureus.60786
  43. Wang P, Berzin TM, Glissen Brown JR, Bharadwaj S, Becq A, Xiao X, et al. Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: A prospective randomised controlled study. Gut. 2019;68(10):1813–9. DOI: 10.1136/gutjnl-2018-317500
  44. Sánchez-Peralta LF, Bote-Curiel L, Picón A, Sánchez-Margallo FM, Pagador JB. Deep learning to find colorectal polyps in colonoscopy: A systematic literature review. Artif Intell Med. 2020;108:101923. DOI: 10.1016/j.artmed.2020.101923
  45. Singh B, Hayes SC, Spence RR, Steele ML, Millet GY, Gergele L. Exercise and colorectal cancer: Asystematic review and meta-analysis of exercise safety, feasibility and effectiveness. Int J Behav Nutr Phys Act. 2020;17(1):122. DOI: 10.1186/s12966-020-01021-7
  46. Gachabayov M, Lebovics E, Rojas A, Felsenreich DM, Latifi R, Bergamaschi R. Performance evaluation of stool DNA methylation tests in colorectal cancer screening: a systematic review and meta-analysis. Colorectal Dis. 2021;23(5):1030–42. DOI: 10.1111/codi.15521
  47. Caldera F, Kane S, Long M, Hashash JG. AGA Clinical practice update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease: Expert review. Clin Gastroenterol Hepatol. 2025;23(5):695–706. DOI: 10.1016/j.cgh.2024.12.011
  48. Cole BF, Logan RF, Halabi S, Benamouzig R, Sandler RS, Grainge MJ, et al. Aspirin for the chemoprevention of colorectal adenomas: Meta-analysis of the randomized trials. JNCI. 2009;101(4):256–66. DOI: 10.1093/jnci/djn485
  49. Sardari A, Usefi H. Machine learning-based meta-analysis of colorectal cancer and inflammatory bowel disease. PloS One. 2023;18(12):e0290192. DOI: 10.1371/journal.pone.0290192
  50. Sulbaran M, Bustamante-Lopez L, Bernardo W, Sakai CM, Sakai P, Nahas S, et al. Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic? J Med Screen. 2022;29(3):148–55. DOI: 10.1177/09691413221074803
  51. Hassan C, Spadaccini M, Iannone A, Maselli R, Jovani M, Chandrasekar VT, et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: A systematic review and meta-analysis. Gastrointest Endosc. 2021;93(1):77–85.e6. DOI: 10.1016/j.gie.2020.06.059
  52. Huang D, Shen J, Hong J, Zhang Y, Dai S, Du N, et al. Effect of artificial intelligence–aided colonoscopy for adenoma and polyp detection: A meta-analysis of randomized clinical trials. Int J Colorectal Dis. 2022;37(3):495–506. DOI: 10.1007/s00384-021-04062-x