Active Lifestyle Patterns Reduce the Risk of Colorectal Cancer in the North of Vietnam: A Hospital-Based Case-Control Study.
Quang La Ngoc,Hien Nguyen Quang,Quang Nguyen Tien,Chung Nguyen Thanh
Cancer control : journal of the Moffitt Cancer Center
A hospital-based, case-control study was conducted to investigate the association between lifestyle patterns and risk of colorectal cancer (CRC) in the north of Vietnam. Demographic factors employed for the models were age, sex, marital status, occupation, education, income, smoking status, alcohol consumption, vegetable consumption, tea, coffee consumption, and physical activity (PA). Individuals of both groups (n = 154 for the control group and n = 136 for the CRC group) were interviewed using a questionnaire by trained interviewers. The findings showed that moderate PA was inversely associated with CRC risk: odds ratio (OR) = 0.19, 95% confidence interval (CI) = 0.10 to 0.36 with < .01. The total PA showed that the highest tertile (>2.7 MET-h/d) was associated with the reduced risk of CRC compared with the lowest tertile one after controlling for confounding factors: adjusted OR = 0.25, 95% CI = 0.09 to 0.74, < .01. Sedentary time was associated with an increased level of CRC risk by 57% as compared between the highest tertile and the lowest one after controlling for confounding factors. Daily consumption of vegetables and 1 to 3 cups of tea per day or more were also associated with decreased risk of CRC. Despite promising findings, a limitation of this research is that it did not establish a temporal relationship between risk factors and CRC due to its retrospective design. However, this is the first analytic study highlighting the role of the active lifestyle pattern associated with reduced CRC risk in Vietnamese adults.
10.1177/1073274819864666
The relationship between drinking alcohol and esophageal, gastric or colorectal cancer: A nationwide population-based cohort study of South Korea.
PloS one
BACKGROUND:Epidemiologic findings of low-volume alcohol consumption in relation to gastrointestinal cancers including gastric cancer are inconsistent. METHODS:The association between alcohol intake and esophageal, gastric and colorectal cancer risk was examined in a population-based prospective cohort of 23,323,730 adults in Korea who had undergone a biennial evaluation provided by the National Health Insurance Corporation between the years 2009 and 2012. After median 5.4 years of follow-up, 9,171 esophageal, 135,382 gastric and 154,970 colorectal cancer cases were identified. Cox regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). RESULTS:Light drinking as well as moderate to heavy alcohol consumption significantly increased the risks of the three gastrointestinal cancers (HR 1.51; 95% CI, 1.43-1.60; HR 1.08; 95% CI, 1.06-1.09; HR 1.12; 95% CI, 1.11-1.14) compared with non-drinkers after adjusting for age, sex, smoking, exercise, income, body mass index, and diabetes. The synergistically increased cancer risk between excessive amount of alcohol consumption and currently smoking or underweight individuals was observed only in the esophageal cancers. CONCLUSIONS:Light drinking including even one alcoholic drink a day is associated with increased risks of esophageal, gastric and colorectal cancer.
10.1371/journal.pone.0185778
BMI Is a Risk Factor for Colorectal Cancer Mortality.
Shaukat Aasma,Dostal Allison,Menk Jeremiah,Church Timothy R
Digestive diseases and sciences
BACKGROUND:The relationship between dietary and lifestyle risk factors and long-term mortality from colorectal cancer is poorly understood. Several factors, such as obesity, intakes of red meat, and use of aspirin, have been reported to be associated with risk of colorectal cancer mortality, though these findings have not been replicated in all studies to date. METHODS:In the Minnesota Colon Cancer Control Study, 46,551 participants 50-80 years old were randomly assigned to usual care (control) or annual or biennial screening by fecal occult blood testing. Colon cancer mortality was assessed after 30 years of follow-up. Dietary intake and lifestyle risk factors were assessed by questionnaire at baseline. RESULTS:Age [hazard ratio (HR) 1.09; 95% CI 1.07, -1.11], male sex (HR 1.25; 95% CI 1.01, 1.57), and higher body mass index (BMI) (HR 1.03; 95% CI 1.00-1.05) increased the risk of CRC mortality, while undergoing screening for CRC was associated with a reduced risk of colorectal cancer mortality (HR 0.76; 95% CI 0.61-0.94 and 0.67; 95% CI 0.53-0.83 for biennial and annual screening, respectively). Intakes of grains, meats, proteins, coffee, alcohol, aspirin, fiber, fruits, and vegetables were not associated with colorectal cancer mortality. CONCLUSIONS:Our study confirms the relationship between BMI and long-term colorectal cancer mortality. Modulation of BMI may reduce risk of CRC mortality.
10.1007/s10620-017-4682-z
Chronological Age and Risk of Chemotherapy Nonfeasibility: A Real-Life Cohort Study of 153 Stage II or III Colorectal Cancer Patients Given Adjuvant-modified FOLFOX6.
Laurent Marie,Des Guetz Gaétan,Bastuji-Garin Sylvie,Culine Stéphane,Caillet Philippe,Aparicio Thomas,Audureau Etienne,Carvahlo-Verlinde Muriel,Reinald Nicoleta,Tournigand Christophe,Landre Thierry,LeThuaut Aurélie,Paillaud Elena,Canouï-Poitrine Florence
American journal of clinical oncology
OBJECTIVES:To assess nonfeasibility of adjuvant-modified FOLFOX6 chemotherapy in patients with stage II or III colorectal cancer. METHODS:Consecutive patients managed between 2009 and 2013 in 2 teaching hospitals in the Paris urban area were included in the CORSAGE (COlorectal canceR, AGe, and chemotherapy fEasability study) cohort study. Nonfeasibility was defined by the frequencies of empirical first-cycle dose reduction (>15%), early discontinuation (<12 cycles), and low relative dose intensity (RDI) (<0.85). Risk factors for chemotherapy nonfeasibility were identified using multivariate logistic regression. RESULTS:Among 153 patients, 56.2% were male (median age, 65.6 y; 35.3%≥70 y; 7.3% with performance status [PS]≥2). For 5-fluorouracil (5-FU), 20.9% of patients had first-cycle dose reduction and 28.1% early discontinuation; RDI was 0.91 (25th to 75th percentiles, 0.68 to 0.99). Factors independently associated with first-cycle 5-FU dose reduction were aged 65 to 69 years versus those younger than 65 years (adjusted odds ratio [aOR], 5.5; 95% confidence interval [CI], 1.5-19.9) but not age 70 years and older, PS≥2 (aOR, 6.02; 95% CI, 1.15-31.4), higher Charlson Comorbidity Index (aOR1-point increase, 1.4; 95% CI, 1.05-1.82), or larger number of medications (aOR 1-medication increase, 1.19; 95% CI, 1.00-1.42). Oxaliplatin dose reduction occurred in 52.3% of patients and early discontinuation in 62.7%; the latter was more common in the 70 years and older group (92.6% vs. 74.6% in the <65-y group; P=0.01); RDI was 0.7 (95% CI, 0.55-0.88). CONCLUSIONS:In the real-world setting, compared with their younger and older counterparts, patients aged 65 to 69 years given modified FOLFOX6 for stage II or III colorectal cancer had higher frequencies of 5-FU nonfeasibility defined based on first-cycle dose reduction, early discontinuation, and RDI; and these differences were independent from PS, comorbidities, and number of medications.
10.1097/COC.0000000000000233
Relationship of prediagnostic body mass index with survival after colorectal cancer: Stage-specific associations.
Kocarnik Jonathan M,Chan Andrew T,Slattery Martha L,Potter John D,Meyerhardt Jeffrey,Phipps Amanda,Nan Hongmei,Harrison Tabitha,Rohan Thomas E,Qi Lihong,Hou Lifang,Caan Bette,Kroenke Candyce H,Strickler Howard,Hayes Richard B,Schoen Robert E,Chong Dawn Q,White Emily,Berndt Sonja I,Peters Ulrike,Newcomb Polly A
International journal of cancer
Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between prediagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I-IV) for both all-cause (p-interaction = 0.03) and CRC-specific mortality (p-interaction = 0.04). Compared to normal BMI (18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II-IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I-II disease, and decreased mortality among those with Stages III-IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.
10.1002/ijc.30163
Demand for Colonoscopy in Colorectal Cancer Screening Using a Quantitative Fecal Immunochemical Test and Age/Sex-Specific Thresholds for Test Positivity.
Chen Sam Li-Sheng,Hsu Chen-Yang,Yen Amy Ming-Fang,Young Graeme P,Chiu Sherry Yueh-Hsia,Fann Jean Ching-Yuan,Lee Yi-Chia,Chiu Han-Mo,Chiou Shu-Ti,Chen Hsiu-Hsi
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Despite age and sex differences in fecal hemoglobin (f-Hb) concentrations, most fecal immunochemical test (FIT) screening programs use population-average cut-points for test positivity. The impact of age/sex-specific threshold on FIT accuracy and colonoscopy demand for colorectal cancer screening are unknown. Using data from 723,113 participants enrolled in a Taiwanese population-based colorectal cancer screening with single FIT between 2004 and 2009, sensitivity and specificity were estimated for various f-Hb thresholds for test positivity. This included estimates based on a "universal" threshold, receiver-operating-characteristic curve-derived threshold, targeted sensitivity, targeted false-positive rate, and a colonoscopy-capacity-adjusted method integrating colonoscopy workload with and without age/sex adjustments. Optimal age/sex-specific thresholds were found to be equal to or lower than the universal 20 μg Hb/g threshold. For older males, a higher threshold (24 μg Hb/g) was identified using a 5% false-positive rate. Importantly, a nonlinear relationship was observed between sensitivity and colonoscopy workload with workload rising disproportionately to sensitivity at 16 μg Hb/g. At this "colonoscopy-capacity-adjusted" threshold, the test positivity (colonoscopy workload) was 4.67% and sensitivity was 79.5%, compared with a lower 4.0% workload and a lower 78.7% sensitivity using 20 μg Hb/g. When constrained on capacity, age/sex-adjusted estimates were generally lower. However, optimizing age/-sex-adjusted thresholds increased colonoscopy demand across models by 17% or greater compared with a universal threshold. Age/sex-specific thresholds improve FIT accuracy with modest increases in colonoscopy demand. Colonoscopy-capacity-adjusted and age/sex-specific f-Hb thresholds may be useful in optimizing individual screening programs based on detection accuracy, population characteristics, and clinical capacity. .
10.1158/1055-9965.EPI-17-0387