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Lee J, Lee J, Ahn J, Lee DW, Kim HR, Kang MY. Association of sedentary work with colon and rectal cancer: systematic review and meta-analysis. Occup Environ Med 2021; 79:277-286. [PMID: 33910983 DOI: 10.1136/oemed-2020-107253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES There has been no research on sedentary behaviour in the occupational domain that occupies a large portion of the daily life. METHODS We conducted a meta-analysis to investigate the association between sedentary work and colorectal cancer. We searched PubMed, Embase and Cochrane databases up to 12 August 2020 for peer-reviewed journal articles that assessed the association between sedentary work and colon or rectal cancer. Pooled estimates of ORs were obtained using random effects models. Statistical tests for publication bias, heterogeneity and sensitivity analysis were applied. RESULTS Of the 5 381 studies initially identified, 23 studies with 64 reports were eligible for inclusion. Sedentary work significantly increased the risk of colon cancer (pooled OR=1.21, 95% CI 1.11 to 1.31, p value ≤0.0001) and rectal cancer (pooled OR=1.08, 95% CI 1.00 to 1.16, p value=0.0395). The adjustment for leisure time physical activity attenuated the association and made the risk estimates non-significant for sedentary behaviour, but the association was independent of sex, control of body mass index and assessment of sedentary behaviour. CONCLUSIONS We found evidence of association between sedentary work and the risk of colon or rectal cancer. Limiting excessive sedentary work could be an important means of preventing colon and rectal cancer.
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Affiliation(s)
- JaeYong Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jongin Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Preventive Medicine, Occupational & Environmental Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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52
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Cillekens B, Lang M, van Mechelen W, Verhagen E, Huysmans MA, Holtermann A, van der Beek AJ, Coenen P. How does occupational physical activity influence health? An umbrella review of 23 health outcomes across 158 observational studies. Br J Sports Med 2021; 54:1474-1481. [PMID: 33239353 DOI: 10.1136/bjsports-2020-102587] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Physical activity (PA) has substantial benefits across a range of health outcomes. There is uncertainty about the PA-specific health effects, and in particular, the occupational domain. In this umbrella review, we synthesised available evidence on the associations between occupational PA (OPA) and health-related outcomes (including cancer, all-cause mortality and cardiovascular disease). This work informed the development of WHO's guidelines on PA and sedentary behaviour (2020). DESIGN Umbrella review of systematic reviews. DATA SOURCE We performed a literature search in PubMed, Web of Science, Embase, CINAHL and Sportdiscuss from database inception to 2 December 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included systematic reviews if they contained a quantitative assessment of OPA and its relationship with at least one health-related outcome. RESULTS We summarised the evidence of 17 reviews covering 23 unique health-related outcomes. We graded most evidence as low or very low, or moderate quality. We found health benefits for those engaging in high versus low OPA for multiple cancer outcomes (including colon and prostate), ischaemic stroke, coronary heart disease and mental health (ie, mental well-being and life satisfaction). High OPA was associated with unfavourable health outcomes for all-cause mortality in men, mental ill health (ie, depression and anxiety), osteoarthritis, and sleep quality and duration. CONCLUSIONS We found favourable associations for most health-related outcomes with high OPA levels, but we also found some evidence for unfavourable associations due to high OPA levels. At this point, there is a need for better quality evidence to provide a unequivocal statement on the health effects of OPA.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Matthias Lang
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Evert Verhagen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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53
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Hatime Z, El Kinany K, Huybrechts I, Gunter MJ, Khalis M, Deoula M, Boudouaya HA, Benslimane A, Nejjari C, Benider A, El Rhazi K. Extended healthy lifestyle index and colorectal cancer risk in the Moroccan population. Eur J Nutr 2021; 60:1013-1022. [PMID: 32572618 DOI: 10.1007/s00394-020-02311-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/15/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Little is known about the combined effect of different lifestyle factors on CRC incidence among populations living in developing countries. In this study, we sought to create an Extended Healthy Lifestyle Index (EHLI) and to investigate its association with CRC risk in the Moroccan population. METHODS A large case-control study including 1516 cases and 1516 controls, matched on age, sex and center were recruited in 5 Moroccan university hospital centers between 2009 and 2017. EHLI scores, including 9 modifiable factors (smoking, alcohol consumption, physical activity intensity, BMI, fruit and vegetables consumption, drinks that promote weight gain, red and processed meat, relatively unprocessed cereals and/or pulses, and dairy products consumption) were assigned to lifestyle information derived from the participants. We assessed the score based on the answers on each of the nine lifestyle components as unhealthy/un-compliant (0 point), healthy/compliant (1 point) and 0.5 for partial compliance to the recommendation. Conditional logistic regression models were used to assess the association between the EHLI and CRC risk and to estimate multivariate ORs and their 95% confidence intervals (CIs). All potential confounder variables were considered. RESULTS After adjusting for potential confounding factors, a significant decrease in the risk of overall CRC was observed when comparing the highest EHLI category with the lowest index category (0.39, 95% CI: 0.33-0.47). These results did not differ by colon or rectum subsite. CONCLUSION Combined healthy lifestyle factors are associated with a significantly lower incidence of CRC in Moroccan populations. Prevention strategies should consider targeting of multiple lifestyle factors.
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Affiliation(s)
- Zineb Hatime
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Khaoula El Kinany
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Inge Huybrechts
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Mohamed Khalis
- School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Meimouna Deoula
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hanae Abir Boudouaya
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Abdelilah Benslimane
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Chakib Nejjari
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Abdellatif Benider
- Department of Medical Oncology, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Karima El Rhazi
- Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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54
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Sex hormones, SHBG and risk of colon and rectal cancer among men and women in the UK Biobank. Cancer Epidemiol 2020; 69:101831. [DOI: 10.1016/j.canep.2020.101831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
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55
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Kim J, Park EY, Park E, Lim MK, Oh JK, Kim B. Metabolic Syndrome and Colorectal Cancer Risk: Results of Propensity Score-Based Analyses in a Community-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228687. [PMID: 33238496 PMCID: PMC7700241 DOI: 10.3390/ijerph17228687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
Background: This study aimed to determine the effects of metabolic syndrome (MetS) on colorectal cancer (CRC) using propensity score (PS) methods. Methods: The study subjects were 2417 men and 4568 women from the Korean National Cancer Center (KNCC) Community Cohort enrolled between 2003 and 2010. Odds risks (ORs) and 95% confidence intervals (CIs) using PS matching analysis, regression models adjusted by the PS or stratified into five strata according to PS, and PS weighting methods were calculated. Results: In women, MetS and abnormally high triglyceride (TG) levels were associated with CRC risk using the PS matching analysis (ORs, for MetS, 2.19 (95% CI, 1.10–4.33); for abnormal TG levels, 2.08 (95% CI, 1.07–4.02)). However, there were no significant associations between MetS and TG levels and CRC risk in men. Conclusions: Our study might provide additional evidence that deteriorated metabolic profiles increase the risk of CRC in women rather than men. Thus, this may have an important role in effective population-level interventions for deteriorated metabolic profiles at an early stage.
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Affiliation(s)
- Jinsun Kim
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea; (J.K.); (E.P.); (J.-K.O.); (B.K.)
| | - Eun Young Park
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea; (J.K.); (E.P.); (J.-K.O.); (B.K.)
- Correspondence:
| | - Eunjung Park
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea; (J.K.); (E.P.); (J.-K.O.); (B.K.)
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, Korea;
| | - Jin-Kyoung Oh
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea; (J.K.); (E.P.); (J.-K.O.); (B.K.)
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, Korea;
| | - Byungmi Kim
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea; (J.K.); (E.P.); (J.-K.O.); (B.K.)
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Mikkelsen MK, Juhl CB, Lund CM, Jarden M, Vinther A, Nielsen DL. The effect of exercise-based interventions on health-related quality of life and physical function in older patients with cancer receiving medical antineoplastic treatments: a systematic review. Eur Rev Aging Phys Act 2020; 17:18. [PMID: 33088348 PMCID: PMC7574419 DOI: 10.1186/s11556-020-00250-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022] Open
Abstract
Older patients with cancer are underrepresented in trials investigating the effect of exercise therapy. The aim of this systematic review was to investigate the effect of exercise therapy during medical antineoplastic treatment in older patients (≥ 65 years) with cancer. A systematic review following the Cochrane guidelines was performed. Randomized controlled trials were identified through a systematic literature search in MEDLINE, EMBASE, CENTRAL, and CINAHL up to December 2019. Study selection was performed independently by two reviewers. Four randomized controlled trials published between 2014 and 2019 were included comprising a total of 412 participants. Most participants were diagnosed with breast, prostate or colorectal cancer. The studies were characterized by large differences in design, interventions and outcomes, which prevented meta-analyses. The interventions ranged from 4 weeks to 12 months and involved both supervised and unsupervised exercise programs. Some evidence of beneficial effects from the interventions were documented on physical function, muscle strength, physical activity and cognitive function. No evidence of effects was found for health-related quality of life, aerobic capacity, body composition, cancer-related symptoms and side effects, or for any clinical outcomes. No adverse events were reported. Exercise therapy seems to be safe and feasible in older patients with cancer. However, due to a limited number of studies, small sample sizes and heterogeneity across study design, the effects of exercise in older patients with cancer receiving medical antineoplastic treatment are inconclusive.
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Affiliation(s)
- Marta Kramer Mikkelsen
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.,Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Carsten Bogh Juhl
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Mary Jarden
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.,QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Dorte Lisbet Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
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57
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Davies GA, Strader C, Chibbar R, Papatheodorou S, Dmytriw AA. The relationship between physical activity and lymphoma: a systematic review and meta analysis. BMC Cancer 2020; 20:962. [PMID: 33023529 PMCID: PMC7539461 DOI: 10.1186/s12885-020-07431-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023] Open
Abstract
Background The literature suggests an increased risk between anthropometrics including higher body mass index and lymphoma incidence; however, the association with physical activity remains unclear. A systematic review/meta-analysis was therefore performed to examine this association with physical activity (total, recreational or occupational). Methods PubMed, Web of Science and Embase were reviewed from inception to October 2019 identifying relevant observational studies. Non-Hodgkin lymphoma (NHL) including subtypes diffuse large B cell lymphoma, follicular lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, and Hodgkin lymphoma (HL) were analyzed. Included studies reported activity, lymphoma cases, effect size and variability measures, and were restricted to human subjects of any age. Data was pooled generating summary relative risk (RR) estimates with 95% confidence intervals (CI) using random-effects models with primary outcome of histologically confirmed incident lymphoma. Results One thousand four hundred studies were initially identified with 18 studies (nine cohort, nine case-control) included in final analysis. Comparing highest vs. lowest activity categories was protective for all lymphoma (RR 0.89, 95%CI 0.81–0.98). Sensitivity analysis demonstrated effect persistence within case-control studies (RR 0.82, 95% CI 0.71–0.96), but not cohort studies (RR 0.95, 95%CI 0.84–1.07). Borderline protective effect was seen for NHL (RR 0.92, 95%CI 0.84–1.00), but not HL (RR 0.72, 95%CI 0.50–1.04). Analysis by NHL subtype or gender showed no effect. Dose response analysis demonstrated a protective effect (p = 0.034) with a 1% risk reduction per 3 MET hours/week (RR 0.99, 95%CI 0.98–1.00). Conclusions Physical activity may have a protective effect against lymphoma development; further studies are required to generate recommendations regarding health policy. Trial registration This study was registered prospectively at PROSPERO: CRD42020156242.
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Affiliation(s)
- Gwynivere A Davies
- Department of Oncology, Juravinski Cancer Centre- Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Christopher Strader
- Department of Surgery, University of Massachusetts Medical Center, Worchester, MA, Canada
| | - Richa Chibbar
- Digestive Disease Center, Beth Israel Lahey Health, Harvard Medical School, Boston, MA, USA
| | | | - Adam A Dmytriw
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Lee HJ, Lee JY, Lee MJ, Kim HK, Kim N, Kim GU, Lee JS, Park HW, Chang HS, Yang DH, Choe J, Byeon JS. Association of low skeletal muscle mass with the presence of advanced colorectal neoplasm: integrative analysis using three skeletal muscle mass indices. Colorectal Dis 2020; 22:1293-1303. [PMID: 32363686 DOI: 10.1111/codi.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/14/2020] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to evaluate an association between colorectal neoplasm (CRN) and skeletal muscle mass using three widely accepted skeletal muscle mass indices (SMIs) in a large population at average risk. METHOD We performed a cross-sectional study using a screening colonoscopy database of 33 958 asymptomatic subjects aged 40-75 years. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analyser. ASM adjusted for height squared (ASM/ht2 ), weight (ASM/wt) and body mass index (ASM/BMI) were used as indices for muscle mass. Logistic regression models were used to evaluate the association between SMIs and CRN. RESULTS In a multivariable-adjusted model, the risk of an advanced CRN increased linearly with decreasing quartiles for all three SMIs. The adjusted odds ratios (ORs) for advanced CRN in quartiles 1, 2 and 3 of ASM/wt compared with that in quartile 4 were 1.279, 1.196 and 1.179, respectively (Ptrend = 0.017); for ASM/BMI, ORs were 1.307, 1.144 and 1.091, respectively (Ptrend = 0.002); and for ASM/ht2 , ORs were 1.342, 1.169 and 1.062, respectively (Ptrend = 0.002). The risk of distally located advanced CRN was higher in quartile 1 than in quartile 4 for all three SMIs (ASM/wt, OR = 1.356; ASM/BMI, OR = 1.383; ASM/ht2 , OR = 1.430). CONCLUSION Our study demonstrated that low skeletal muscle mass was consistently associated with the presence of advanced CRN in a population at average risk regardless of the operational definition of the SMI, and it was particularly associated with distal advanced CRN.
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Affiliation(s)
- H J Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Y Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M J Lee
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-K Kim
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - N Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G-U Kim
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H W Park
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-S Chang
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D-H Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Choe
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Fisher SA, Peddle-McIntyre CJ, Burton K, Newton RU, Marcq E, Lake RA, Nowak AK. Voluntary exercise in mesothelioma: effects on tumour growth and treatment response in a murine model. BMC Res Notes 2020; 13:435. [PMID: 32933580 PMCID: PMC7493394 DOI: 10.1186/s13104-020-05284-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022] Open
Abstract
Objective There is substantial evidence that exercise can safely reduce the risk of cancer and improve survival in different human cancer populations. Long latency periods associated with carcinogen–induced cancers like asbestos induced mesothelioma provide an opportunity to implement exercise as an intervention to delay or prevent disease development. However, there are limited studies investigating the ability of exercise to prevent or delay cancer, and exercise as a preventive strategy has never been assessed in models with a known carcinogen. We investigated the potential of voluntary exercise (VE) to delay development of asbestos related disease (ARD) in our well-characterised, asbestos induced MexTAg model of mesothelioma. Results Asbestos exposed MexTAg mice were given continuous or delayed access to VE and ARD assessed over time. We found that the addition of VE did not affect ARD development in asbestos exposed MexTAg mice. However, non–asbestos exposed, aged matched control mice participated in significantly more VE behaviours, suggesting subclinical development of ARD after asbestos exposure had a greater impact on VE participation than age alone. These data highlight the importance of model choice and the potential limitation that some pre–clinical studies may not accurately represent the clinical paradigm, particularly in the context of prevention studies.
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Affiliation(s)
- Scott A Fisher
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia. .,School of Biomedical Sciences, University of Western Australia, Perth, Australia.
| | - Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Kimberley Burton
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Elly Marcq
- Centre for Oncological Research, University of Antwerp, Antwerp, Belgium
| | - Richard A Lake
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia.,School of Medicine, University of Western Australia, Perth, Australia
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Abstract
Despite the steady decline in the incidence of colorectal cancer (CRC) and cancer-related mortality in Americans of 50 years and older over the last few decades, there has been a disturbing trend of steadily rising incidence in early-onset colorectal cancer (EOCRC), defined as CRC in those younger than 50 years. With the incidence of EOCRC increasing from 4.8 per 100,000 in 1988 to 8.0 per 100,000 in 2015, and with the decreased rates in those older than 50 years largely attributed to improved screening in the older population, new screening recommendations have recently lowered the age for screening average-risk individuals from 50 to 45. EOCRC has been found to present differently from late-onset CRC, with a higher proportion of patients presenting with left-sided and rectal cancer, more aggressive histological features, and more advanced stage at the time of diagnosis. This article reviews the most recent evidence from population-based studies and institutional series, as well as the newest screening guidelines, and provides an up-to-date summary of our current understanding of EOCRC, from clinical presentation to tumor biology and prognosis, and future directions in treatment and prevention.
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Affiliation(s)
- Blake Read
- Department of Surgery, Mills-Peninsula Medical Center, Palo Alto Medical Foundation, Burlingame, California
| | - Patricia Sylla
- Division of Colon and Rectal Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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61
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Brown A, Wilson DK, Sweeney AM, Van Horn ML. The Moderating Effects of Social Support and Stress on Physical Activity in African American Women. Ann Behav Med 2020; 55:376-382. [PMID: 32692356 DOI: 10.1093/abm/kaaa051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND African American women participate in less physical activity (PA), have higher rates of chronic disease, and report higher perceived stress relative to other race and sex demographic groups. PURPOSE Based on the stress-buffering hypothesis, this study tested the hypothesis that social support would buffer the negative effects of perceived stress on moderate-to-vigorous PA (MVPA) under high, but not low, perceived stress. METHODS Participants were 143 African American women (mean [M] age = 43.94, standard deviation [SD] = 8.62; M body mass index = 37.94, SD = 8.11) enrolled in the Families Improving Together (FIT) for Weight Loss Trial. Average daily minutes of MVPA were obtained via 7 day accelerometer estimates at baseline and 8 and 16 weeks. RESULTS A multilevel growth model demonstrated a significant three-way interaction between stress, social support, and time (B = -0.31, standard error [SE] = 0.14, p = .03). Simple slopes analyses revealed that, at baseline, among participants with high social support (+1 SD), stress was positively associated with greater MVPA (B = 0.49, SE = 0.18, p = .008), whereas among participants with low social support (-1 SD), stress was not significantly associated with MVPA (B = -0.04, SE = 0.14, p = .81). However, at 8 and 16 weeks, stress was not significantly associated with MVPA for either high or low support groups. CONCLUSIONS Findings highlight the importance of integrating constructs of stress and social support into future physical activity intervention programs for African American women and the need to evaluate changes in stress and social support longitudinally.
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Affiliation(s)
- Asia Brown
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Dawn K Wilson
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Allison M Sweeney
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - M Lee Van Horn
- Department of Educational Psychology, University of New Mexico, Albuquerque, NM, USA
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Carr PR, Weigl K, Edelmann D, Jansen L, Chang-Claude J, Brenner H, Hoffmeister M. Estimation of Absolute Risk of Colorectal Cancer Based on Healthy Lifestyle, Genetic Risk, and Colonoscopy Status in a Population-Based Study. Gastroenterology 2020; 159:129-138.e9. [PMID: 32179093 PMCID: PMC7387145 DOI: 10.1053/j.gastro.2020.03.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/04/2020] [Accepted: 03/07/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Estimates of absolute risk of colorectal cancer (CRC) are needed to facilitate communication and better inform the public about the potentials and limits of cancer prevention. METHODS Using data from a large population-based case-control study in Germany (Darmkrebs: Chancen der Verhütung durch Screening [DACHS] study, which began in 2003) and population registry data, we calculated 30-year absolute risk estimates for development of CRC based on a healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness), a polygenic risk score (based on 90 single-nucleotide polymorphisms), and colonoscopy history. RESULTS We analyzed data from 4220 patients with CRC and 3338 individuals without CRC. Adherence to a healthy lifestyle and colonoscopy in the preceding 10 years were associated with a reduced relative risk of CRC in men and women. We observed a higher CRC risk in participants with high or intermediate genetic risk scores. For 50-year-old men and women without a colonoscopy, the absolute risk of CRC varied according to the polygenic risk score and the healthy lifestyle score (men, 3.5%-13.4%; women, 2.5%-10.6%). For 50-year-old men and women with a colonoscopy, the absolute risk of developing CRC was much lower but still varied according to the polygenic risk score and the healthy lifestyle score (men, 1.2%-4.8%; women, 0.9%-4.2%). Among all risk factor profiles, the 30-year absolute risk estimates consistently decreased with adherence to a healthy lifestyle. CONCLUSIONS In a population-based study, we found that a colonoscopy can drastically reduce the absolute risk of CRC and that the genetically predetermined risk of CRC can be further reduced by adherence to a healthy lifestyle. Our results show the magnitude of CRC prevention possible through colonoscopy and lifestyle at a predefined genetic risk. This observational study has been registered in the German Clinical Trials Register (DRKS00011793), which is a primary registry in the World Health Organization Registry Network.
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Affiliation(s)
- Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
| | - Korbinian Weigl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, 69120,German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany, 69120
| | - Dominic Edelmann
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany, 69120
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, 69120
| | - Jenny Chang-Claude
- Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany, 20246,Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany, 69120
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, 69120,German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany, 69120,Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany, 69120
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, 69120
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Mahmood S, MacInnis RJ, Karahalios A, English DR, Lynch BM. Leisure-Time Physical Activity Versus Sedentary Behaviour in Relation to Colorectal Adenoma and Cancer: Are these Two Distinct Risk Factors? CURRENT COLORECTAL CANCER REPORTS 2020. [DOI: 10.1007/s11888-020-00454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Hofseth LJ, Hebert JR, Chanda A, Chen H, Love BL, Pena MM, Murphy EA, Sajish M, Sheth A, Buckhaults PJ, Berger FG. Early-onset colorectal cancer: initial clues and current views. Nat Rev Gastroenterol Hepatol 2020; 17:352-364. [PMID: 32086499 PMCID: PMC10711686 DOI: 10.1038/s41575-019-0253-4] [Citation(s) in RCA: 194] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Over the past several decades, the incidence of early-onset colorectal cancer (EOCRC; in patients <50 years old) has increased at an alarming rate. Although robust and scientifically rigorous epidemiological studies have sifted out environmental elements linked to EOCRC, our knowledge of the causes and mechanisms of this disease is far from complete. Here, we highlight potential risk factors and putative mechanisms that drive EOCRC and suggest likely areas for fruitful research. In addition, we identify inconsistencies in the evidence implicating a strong effect of increased adiposity and suggest that certain behaviours (such as diet and stress) might place nonobese and otherwise healthy people at risk of this disease. Key risk factors are reviewed, including the global westernization of diets (usually involving a high intake of red and processed meats, high-fructose corn syrup and unhealthy cooking methods), stress, antibiotics, synthetic food dyes, monosodium glutamate, titanium dioxide, and physical inactivity and/or sedentary behaviour. The gut microbiota is probably at the crossroads of these risk factors and EOCRC. The time course of the disease and the fact that relevant exposures probably occur in childhood raise important methodological issues that are also discussed.
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Affiliation(s)
- Lorne J Hofseth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA.
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA.
| | - James R Hebert
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Anindya Chanda
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hexin Chen
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - Bryan L Love
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Maria M Pena
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - E Angela Murphy
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Mathew Sajish
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Amit Sheth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Computer Science and Engineering, College of Engineering, University of South Carolina, Columbia, SC, USA
| | - Phillip J Buckhaults
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Franklin G Berger
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
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Stabell AC, Wilson M, Jankowski CM, MaWhinney S, Erlandson KM. The Impact of a Structured, Supervised Exercise Program on Daily Step Count in Sedentary Older Adults With and Without HIV. J Acquir Immune Defic Syndr 2020; 84:228-233. [PMID: 32084050 PMCID: PMC7228846 DOI: 10.1097/qai.0000000000002326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND People with HIV (PWH) may have lower daily activity levels compared with persons without HIV. We sought to determine the impact of initiating a supervised exercise program on the daily step count of sedentary PWH and uninfected controls. METHODS PWH and controls, aged 50-75, were enrolled in a 24-week supervised exercise program. All individuals were given a pedometer and instructed in regular use. A linear mixed model taking into account random effects was used to model daily step count. RESULTS Of 69 participants that began the study, 55 completed and 38 (21 PWH, 17 controls) had complete pedometer data. Baseline daily step count on nonsupervised exercise day was (estimated geometric mean, 95% confidence interval) 3543 (1306 to 9099) for PWH and 4182 (1632 to 10,187) for controls. Both groups increased daily steps on supervised [43% (20 to 69)%, P < 0.001] but not unsupervised exercise days [-12% (-24 to 1)%, P = 0.071]. Compared with controls, PWH had 26% [(-47 to 4)%, P = 0.08] fewer daily steps on days with supervised exercise and 35% [-53 to -10)%, P = 0.011] fewer daily steps on days without supervised exercise. Higher body mass index (per 1 unit) and smoking were associated with fewer daily steps [-5% (-9 to -1)%; -49% (-67 to -23)%; P ≤ 0.012]. Days with precipitation [-8% (-13 to -3)%, P = 0.002] or below freezing [-10% [-15 to -4)%, P < 0.001] were associated with fewer steps. CONCLUSION Supervised exercise increased daily step counts in sedentary individuals, but at the expense of fewer steps on nonsupervised exercise days.
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Affiliation(s)
- Alex C. Stabell
- University of Colorado, School of Medicine, Aurora, CO
- New York Presbyterian Hospital-Columbia University, New York, NY (current position)
| | - Melissa Wilson
- University of Colorado, School of Public Health, Department of Biostatistics and Informatics, Aurora, CO
| | | | - Samantha MaWhinney
- University of Colorado, School of Public Health, Department of Biostatistics and Informatics, Aurora, CO
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Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Winters-Stone K, Gerber LH, George SM, Fulton JE, Denlinger C, Morris GS, Hue T, Schmitz KH, Matthews CE. American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Med Sci Sports Exerc 2020; 51:2391-2402. [PMID: 31626056 DOI: 10.1249/mss.0000000000002117] [Citation(s) in RCA: 410] [Impact Index Per Article: 102.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The American College of Sports Medicine convened an International Multidisciplinary Roundtable on Exercise and Cancer in March 2018 to evaluate and translate the evidence linking physical activity and cancer prevention, treatment, and control. This article discusses findings from the Roundtable in relation to the biologic and epidemiologic evidence for the role of physical activity in cancer prevention and survival. RESULTS The evidence supports that there are a number of biologically plausible mechanisms, whereby physical activity can influence cancer risk, and that physical activity is beneficial for the prevention of several types of cancer including breast, colon, endometrial, kidney, bladder, esophageal, and stomach. Minimizing time spent in sedentary behavior may also lower risk of endometrial, colon and lung cancers. Conversely, physical activity is associated with higher risk of melanoma, a serious form of skin cancer. Further, physical activity before and after a cancer diagnosis is also likely to be relevant for improved survival for those diagnosed with breast and colon cancer; with data suggesting that postdiagnosis physical activity provides greater mortality benefits than prediagnosis physical activity. CONCLUSIONS Collectively, there is consistent, compelling evidence that physical activity plays a role in preventing many types of cancer and for improving longevity among cancer survivors, although the evidence related to higher risk of melanoma demonstrates the importance of sun safe practices while being physically active. Together, these findings underscore the importance of physical activity in cancer prevention and control. Fitness and public health professionals and health care providers worldwide are encouraged to spread the message to the general population and cancer survivors to be physically active as their age, abilities, and cancer status will allow.
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Affiliation(s)
- Alpa V Patel
- Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Christine M Friedenreich
- Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Sciences, Calgary, CANADA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Sandra C Hayes
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, AUSTRALIA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, CANADA
| | | | | | - Stephanie M George
- Office of Disease Prevention, National Institutes of Health, Bethesda, MD
| | - Janet E Fulton
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Crystal Denlinger
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Penn State University, Hershey, PA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Esbensen BA, Kennedy N, Brodin N. Prevention and adherence in Rheumatic and Musculoskeletal disease. Best Pract Res Clin Rheumatol 2020; 34:101525. [PMID: 32417107 DOI: 10.1016/j.berh.2020.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Rheumatic and Musculoskeletal Diseases (RMDs) are chronic conditions that affect a substantial number of people. RMDs are significantly related to co-morbidity. Therefore, focusing on prevention in RMDs is of importance to promote and maintain health. Prevention includes primary-, secondary-, tertiary-, and clinical prevention. Primary prevention aims to prevent the onset of disease before the disease process begins, secondary prevention includes detecting and reducing disease and risk factors at the earliest possible point, and tertiary prevention aims to limit the influence of a recognized or verified disease and to address or reduce further development or worsening of the disease, including physical and psychosocial disability. Clinical prevention attempts to integrate prevention into the disease management to limit disease progression and prevent complications and relapse. This chapter will focus on the evidence for prevention and highlight how innovations and trends can contribute by using digital technologies as an example.
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Affiliation(s)
- Bente Appel Esbensen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Valdemar Hansens Vej 13-17, Entrance 5, DK-2600, Glostrup, Denmark.
| | - Norelee Kennedy
- Discipline of Physiotherapy, School of Allied Health, Faculty of Education & Health Sciences and Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Nina Brodin
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, S-141 83, Huddinge, Sweden.
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Santillo A, Giacco A, Falvo S, Di Giacomo Russo F, Senese R, Di Fiore MM, Chieffi Baccari G, Lanni A, de Lange P. Mild Exercise Rescues Steroidogenesis and Spermatogenesis in Rats Submitted to Food Withdrawal. Front Endocrinol (Lausanne) 2020; 11:302. [PMID: 32477274 PMCID: PMC7237727 DOI: 10.3389/fendo.2020.00302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/21/2020] [Indexed: 12/02/2022] Open
Abstract
The present investigation was undertaken to increase our insight into the molecular basis of the physiological changes in rat testis induced by food withdrawal, and to clarify whether reduced testicular function can be ameliorated by mild exercise. Male rats were selected for four separate experiments. The first of each group was chow-fed, the second was chow-fed and submitted to exercise (5 bouts in total for 30 min at 15 m/min, and 0° inclination), the third was submitted to food withdrawal (66 h) and the fourth was submitted to food withdrawal and to exercise. At the end of experiments, we investigated (i) serum and testicular sex hormone levels; (ii) protein levels of StAR, 3β-Hydroxysteroid dehydrogenase (3β-HSD) and P450 aromatase, which play a key role in steroid hormone biosynthesis; and (iii) protein levels of mitotic and meiotic markers of spermatogenesis in rats, in relation to testis morphology and morphometry. We found that mild exercise or food withdrawal alone induced a significant increase or decrease in both serum and testis testosterone levels, respectively. Interestingly, we found that these levels were brought back to basal levels when food withdrawal was combined with mild exercise. The changes in testosterone levels observed in our experimental groups correlated well with the expression of steroidogenic enzymes as well as with spermatogenic activity. With mild exercise the increased testosterone/17β-estradiol (T/E2) ratio in the testis correlated with an increased spermatogenic activity. The T/E2 ratio dropped in fasted rats and was significantly reversed when food withdrawal was combined with exercise. Histological and morphometric analyses confirmed that spermatogenic activity varied in concomitance with each experimental condition. Importantly, the testis and serum T/E2 ratios correlated, confirming that exercise rescues the decline in food withdrawal-induced spermatogenesis. In conclusion, this study highlights that mild exercise normalizes the reduced spermatogenic activity caused by food withdrawal through the modulation of the steroidogenic pathway and restoring the T/E2 ratio, underlining the beneficial effects of mild exercise on the prevention and/or amelioration of reduced testis function caused by restricted caloric intake.
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Affiliation(s)
- Alessandra Santillo
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Antonia Giacco
- Department of Science and Technology, University of Sannio, Benevento, Italy
| | - Sara Falvo
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Federica Di Giacomo Russo
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Rosalba Senese
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Maria Maddalena Di Fiore
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Gabriella Chieffi Baccari
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Antonia Lanni
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
| | - Pieter de Lange
- Department of Environmental, Biological, and Pharmaceutical Sciences and Technologies, University of Campania “L. Vanvitelli, ”Caserta, Italy
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Targeting of oncogenic signaling pathways by berberine for treatment of colorectal cancer. Med Oncol 2020; 37:49. [PMID: 32303850 DOI: 10.1007/s12032-020-01367-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/18/2020] [Indexed: 12/12/2022]
Abstract
Studies indicate that inhibiting a single signaling pathway or one single product of a gene is insufficient for the prevention and treatment of cancer. This is due to the fact that dysregulation must occur in more than 500 genes in order to produce a cancerous phenotype. Despite this evidence, available drugs used for cancer treatment focus on a single target. Meanwhile, berberine as a nutraceutical is capable of targeting various processes involved in tumor development including proliferation, invasion, angiogenesis, and metastasis. In comparison with synthetic agents, berberine is cheaper, safer, and more available. Berberine has shown anti-inflammatory properties which make it an ideal option in order to prevent inflammation-associated cancers. Colorectal cancer is one of the most common cancers all over the world and its incidence is increasing each day. Therefore, further investigations about berberine could be helpful in the discovery of novel agents for preventing and/or treating colorectal cancer. This review emphasizes the studies investigating the roles of berberine in colorectal cancer such as controlling cell signaling pathways, inducing apoptosis, regulating microRNAs, attenuating oxidative stress, and affecting inflammation.
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Lee HH, Dunsiger S, Bohlen LC, Boyle HK, Emerson JA, Williams DM. Age Moderates the Effect of Self-Paced Exercise on Exercise Adherence among Overweight Adults. J Aging Health 2020; 32:154-161. [PMID: 30466334 PMCID: PMC8880175 DOI: 10.1177/0898264318812139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The present study tested the hypothesis that the effect of self-paced exercise on adherence to exercise programs is more pronounced with increasing age. Method: Fifty-nine low-active overweight adults (18-65 years) were encouraged to walk 30 to 60 min/day and randomized to either self-paced (n = 30) or prescribed moderate-intensity (n = 29) conditions. Results: The effect of study condition was moderated by age (main effect: b = 6.14, SE = 2.54, p = .02; Condition × Age: b = -11.55, SE = 3.77, p < .01), such that among participants >50 years, those in the self-paced condition exercised 6 more min/day than participants in the prescribed moderate-intensity condition (p = .02), whereas among participants <50 years, those in the self-paced condition exercised 5.4 fewer min/day compared with those in the moderate-intensity condition (p = .05). Affective response to physical activity did not mediate the moderating effect of age. Discussion: As age increases, adults may be more likely to adhere to self-paced versus prescribed moderate-intensity exercise.
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Affiliation(s)
| | - Shira Dunsiger
- Brown University, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
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Siegel RL, Jakubowski CD, Fedewa SA, Davis A, Azad NS. Colorectal Cancer in the Young: Epidemiology, Prevention, Management. Am Soc Clin Oncol Educ Book 2020; 40:1-14. [PMID: 32315236 DOI: 10.1200/edbk_279901] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Colorectal cancer (CRC) incidence rates in the United States overall have declined since the mid-1980s because of changing patterns in risk factors (e.g., decreased smoking) and increases in screening. However, this progress is increasingly confined to older adults. CRC occurrence has been on the rise in patients younger than age 50, often referred to as early-onset disease, since the mid-1990s. Young patients are more often diagnosed at an advanced stage and with rectal disease than their older counterparts, and they have numerous other unique challenges across the cancer management continuum. For example, young patients are less likely than older patients to have a usual source of health care; often need a more complex treatment protocol to preserve fertility and sexual function; are at higher risk of long-term and late effects, including subsequent primary malignancies; and more often suffer medical financial hardship. Diagnosis is often delayed because of provider- and patient-related factors, and clinicians must have a high index of suspicion if young patients present with rectal bleeding or changes in bowel habits. Educating primary care providers and the larger population on the increasing incidence and characteristic symptoms is paramount. Morbidity can further be averted by increasing awareness of the criteria for early screening, which include a family history of CRC or polyps and a genetic predisposition.
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Affiliation(s)
| | | | | | | | - Nilofer S Azad
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
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Wang ST, Cui WQ, Pan D, Jiang M, Chang B, Sang LX. Tea polyphenols and their chemopreventive and therapeutic effects on colorectal cancer. World J Gastroenterol 2020; 26:562-597. [PMID: 32103869 PMCID: PMC7029350 DOI: 10.3748/wjg.v26.i6.562] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/30/2019] [Accepted: 01/11/2020] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC), a multifactorial disease, is usually induced and developed through complex mechanisms, including impact of diet and lifestyle, genomic abnormalities, change of signaling pathways, inflammatory response, oxidation stress, dysbiosis, and so on. As natural polyphenolic phytochemicals that exist primarily in tea, tea polyphenols (TPs) have been shown to have many clinical applications, especially as anticancer agents. Most animal studies and epidemiological studies have demonstrated that TPs can prevent and treat CRC. TPs can inhibit the growth and metastasis of CRC by exerting the anti-inflammatory, anti-oxidative or pro-oxidative, and pro-apoptotic effects, which are achieved by modulations at multiple levels. Many experiments have demonstrated that TPs can modulate several signaling pathways in cancer cells, including the mitogen-activated protein kinase pathway, phosphatidylinositol-3 kinase/Akt pathway, Wnt/β-catenin pathway, and 67 kDa laminin receptor pathway, to inhibit proliferation and promote cell apoptosis. In addition, novel studies have also suggested that TPs can prevent the growth and metastasis of CRC by modulating the composition of gut microbiota to improve immune system and decrease inflammatory responses. Molecular pathological epidemiology, a novel multidisciplinary investigation, has made great progress on CRC, and the further molecular pathological epidemiology research should be developed in the field of TPs and CRC. This review summarizes the existing in vitro and in vivo animal and human studies and potential mechanisms to examine the effects of tea polyphenols on CRC.
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Affiliation(s)
- Shi-Tong Wang
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Wen-Qi Cui
- Department of Neurology, Shengjing Hospital, Affiliated Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Dan Pan
- Department of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Min Jiang
- Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Bing Chang
- Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Li-Xuan Sang
- Department of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Koyanagi YN, Suzuki E, Imoto I, Kasugai Y, Oze I, Ugai T, Iwase M, Usui Y, Kawakatsu Y, Sawabe M, Hirayama Y, Tanaka T, Abe T, Ito S, Komori K, Hanai N, Tajika M, Shimizu Y, Niwa Y, Ito H, Matsuo K. Across-Site Differences in the Mechanism of Alcohol-Induced Digestive Tract Carcinogenesis: An Evaluation by Mediation Analysis. Cancer Res 2020; 80:1601-1610. [PMID: 32005715 DOI: 10.1158/0008-5472.can-19-2685] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/12/2019] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
Abstract
A genetic variant on aldehyde dehydrogenase 2 (ALDH2 rs671, Glu504Lys) contributes to carcinogenesis after alcohol consumption. Somewhat conversely, the ALDH2 Lys allele also confers a protective effect against alcohol-induced carcinogenesis by decreasing alcohol consumption due to acetaldehyde-related adverse effects. Here, we applied a mediation analysis to five case-control studies for head and neck, esophageal, stomach, small intestine, and colorectal cancers, with 4,099 cases and 6,065 controls, and explored the potentially heterogeneous impact of alcohol drinking on digestive tract carcinogenesis by decomposing the total effect of the ALDH2 Lys allele on digestive tract cancer risk into the two opposing effects of the carcinogenic effect (direct effect) and the protective effect (indirect effect mediated by drinking behavior). Alcohol was associated with an increased risk of most digestive tract cancers, but significant direct effects were observed only for upper gastrointestinal tract cancer risk, and varied substantially by site, with ORs (95% confidence interval) of 1.83 (1.43-2.36) for head and neck cancer, 21.15 (9.11-49.12) for esophageal cancer, and 1.65 (1.38-1.96) for stomach cancer. In contrast, a significant protective indirect effect was observed on risk for all cancers, except small intestine cancer. These findings suggest that alcohol is a major risk factor for digestive tract cancers, but its impact as a surrogate for acetaldehyde exposure appears heterogeneous by site. Meanwhile, the behavior-related effect of the ALDH2 Lys allele results in a decreased risk of most digestive tract cancers. SIGNIFICANCE: These findings support that genetic alcohol avoidance is a factor against alcohol-induced cancers.
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Affiliation(s)
- Yuriko N Koyanagi
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Aichi, Japan
| | - Etsuji Suzuki
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Issei Imoto
- Division of Molecular Genetics, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Aichi, Japan
| | - Yumiko Kasugai
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan.,Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Tomotaka Ugai
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Madoka Iwase
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Yoshiaki Usui
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Aichi, Japan
| | - Yukino Kawakatsu
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Michi Sawabe
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Yutaka Hirayama
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Tsutomu Tanaka
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Tetsuya Abe
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Seiji Ito
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Yasumasa Niwa
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Aichi, Japan.,Department of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan. .,Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Development of a Tool to Increase Physical Activity among People at Risk for Diabetes in Low-Resourced Communities in Cape Town. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030865. [PMID: 32019135 PMCID: PMC7037043 DOI: 10.3390/ijerph17030865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/20/2019] [Accepted: 12/29/2019] [Indexed: 12/23/2022]
Abstract
Targeted lifestyle interventions, including physical activity (PA), have been proven to prevent or delay the onset of diabetes. South Africa’s unique context, complex environment and varied cultures and ethnicities require tailored interventions. Our objective was to develop a context-appropriate tool for the South African Diabetes Prevention Programme’s PA lifestyle component in order to enable people at risk of developing diabetes to adopt PA. We used mixed methods to inform the development of the tool. Descriptive analyses of baseline survey data included socio-demographics, anthropometrics, blood pressure and biochemical measurements, reported medical history, PA behaviours, and built environment information. Focus group discussions assisted in understanding perceived challenges, barriers and facilitators/opportunities to PA. A literature search on successful South African PA interventions was done, and PA experts in Cape Town were consulted. Quantitative data were analysed using the software R, version 3.4.4 and qualitative data were thematically analysed. Participants (n = 316) recruited were mostly black (54.4%) and of mixed-ancestry (44.6%); they were mainly female (80.1%), obese (75.2%), and had an haemoglobin A1c (HbA1c) above 5.7% (65.5%), with 30% having hypertension and 87% (self-reported) meeting the World Health Organisation (WHO) PA recommendation. Main barriers to PA practice were safety, cost and accessibility of sports facilities, and laziness. We included practising moderate-intensity aerobic and resistance exercises and take-home self-help materials as recommended. By combining results, we produced a targeted, practical and promotional PA booklet.
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75
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Jung SY, Papp JC, Sobel EM, Zhang ZF. Post Genome-Wide Gene-Environment Interaction Study Using Random Survival Forest: Insulin Resistance, Lifestyle Factors, and Colorectal Cancer Risk. Cancer Prev Res (Phila) 2019; 12:877-890. [PMID: 31554631 PMCID: PMC6893139 DOI: 10.1158/1940-6207.capr-19-0278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/28/2019] [Accepted: 09/20/2019] [Indexed: 01/23/2023]
Abstract
Molecular and genetic pathways of insulin resistance (IR) connecting colorectal cancer and obesity factors in postmenopausal women remain inconclusive. We examined the IR pathways on both genetic and phenotypic perspectives at the genome-wide level. We further constructed colorectal cancer risk profiles with the most predictive IR SNPs and lifestyle factors. In our earlier genome-wide association gene-environmental interaction study, we used data from a large cohort of postmenopausal women in the Women's Health Initiative Database for Genotypes and Phenotypes Study and identified 58 SNPs in relation to IR phenotypes. In this study, we evaluated the identified IR SNPs and selected 34 lifestyles for their association with colorectal cancer risk in a total of 11,078 women (including 736 women with colorectal cancer) using a 2-stage multimodal random survival forest analysis. In overall and subgroup (defined via body mass index, exercise, and dietary-fat intake) analyses, we identified 2 SNPs (LINC00460 rs1725459 and MTRR rs722025) and lifetime cumulative exposure to estrogen (oral contraceptive use) and cigarette smoking as the most common and strongest predictive markers for colorectal cancer risk across the analyses. The combinations of genetic and lifestyle factors had much greater impact on colorectal cancer risk than any individual risk factors, and a possible synergism existed to increase colorectal cancer risk in a gene-behavior dose-dependent manner. Our findings may inform research on the role of IR in the etiology of colorectal cancer and contribute to more accurate prediction of colorectal cancer risk, suggesting potential intervention strategies for women with specific genotypes and lifestyles to reduce their colorectal cancer risk.
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Affiliation(s)
- Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California, Los Angeles, Los Angeles, California.
| | - Jeanette C Papp
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Eric M Sobel
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Siegel RL, Torre LA, Soerjomataram I, Hayes RB, Bray F, Weber TK, Jemal A. Global patterns and trends in colorectal cancer incidence in young adults. Gut 2019; 68:2179-2185. [PMID: 31488504 DOI: 10.1136/gutjnl-2019-319511] [Citation(s) in RCA: 410] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Early-onset colorectal cancer (CRC) is increasing in the USA despite rapid declines in older ages. Similar patterns are reported in Australia and Canada, but a comprehensive global analysis of contemporary data is lacking. DESIGN We extracted long-term data from Cancer Incidence in Five Continents and supplemental sources to report on worldwide CRC incidence rates and trends by age (20-49 years and ≥50 years) through diagnosis year 2012 or beyond (Australia, Finland, New Zealand, Norway, Sweden, USA). RESULTS During 2008-2012, age-standardised CRC incidence rates in adults <50 ranged from 3.5 per 100 000 (95% CI 3.2 to 3.9) in India (Chennai) to 12.9 (95% CI 12.6 to 13.3) in Korea. During the most recent decade of available data, incidence in adults <50 was stable in 14 of 36 countries; declined in Austria, Italy and Lithuania; and increased in 19 countries, nine of which had stable or declining trends in older adults (Australia, Canada, Denmark, Germany, New Zealand, Slovenia, Sweden, UK and USA). In Cyprus, Netherlands and Norway, inclines in incidence in young adults were twice as rapid as those in older adults (eg, Norway average annual per cent change (AAPC), 1.9 (95% CI 1.4 to 2.5) vs 0.5 (95% CI 0.3 to 0.7)). Among most high-income countries with long-term data, the uptick in early-onset disease began in the mid-1990s. The steepest increases in young adults were in Korea (AAPC, 4.2 (95% CI 3.4 to 5.0)) and New Zealand (AAPC, 4.0 (95% CI 2.1 to 6.0)). CONCLUSION CRC incidence increased exclusively in young adults in nine high-income countries spanning three continents, potentially signalling changes in early-life exposures that influence large bowel carcinogenesis.
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Affiliation(s)
- Rebecca L Siegel
- Intramural Research Department, American Cancer Society, Atlanta, Georgia, USA
| | - Lindsey A Torre
- Intramural Research Department, American Cancer Society, Atlanta, Georgia, USA
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Richard B Hayes
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Thomas K Weber
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Surgical Oncology, Northwell Health Cancer Institute, Great Neck, New York, USA
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, Atlanta, Georgia, USA
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Conti L, Del Cornò M, Gessani S. Revisiting the impact of lifestyle on colorectal cancer risk in a gender perspective. Crit Rev Oncol Hematol 2019; 145:102834. [PMID: 31790930 DOI: 10.1016/j.critrevonc.2019.102834] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer-related mortality in the world. Patterns and trends in CRC incidence and mortality correlate with increasing adoption of Western lifestyles and with the overweight/obesity epidemic. Both genetic background and a range of modifiable environmental/lifestyle factors play a role in CRC etiology. Among these the links of body weight, dietary patterns and physical activity (PA) behavior with CRC risk are some of the strongest for any type of cancer, with a different impact in women and men. Nonetheless, gender disparities still represent a neglected aspect of CRC management. This review sheds light on gender-related association of obesity and different dietary/PA habits with CRC risk, highlighting the importance of lifestyle modifications in the prevention of this neoplastic disease. In this scenario, intervention studies are strongly recommended to define the most effective dietary/PA regimens for primary prevention of cancer in women and men.
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Affiliation(s)
- Lucia Conti
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Manuela Del Cornò
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
| | - Sandra Gessani
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
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Savijärvi S, Seppä K, Malila N, Pitkäniemi J, Heikkinen S. Trends of colorectal cancer incidence by education and socioeconomic status in Finland. Acta Oncol 2019; 58:1557-1563. [PMID: 31437070 DOI: 10.1080/0284186x.2019.1652340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The aim of this study was to investigate if the incidence of colorectal cancer (CRC) is associated with education and socioeconomic status (SES) in Finland, and if there are any changes in incidence differences between the groups over the period 1976-2014.Material and methods: CRC cases (N = 77,614) were retrieved from the Finnish Cancer Registry and linked with information on the education level and SES from Statistics Finland. We used Poisson regression model to quantify differences in incidence rates between the groups, and to assess changes over calendar time.Results and conclusions: Colon cancer incidence was higher among the highly educated, than in those with basic education. Similar differences were observed by SES in men. Incidence rates increased steeply over time among men with basic education (from 16.7/100,000 in 1976-1979 to 31.8 in 2010-2014), resulting in narrowed differences between the groups (p < .001). Incidence trends of proximal and distal colon and rectal cancer in men showed similar patterns. Heterogeneity across time periods by SES was observed only in colon cancer incidence in men (p = .009). No such large differences were detected in women. Steep increase in colon cancer incidence in men with basic education, and the respective persistent high incidence in the highly educated highlights the importance of focusing the preventive measures on modifiable lifestyle factors in order to reduce CRC incidence and to narrow the educational and socioeconomic health differences.
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Affiliation(s)
| | | | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
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Pacheco LS, Anderson CAM, Lacey JV, Giovannucci EL, Lemus H, Araneta MRG, Sears DD, Talavera GA, Martinez ME. Sugar-sweetened beverages and colorectal cancer risk in the California Teachers Study. PLoS One 2019; 14:e0223638. [PMID: 31596902 PMCID: PMC6785057 DOI: 10.1371/journal.pone.0223638] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/25/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The association between sugar-sweetened beverage (SSB) consumption and colorectal cancer (CRC) risk remains unclear and published data are limited. METHODS The analytic cohort included 99,798 women, free of cancer at baseline, from the California Teachers Study, a longitudinal cohort comprised of 133,477 female teachers and administrators who were active or recently retired members of the California State Teachers Retirement System in 1995. SSB consumption constituted caloric soft drinks, sweetened bottled waters and teas, and fruit drinks, derived from a self-administered food frequency questionnaire. Consumption was divided into four categories: Rare or never, >rare/never to <1 serving/week, ≥1 serving/week to <1 serving/day, and ≥1 serving/day. CRC endpoints were based on annual linkage with California Cancer Registry, defined as first diagnosis of CRC, and classified following the Surveillance, Epidemiology, and End Results Program coding system. Multivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HR) and 95% confidence intervals (CI) for assessing the association between SSB consumption and incident CRC. RESULTS A total of 1,318 incident CRC cases were identified over 20 years of follow-up (54.5% proximal colon and 45.5% distal colorectum). Compared with rare/never consumers, the multivariable-adjusted HRs (95% CI) were 1.14 (0.86, 1.53) for total CRC; 1.11 (0.73, 1.68) for proximal colon; and 1.22 (0.80, 1.86) for distal colorectum cancers among women consuming ≥ 1 serving/day of SSBs. CONCLUSION SSBs were not significantly associated with CRC risk. The biological effects of high SSB consumption make it important to continue to evaluate whether SSBs are associated with CRC. Additionally, future studies should further assess SSBs in large, racial/ethnically diverse cohorts of males and females, and, if feasible, address changes in SSB consumption over time.
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Affiliation(s)
- Lorena S. Pacheco
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Cheryl A. M. Anderson
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, United States of America
| | - James V. Lacey
- Division of Health Analytics, Department of Computational and Quantitative Medicine, City of Hope, Duarte, California, United States of America
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Hector Lemus
- School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Maria Rosario G. Araneta
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- College of Health Solution, Arizona State University, Phoenix, Arizona, United States of America
| | - Gregory A. Talavera
- School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Maria Elena Martinez
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
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Murphy N, Moreno V, Hughes DJ, Vodicka L, Vodicka P, Aglago EK, Gunter MJ, Jenab M. Lifestyle and dietary environmental factors in colorectal cancer susceptibility. Mol Aspects Med 2019; 69:2-9. [PMID: 31233770 DOI: 10.1016/j.mam.2019.06.005] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) incidence changes with time and by variations in diet and lifestyle, as evidenced historically by migrant studies and recently by extensive epidemiologic evidence. The worldwide heterogeneity in CRC incidence is strongly suggestive of etiological involvement of environmental exposures, particularly lifestyle and diet. It is established that physical inactivity, obesity and some dietary factors (red/processed meats, alcohol) are positively associated with CRC, while healthy lifestyle habits show inverse associations. Mechanistic evidence shows that lifestyle and dietary components that contribute to energy excess are linked with increased CRC via metabolic dysfunction, inflammation, oxidative stress, bacterial dysbiosis and breakdown of gut barrier integrity while the reverse is apparent for components associated with decreased risk. This chapter will review the available evidence on lifestyle and dietary factors in CRC etiology and their underlying mechanisms in CRC development. This short review will also touch upon available information on potential gene-environment interactions, molecular sub-types of CRC and anatomical sub-sites within the colorectum.
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Affiliation(s)
- Neil Murphy
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Victor Moreno
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO). Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL). Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - David J Hughes
- Cancer Biology and Therapeutics Group, School of Biomolecular and Biomedical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Ludmila Vodicka
- Department of the Molecular Biology of Cancer, Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic; Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Pavel Vodicka
- Department of the Molecular Biology of Cancer, Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic; Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Elom K Aglago
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Mazda Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France.
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Chen N, Kong Y, Wu Y, Gao Q, Fu J, Sun X, Geng Q. CAC1 knockdown reverses drug resistance through the downregulation of P-gp and MRP-1 expression in colorectal cancer. PLoS One 2019; 14:e0222035. [PMID: 31504073 PMCID: PMC6736305 DOI: 10.1371/journal.pone.0222035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/20/2019] [Indexed: 12/29/2022] Open
Abstract
CDK2-associated cullin domain 1 (CAC1) is as a novel cell cycle regulator widely expressed in colorectal cancer (CRC). However, its expression and function in drug resistant CRC cells remains elusive. Therefore, the present study aimed to assess the biochemical function and relevance of CAC1 in drug resistant CRC cells, and detect the potential mechanism. For this purpose, a total of 83 CRC cases were collected for the immunohistochemical analysis of CAC1 expression. Functional studies (stable transfection, flow cytometry, colony formation, and invasion and migration assays) were performed in SW480, LoVo and their corresponding 5-FU resistant cells. In addition, a nude mice xenograft model was established for further observation in vivo. In the present study, CAC1 protein expression was higher in CRC tissues than that in normal tissues (P<0.05). Furthermore, CAC1 protein expression was higher in SW480/5-FU cells than in SW480 cells. CAC1 knockdown arrested 5-FU resistant cells at the G1/S phase and increased the sensitivity of 5-FU resistant cells to 5-FU by inducing apoptosis. In addition, CAC1 reduced the invasive and migration ability of SW480/5-FU and LoVo/5-FU cells in vitro, and reduced their tumorigenicity and metastatic ability in vivo. Finally, CAC1 knockdown resulted in decreased P-glycoprotein and MRP-1 protein expression. Based on these results, it can be concluded that CAC1 plays an important role in the occurrence and promotion of drug resistance in CRC. Therefore, the knockdown of CAC1 may be considered as a new strategy for the development of CRC drug resistance treatments in the future.
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Affiliation(s)
- Nanzheng Chen
- The thoracic surgery department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ying Kong
- The general surgery department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yunhua Wu
- The medical oncology department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qi Gao
- The medical oncology department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Junke Fu
- The thoracic surgery department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xuejun Sun
- The medical oncology department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qianqian Geng
- The nuclear medicine department of the First affiliated hospital of Xi’an Jiaotong University, Xi’an, China
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Nakamura T, Ishikawa H, Sakai T, Ayabe M, Wakabayashi K, Mutoh M, Matsuura N. Effect of physical fitness on colorectal tumor development in patients with familial adenomatous polyposis. Medicine (Baltimore) 2019; 98:e17076. [PMID: 31567943 PMCID: PMC6756628 DOI: 10.1097/md.0000000000017076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/18/2019] [Accepted: 08/14/2019] [Indexed: 11/25/2022] Open
Abstract
Although accumulated epidemiological evidence indicates that a good physical fitness level may prevent the development of sporadic colorectal cancer (CRC), few studies have examined the effect of physical fitness level on familial adenomatous polyposis (FAP). This cross-sectional study aimed to examine the relationship between physical fitness and CRC development in patients with FAP.A total of 119 patients (54 male; 65 female) with FAP, aged 17 to 73 years, underwent a step test to induce exercise stress. Predicted maximal oxygen uptake (VO2max) was calculated for each patient by using heart rate as an index of physical fitness. The association of VO2max with the presence or absence of CRC and polyp diameter was examined. Patients with FAP were divided into 3 categories according to their VO2max (high, medium, and low). The association between maximum polyp size and VO2max among the patients with FAP without a history of colectomy was examined.The risk of CRC was significantly higher in the low VO2max group than in the high VO2max group (odds ratio = 4.07; 95% confidence interval, 1.02-16.26). The maximum polyp diameter was significantly negatively correlated with the VO2max among the patients with FAP without a history of colectomy (r = -.44, P = .01). In the multiple linear regression analysis, maximum polyp diameter was independently correlated with VO2max.Our results suggest a preventive association between physical fitness and CRC development or colorectal adenoma growth exists in patients with FAP.
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Affiliation(s)
- Tomiyo Nakamura
- Department of Molecular Pathology, Osaka University Graduate School of Medicine & Health Science, Osaka
- Department of Food Sciences and Human Nutrition, Ryukoku University, Shiga
| | | | - Toshiyuki Sakai
- Department of Drug Discovery Medicine, Kyoto Prefectural University of Medicine, Kyoto
| | - Makoto Ayabe
- Department of System Human Information Engineering, Okayama Prefectural University, Okayama
| | - Keiji Wakabayashi
- Graduate Division of Nutritional and Environmental Sciences, University of Shizuoka, Shizuoka
| | - Michihiro Mutoh
- Division of Prevention, Center for Public Health Sciences, National Cancer Center,Tokyo, Japan
| | - Nariaki Matsuura
- Department of Molecular Pathology, Osaka University Graduate School of Medicine & Health Science, Osaka
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Colorectal cancer in Saudi Arabia as the proof-of-principle model for implementing strategies of predictive, preventive, and personalized medicine in healthcare. EPMA J 2019; 11:119-131. [PMID: 32140189 DOI: 10.1007/s13167-019-00186-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/14/2019] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is the most commonly diagnosed cancer among Saudi males and ranks third in females with up to 73% of cases diagnosed at late stage. This review provides an analysis of CRC situation in the Kingdom of Saudi Arabia (KSA) from healthcare perspective. A PUBMED (1986-2018) search was done to identify publications focusing on CRC in KSA. Due to reports of increased CRC incidence among young age group (< 50), and given the young population of KSA, the disease may burden the national healthcare system in the next decades. Environmental factors attributed to increasing incidence rates of CRC include red meat consumption, sedentary lifestyle, and increased calorie intake. Despite substantial investment in healthcare, attention to predictive diagnostics and targeted prevention is lacking. There is a need to develop national screening guidelines based on evidence that supports a reduction in incidence and mortality of CRC when screening is implemented. Future approaches are discussed based on multi-level diagnostics, risk assessment, and population screening programs focused on the needs of young populations that among others present the contents of the advanced approach by predictive, preventive, and personalized medicine. Recommendations are provided that could help to develop policies at regional and national levels. Countries with demographics and lifestyle similar to KSA may gain insights from this review to shape their policies and procedures.
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84
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Marshall CH, Al-Mallah MH, Dardari Z, Brawner CA, Lamerato LE, Keteyian SJ, Ehrman JK, Visvanathan K, Blaha MJ. Cardiorespiratory fitness and incident lung and colorectal cancer in men and women: Results from the Henry Ford Exercise Testing (FIT) cohort. Cancer 2019; 125:2594-2601. [PMID: 31056756 PMCID: PMC6778750 DOI: 10.1002/cncr.32085] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND To the authors' knowledge, the relationship between cardiorespiratory fitness (CRF) and lung and colorectal cancer outcomes is not well established. METHODS A retrospective cohort study was performed of 49,143 consecutive patients who underwent clinician-referred exercise stress testing from 1991 through 2009. The patients ranged in age from 40 to 70 years, were without cancer, and were treated within the Henry Ford Health System in Detroit, Michigan. CRF, measured in metabolic equivalents of task (METs), was categorized as <6 (reference), 6 to 9, 10 to 11, and ≥12. Incident cancer was obtained through linkage to the cancer registry and all-cause mortality from the National Death Index. RESULTS Participants had a mean age of 54 ± 8 years. Approximately 46% were female, 64% were white, 29% were black, and 1% were Hispanic. The median follow-up was 7.7 years. Cox proportional hazard models, adjusted for age, race, sex, body mass index, smoking history, and diabetes, found that those in the highest fitness category (METs ≥12) had a 77% decreased risk of lung cancer (hazard ratio [HR], 0.23; 95% CI, 0.14-0.36) and a 61% decreased risk of incident colorectal cancer (HR, 0.39; 95% CI, 0.23-0.66; with additional adjustment for aspirin and statin use). Among those diagnosed with lung and colorectal cancer, those with high fitness had a decreased risk of subsequent death of 44% and 89%, respectively (HR, 0.56 [95% CI, 0.32-1.00] and HR, 0.11 [95% CI, 0.03-0.37], respectively). CONCLUSIONS In what to the authors' knowledge is the largest study performed to date, higher CRF was associated with a lower risk of incident lung and colorectal cancer in men and women and a lower risk of all-cause mortality among those diagnosed with lung or colorectal cancer.
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Affiliation(s)
- Catherine Handy Marshall
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mouaz H Al-Mallah
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan
- King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Zeina Dardari
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Clinton A Brawner
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Lois E Lamerato
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Steven J Keteyian
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Jonathan K Ehrman
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Kala Visvanathan
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
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Wang J, Huang L, Gao Y, Wang Y, Chen S, Huang J, Zheng W, Bao P, Gong Y, Zhang Y, Wang M, Wong MCS. Physically active individuals have a 23% lower risk of any colorectal neoplasia and a 27% lower risk of advanced colorectal neoplasia than their non-active counterparts: systematic review and meta-analysis of observational studies. Br J Sports Med 2019; 54:582-591. [PMID: 31296585 DOI: 10.1136/bjsports-2018-100350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Few studies have examined the associations between physical activity (PA), sedentary behaviour (SB) and risk of colorectal neoplasia (CN). METHODS We systematically searched Medline, Embase, PsyInfo, Cochrane and other sources from their inception to 30 September 2018 for cohort, case-control and cross-sectional studies that evaluated these associations in asymptomatic, average-risk subjects. Random-effect models were used to estimate relative risks (RRs) of any-type CN, advanced CN, and non-advanced CN, respectively, in individuals with the highest versus the lowest level of PA and SB. Dose-response analyses and subgroup analyses were conducted. The I2 statistic was used to examine heterogeneity among studies. RESULTS We identified 32 observational studies, including 17 cross-sectional studies, 10 case-control studies and five longitudinal studies. PA (highest vs lowest) was inversely associated with risk for any-type CN (n=23 studies) and advanced CN (n=15 studies), with a RR of 0.77 (95% CI=0.71 to 0.83, I2=57.5%) and 0.73 (95% CI=0.63 to 0.82, I2=45.5%), respectively. There was no association between PA and non-advanced CN (n=5 studies). There was an as association between PA and any-type CN in both sexes, and also for the distal colon. We found no dose-response relationship between PA and any-type or advanced CN. Based on three studies identified, SB time (longest vs shortest) was associated with an increased risk of advanced CN (RR=1.24, 95% CI 1.04 to 1.49, I2=14.4%). No publication bias was detected by Begg's test. CONCLUSION We report a 23% lower relative risk of any type of CN and a 27% lower risk of advanced CN in people with the highest level of PA compared with those in the lowest.
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Affiliation(s)
- Jingjing Wang
- National Physical Fitness Research Center, China Institute of Sport Science, Beijing, China
| | - Liwen Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Yang Gao
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Yanhong Wang
- School of Basic Medicine, Peking Union Medical College and Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Shanquan Chen
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Wenjing Zheng
- The Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pingping Bao
- The Office of Chronic Disease Control, Shanghai CDC, Shanghai, China
| | - Yangming Gong
- The Office of Chronic Disease Control, Shanghai CDC, Shanghai, China
| | - Yanfeng Zhang
- National Physical Fitness Research Center, China Institute of Sport Science, Beijing, China
| | - Mei Wang
- National Physical Fitness Research Center, China Institute of Sport Science, Beijing, China
| | - Martin Chi Sang Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
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86
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Energy balance related lifestyle factors and risk of endometrial and colorectal cancer among individuals with lynch syndrome: a systematic review. Fam Cancer 2019; 18:399-420. [PMID: 31236808 DOI: 10.1007/s10689-019-00135-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 06/04/2019] [Indexed: 01/17/2023]
Abstract
Lifestyle factors related to energy balance, such as excess body weight, poor diet, and physical inactivity, are associated with risk of sporadic endometrial cancer (EC) and colorectal cancer (CRC). There are limited data on energy balance-related lifestyle factors and EC or CRC risk among individuals with lynch syndrome, who are at extraordinarily higher risk of developing EC or CRC. We conducted a systematic review of evidence related to weight status, weight change, dietary habits, and physical activity on EC and CRC risk among individuals with lynch syndrome. Findings are reported narratively. We searched Medline, EMBASE, CENTRAL, PubMed, and clinicaltrials.gov up to June 14th, 2018. In total, 1060 studies were identified and 16 were included. Three studies were related to EC and 13 to CRC. Overall, evidence suggests that weight status/weight change may not be associated with EC risk and multivitamin and folic-acid supplementation may be associated with decreased EC risk. Early-adulthood overweight/obese weight-status and adulthood weight-gain may be associated with increased CRC risk, whereas multivitamin supplementation, tea and high fruit intake, and physical activity may be associated with decreased CRC risk. Current evidence proposes that recommendations related to weight, some dietary habits, and physical activity recommended for the general public are also relevant to individuals with lynch syndrome. More research is needed, specifically prospective cohorts and randomized controlled trials, to determine if tailored recommendations are needed among individuals with lynch syndrome.
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87
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Murphy N, Ward HA, Jenab M, Rothwell JA, Boutron-Ruault MC, Carbonnel F, Kvaskoff M, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Weiderpass E, Skeie G, Borch KB, Tjønneland A, Kyrø C, Overvad K, Dahm CC, Jakszyn P, Sánchez MJ, Gil L, Huerta JM, Barricarte A, Quirós JR, Khaw KT, Wareham N, Bradbury KE, Trichopoulou A, La Vecchia C, Karakatsani A, Palli D, Grioni S, Tumino R, Fasanelli F, Panico S, Bueno-de-Mesquita B, Peeters PH, Gylling B, Myte R, Jirström K, Berntsson J, Xue X, Riboli E, Cross AJ, Gunter MJ. Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study. Clin Gastroenterol Hepatol 2019; 17:1323-1331.e6. [PMID: 30056182 PMCID: PMC6542674 DOI: 10.1016/j.cgh.2018.07.030] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. METHODS In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. RESULTS After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. CONCLUSIONS The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
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Affiliation(s)
- Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
| | - Heather A Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Joseph A Rothwell
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Marie-Christine Boutron-Ruault
- Le Centre de recherche en Epidémiologie et Santé des Populations, Faculte de Médecine, University Paris-Sud, Faculte de Médecine, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Franck Carbonnel
- Le Centre de recherche en Epidémiologie et Santé des Populations, Faculte de Médecine, University Paris-Sud, Faculte de Médecine, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France; Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Marina Kvaskoff
- Le Centre de recherche en Epidémiologie et Santé des Populations, Faculte de Médecine, University Paris-Sud, Faculte de Médecine, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Krasimira Aleksandrova
- Department of Epidemiology, Nutrition, Immunity and Metabolism Start-up Laboratory, Potsdam-Rehbrücke, Germany
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | | | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Paula Jakszyn
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitallet de Llobregat, Barcelona, Spain; Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Leire Gil
- Public Health Division of Gipuzkoa, Research Institute of BioDonostia, San Sebastian, Spain
| | - José M Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, Biomedical Research Institute of Murcia-Arrixaca, Murcia, Spain
| | - Aurelio Barricarte
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | | | - Kay-Tee Khaw
- University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Nick Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece; World Health Organization Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece; Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Haidari, Greece
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute, Cancer Research and Prevention Institute, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Civic-M.P. Arezzo Hospital, Azienda Sanitaria Provinciale Ragusa, Italy
| | - Francesca Fasanelli
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment (Netherlands National Institute for Public Health and the Environment), Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
| | - Björn Gylling
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Robin Myte
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Karin Jirström
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jonna Berntsson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Xiaonan Xue
- Albert Einstein College of Medicine, Bronx, New York, New York
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
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Rezende LFMD, Lee DH, Keum N, Nimptsch K, Song M, Lee IM, Eluf-Neto J, Ogino S, Fuchs C, Meyerhardt J, Chan AT, Willett W, Giovannucci E, Wu K. Physical activity during adolescence and risk of colorectal adenoma later in life: results from the Nurses' Health Study II. Br J Cancer 2019; 121:86-94. [PMID: 31114018 PMCID: PMC6738055 DOI: 10.1038/s41416-019-0454-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/22/2019] [Accepted: 03/28/2019] [Indexed: 01/08/2023] Open
Abstract
Background Physical activity during adulthood has been consistently associated with lower risk of colorectal cancers, but whether physical activity during adolescence may also play a role in colorectal carcinogenesis is unclear. Methods We included 28,250 women in the Nurses’ Health Study II who provided data on physical activity during adolescence (ages 12–22 years) in 1997 and underwent lower bowel endoscopy (1998–2011). We used logistic regression models for clustered data to examine the association between physical activity during adolescence and risk of adenoma later in life. Results Physical activity during adolescence was inversely associated with risk of colorectal adenoma (2373 cases), independent of physical activity during adulthood. The multivariable-adjusted odds ratio (OR) of adenoma was 0.89 (95% CI 0.77–1.02; Ptrend = 0.03) comparing women with ≥ 72 metabolic equivalent of tasks-hours/week (MET-h/week) to < 21 MET-h/week. Women with high physical activity during both adolescence (≥53.3 MET-h/week) and adulthood (≥23.1 MET-h/week) had significantly lower risk of adenoma (all adenomas: OR 0.76; 95% CI 0.66–0.88; advanced adenoma: OR 0.61; 95% CI 0.45–0.82) compared to women with low physical activity during both stages of life. Conclusions Our findings suggest that physical activity during adolescence may lower the risk of colorectal adenoma later in life.
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Affiliation(s)
- Leandro Fórnias Machado de Rezende
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - NaNa Keum
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .,Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea.
| | - Katharina Nimptsch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - José Eluf-Neto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Shuji Ogino
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Charles Fuchs
- Yale Cancer Center; Department of Medicine, Yale School of Medicine; Smilow Cancer Hospital, New Haven, CT, USA
| | | | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Walter Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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89
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Kruk J, Aboul-Enein HY, Kładna A, Bowser JE. Oxidative stress in biological systems and its relation with pathophysiological functions: the effect of physical activity on cellular redox homeostasis. Free Radic Res 2019; 53:497-521. [PMID: 31039624 DOI: 10.1080/10715762.2019.1612059] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The body of evidence from the past three decades demonstrates that oxidative stress can be involved in several diseases. This study aims to summarise the current state of knowledge on the association between oxidative stress and the pathogenesis of some characteristic to the biological systems diseases and aging process. This review also presents the effect of physical activity on redox homeostasis. There is strong evidence from studies for participation of reactive oxygen and nitrogen species in pathogenesis of acute and chronic diseases based on animal models and human studies. Elevated levels of pro-oxidants and various markers of the oxidative stress and cells and tissues damage linked with pathogenesis of cancer, atherosclerosis, neurodegenerative diseases hypertension, diabetes mellitus, cardiovascular disease, atherosclerosis, reproductive system diseases, and aging were reported. Evidence confirmed that inflammation contributes widely to multiple chronic diseases and is closely linked with oxidative stress. Regular moderate physical activity regulates oxidative stress enhancing cellular antioxidant defence mechanisms, whereas acute exercise not preceded by training can alter cellular redox homeostasis towards higher level of oxidative stress. Future studies are needed to clarify the multifaceted effects of reactive oxygen/nitrogen species on cells and tissues and to continue study on the biochemical roles of antioxidants and physical activity in prevention of oxidative stress-related tissue injury.
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Affiliation(s)
- Joanna Kruk
- a Faculty of Physical Culture and Health Promotion , University of Szczecin , Cukrowa 12 , Szczecin , Poland
| | - Hassan Y Aboul-Enein
- b Department of National Pharmaceutical and Medicinal Chemistry, Division of Pharmaceutical and Drug Industries Research , National Research Centre , Dokki , Egypt
| | - Aleksandra Kładna
- c Faculty of Medicine, Biotechnology and Laboratory Medicine , Pomeranian Medical University , Szczecin , Poland
| | - Jacquelyn E Bowser
- d John Hazen White College of Arts & Sciences , Johnson & Wales University , Providence , USA
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90
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Oruç Z, Kaplan MA. Effect of exercise on colorectal cancer prevention and treatment. World J Gastrointest Oncol 2019; 11:348-366. [PMID: 31139306 PMCID: PMC6522766 DOI: 10.4251/wjgo.v11.i5.348] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023] Open
Abstract
In recent years, because of improved cancer screening, detection and treatment modalities, a rapid increase in the population of colorectal and other cancer survivors has been observed. The increasing population has justified the requirement of preventive strategies such as lifestyle modifications with regard to obesity, physical activity, diet and smoking. Physical activity may prevent approximately 15% of the colon cancers. Furthermore, several observational studies have demonstrated the efficacy and dose-dependent and anti-cancer effects of exercise on decreasing the mortality and risk of recurrence before and after the colorectal cancer (CRC) diagnosis. However, the required exercise dose, type and intensity are yet unclear. The results of randomised prospective studies are expected to determine the optimal amount, type and intensity of exercise and formulate the most appropriate exercise plan and guidelines, according to the requirements and comorbidities of the patients. In addition, recent studies have focused on the molecular and genetic mechanisms underlying the effect of physical activity on disease outcomes and recurrence rates. This review aimed to investigate the effects of physical activity and the biological basis of these effects in preventing the risk and recurrence of CRC and decreasing the hazards of cancer and cancer treatment.
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Affiliation(s)
- Zeynep Oruç
- Department of Medical Oncology, Mersin City Hospital, Mersin 33000, Turkey
| | - Muhammed Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
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Gupta R, Bhatt LK, Johnston TP, Prabhavalkar KS. Colon cancer stem cells: Potential target for the treatment of colorectal cancer. Cancer Biol Ther 2019; 20:1068-1082. [PMID: 31050577 DOI: 10.1080/15384047.2019.1599660] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Despite incessant research, colon cancer still is one of the most common causes of fatalities in both men and women worldwide. Also, nearly 50% of patients with colorectal cancer show tumor recurrence. Recent investigations have highlighted the involvement of colon cancer stem cells (CCSCs) in cancer relapse and chemoresistance. CCSCs deliver a significant protumorigenic niche through persistent overexpression of self-renewal capabilities. Moreover, CSCs cross network with stromal cells, immune infiltrates, and cyotokine-chemokine, which potentiate their aggressive proliferative potential. Targeting CCSCs through small molecule inhibitors, miRNAs, and monoclonal antibodies (mAbs) in in vivo studies has generated compelling evidence for the effectiveness of these various treatments. This review effectively compiles the role of CCSC surface markers and dysregulated and/or upregulated pathways in the pathogenesis of colorectal cancer that can be used to target CCSCs for effective colorectal cancer treatment.
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Affiliation(s)
- Riya Gupta
- a Department of Pharmacology , SVKM's Dr. Bhanuben Nanavati College of Pharmacy , Mumbai , India
| | - Lokesh Kumar Bhatt
- a Department of Pharmacology , SVKM's Dr. Bhanuben Nanavati College of Pharmacy , Mumbai , India
| | - Thomas P Johnston
- b Division of Pharmacology and Pharmaceutical Sciences , University of Missouri-Kansas City , Kansas City , MO , USA
| | - Kedar S Prabhavalkar
- a Department of Pharmacology , SVKM's Dr. Bhanuben Nanavati College of Pharmacy , Mumbai , India
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92
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Roos ET, Lahti JM, Rahkonen O. Lifestyle and cancer-a joint pairwise association of lifestyle habits with subsequent cancer diagnosis. Eur J Public Health 2019; 29:340-345. [PMID: 30202857 DOI: 10.1093/eurpub/cky184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Unhealthy behaviours increase cancer risk. However, lifestyle habits co-occur and their joint association with cancer is not known. METHODS A survey among midlife employees included data on lifestyle habits and covariates (N = 8960, response rate 67%, 80% women). The joint variables of lifestyle habits were prospectively linked with register data on cancer diagnosis (mean follow-up time 12.1 years). Cox proportional hazard model was used to calculate hazard ratios (HR), and their 95% confidence intervals. RESULTS Smoking was associated with subsequent cancer risk and the association was strengthened by inactivity (HR 1.94, 1.46-2.59) and unhealthy diet (HR 1.92, 1.43-2.57). Smoking combined with both low (HR 1.70, 1.19-2.41) and moderate (HR 1.68, 1.27-2.23) alcohol consumption was also associated with increased cancer risk, as was unhealthy diet combined with moderate alcohol consumption (HR 1.55, 1.17-2.06) and inactivity (HR 1.44, 1.10-1.88). Inactivity combined with either low (HR 1.44, 1.06-1.96) or moderate (HR 1.47, 1.11-1.95) alcohol use was associated with subsequent cancer risk. CONCLUSIONS Key unhealthy behaviours have additive effects. Preventive measures should be targeted to especially smokers and those having several adverse lifestyle habits.
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Affiliation(s)
- Eira T Roos
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jouni M Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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93
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Park SY, Wilkens LR, Haiman CA, Le Marchand L. Physical Activity and Colorectal Cancer Risk by Sex, Race/Ethnicity, and Subsite: The Multiethnic Cohort Study. Cancer Prev Res (Phila) 2019; 12:315-326. [PMID: 30910780 DOI: 10.1158/1940-6207.capr-18-0452] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/15/2019] [Accepted: 03/18/2019] [Indexed: 01/03/2023]
Abstract
Physical activity has been associated with a lower risk of colorectal cancer. However, data is lacking on whether the association is consistent between sexes and across different races/ethnicities and anatomic subsites of tumors. We analyzed data from the Multiethnic Cohort in Hawaii and California, consisting of mostly African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites ages 45-75 years at recruitment. During a mean follow-up of 16.8 years, 4,430 invasive adenocarcinoma cases of the colorectum were identified among 172,502 eligible participants. Cox proportional hazards models were used to estimate the HR and 95% confidence interval (CI). The multivariate-adjusted HR (95% CI) for the highest versus lowest quintiles of physical activity (metabolic equivalent hours of moderate or vigorous activities per day) was 0.76 (0.66-0.87) in men (P trend < 0.001) and 0.94 (0.80-1.11) in women (P trend = 0.53, P heterogeneity by sex = 0.07). Sleeping and sitting hours were not associated with colorectal cancer risk both in men and women. In men, the inverse association was statistically significant among African Americans and Japanese Americans, for right colon and rectal cancer, and in all body mass index groups, although heterogeneity tests were not significant across race/ethnicity or anatomic subsite of tumors. The findings confirm the inverse association between physical activity and colorectal cancer, which appears to be stronger in men, and suggest possible differences in the strength of the association by race/ethnicity and anatomic subsite of tumors.
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Affiliation(s)
- Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
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94
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Physical Activity and Gastrointestinal Cancer Risk: A Review. ACTA MEDICA BULGARICA 2019. [DOI: 10.2478/amb-2019-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: Western lifestyle characterized by increased consumption of red meat, fat, processed food, smoking, alcohol drinking, lower consumption of vegetables and physical inactivity has been associated with a higher gastrointestinal cancer risk. Digestive system cancers are diagnosed at late stages when they show poor response to treatment and are associated with a high mortality rate. Colorectal, gastric, esophageal and pancreatic cancers are among the most common cancers worldwide. Studies show that more than 50% of gastrointestinal cancers develop as a result of inappropriate lifestyle. An inverse association between physical activity and many chronic diseases has been proved so far. However, the association between physical activity and some gastrointestinal cancers is still controversial. This study was aimed to determine the association between physical activity and gastrointestinal cancers risk.
Methods: We conducted a comprehensive search of English and Persian databases from February 2007 till December 2017, for studies investigating the association of physical activity and risk of gastrointestinal cancers. Finally, after reading full text of articles, 123 studies were included.
Results: Physical activity can be helpful in reducing the risk of gastrointestinal cancer, especially colon and pancreatic cancers. The risk reduction is not similar for different types of gastrointestinal cancers and also among males and females.
Conclusion: Different types of physical activity are associated with a lower risk of gastrointestinal cancer. However, it is unknown which type and intensity of physical activity are associated with a protective effect against gastro-intestinal cancer.
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95
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Robertson DJ, Ladabaum U. Opportunities and Challenges in Moving From Current Guidelines to Personalized Colorectal Cancer Screening. Gastroenterology 2019; 156:904-917. [PMID: 30593801 DOI: 10.1053/j.gastro.2018.12.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Douglas J Robertson
- Department of Veterans Affairs Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth and The Dartmouth Institute, Hanover, New Hampshire.
| | - Uri Ladabaum
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California
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96
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Psaltopoulou T, Sergentanis TN, Ntanasis-Stathopoulos I, Tzanninis IG, Riza E, Dimopoulos MA. Anthropometric characteristics, physical activity and risk of hematological malignancies: A systematic review and meta-analysis of cohort studies. Int J Cancer 2019; 145:347-359. [PMID: 30614529 DOI: 10.1002/ijc.32109] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/02/2018] [Accepted: 12/19/2018] [Indexed: 12/20/2022]
Abstract
Overweight/obesity, adult attained height and physical activity are possible risk factors for hematological malignancies. This meta-analysis aims to evaluate the associations between these factors and hematological cancer risk in adults. Eligible cohort studies were sought in PubMed up to May 31, 2016; overall, 44 studies were included in the present analyses. Pooled relative risk estimates were calculated using random-effects models; separate analyses were conducted for non-Hodgkin lymphoma (NHL) and subtypes (diffuse large B-cell lymphoma, DLBCL; follicular cell lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia, SLL/CLL), Hodgkin lymphoma (HL), multiple myeloma (MM), leukemia and subtypes (acute lymphoblastic leukemia, acute myeloid leukemia, AML). Obesity was associated with increased risk of NHL, HL, MM, leukemia overall and AML in both sexes, as well as with higher DLBCL risk in women; the dose-response meta-regression analysis confirmed these associations. Less pronounced effects were observed regarding overweight, as it was associated with increased MM risk in both sexes, NHL risk in males, DLBCL and overall leukemia risk in females. Taller men presented with significantly higher risk of NHL and taller women were affected by higher risk of NHL, DLBCL, FL, CLL/SLL, MM, leukemia and AML. On the other hand, physical activity and abdominal fatness were not associated with the risk of hematological malignancies. In conclusion, this meta-analysis highlights the pivotal role of anthropometric measures in shaping the risk of hematological malignancies in adults. Additional, well-designed studies stemming from all the continents are needed for the further substantiation and generalization of the results.
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Affiliation(s)
- Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis-Georgios Tzanninis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Kim NH, Jung YS, Yang HJ, Park SK, Park JH, Park DI, Sohn CI. Prevalence of and Risk Factors for Colorectal Neoplasia in Asymptomatic Young Adults (20-39 Years Old). Clin Gastroenterol Hepatol 2019; 17:115-122. [PMID: 30025922 DOI: 10.1016/j.cgh.2018.07.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/30/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS The incidence of colorectal cancer is increasing among persons 50 years old or younger. However, data on the epidemiology of young-onset colorectal neoplasia (CRN) are limited. Although some studies have investigated the epidemiology of CRN in persons younger than 50 years, most have focused on persons 40 years or older. We evaluated the prevalence of and risk factors for CRN in adults younger than 40 years. METHODS We performed a cross-sectional analysis of 72,356 asymptomatic individuals, 20-39 years old, who underwent colonoscopies as participants in the Kangbuk Samsung Health Study in South Korea, from August 2004 through December 2015. Data on medical history and health-related behavior were collected from self-administered questionnaires. Patients were divided into groups based on age (20-29 years, n = 7340 or 30-39 years, n = 65,016), and χ2 tests were used to compare categorical variables between groups. A multivariate logistic regression model was used to assess the risk factors for overall and advanced CRN. RESULTS The prevalence of overall CRN in group of 20-29 years was 5.9% and in the group of 30-39 years was 9.5% (P < .001); prevalence values for advanced CRN were 0.6% and 0.9%, respectively (P = .005). In the group of 30-39 years, age, smoking, alcohol intake, obesity, and abdominal obesity were independent risk factors for overall and advanced CRN. Additionally, male sex and metabolic syndrome were independent risk factors for overall CRN, whereas regular exercise reduced risk of overall CRN. Even in the 20-29 years group, obesity, abdominal obesity, and increased levels of triglycerides were independent risk factors for overall and advanced CRN, whereas age, increased blood pressure, and increased fasting blood glucose level were independent risk factors for overall CRN. CONCLUSION In a retrospective analysis of 72,356 asymptomatic persons under 40 years of age evaluated by colonoscopy in Korea, we found modifiable factors, such as smoking, alcohol intake, obesity, and metabolic syndrome, to be significant risk factors for CRN-even in persons of 20-39 years old. Colorectal cancer screening strategies should consider these risk factors.
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Affiliation(s)
- Nam Hee Kim
- Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shahjehan F, Merchea A, Cochuyt JJ, Li Z, Colibaseanu DT, Kasi PM. Body Mass Index and Long-Term Outcomes in Patients With Colorectal Cancer. Front Oncol 2018; 8:620. [PMID: 30631753 PMCID: PMC6315135 DOI: 10.3389/fonc.2018.00620] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/30/2018] [Indexed: 12/27/2022] Open
Abstract
Background: The association between body mass index (BMI) and colorectal cancer is unique. There are several patient- and tumor-related factors that affect this and associations are not entirely clear. The primary aim of this study is to examine the association between BMI and survival after colorectal cancer diagnosis. Methods: Among 26,908 Mayo Clinic patients diagnosed with colorectal cancer between 1972 and 2017, 3,799 patients had information on BMI within 6 months prior to cancer diagnosis. Multivariable Cox regression models were used to assess the differences in overall survival between BMI groups in each cancer stage, controlling for age, gender, year of diagnosis, and cancer location. The impact of change of BMI at 30, 60, and 90 days on survival afterwards were also analyzed. Results: Among 3,799 patients included in the study, there were 29% normal weight, 2% underweight, 36% overweight, and 33% obese patients. With all stages combined together, the overall 5-years survival rates for underweight, normal weight, overweight, and obese patients were 33, 56, 60, and 65%, respectively (p < 0.001). The results show that, the difference in overall survival was not statistically significant when underweight, overweight, and obese patients were compared to normal weight patients in stage 1 and stage 2, although there was a trend that overweight patients had better survival than normal weight group in stage 2 cancer patients (HR = 0.8, p = 0.086). In stage 3 and 4 patients combined, underweight group demonstrated a significant disadvantage (HR = 1.96, p = 0.007) for overall survival compared to the normal weight group. Additionally, post-diagnosis BMI drop more than 10% from either a previous time (HR = 1.88, p = 0.002) or pre-diagnosis time (HR = 1.61, p < 0.001) was associated with worse overall survival after adjusting for baseline variables. Conclusions: BMI is an important consideration in patients with colorectal cancer. Outcomes are stage-dependent where in some situations obesity maybe an advantage. More importantly, being underweight is a significant negative predictor of outcome. The impact of drop in BMI or weight, on survival of CRC patients, needs to be studied further since this is potentially an actionable variable and a dynamic biomarker that may help improve outcome in these patients.
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Affiliation(s)
- Faisal Shahjehan
- Division of Hematology and Oncology, Mayo Clinic Jacksonville, FL, United States
| | - Amit Merchea
- Division of Colon and Rectal Surgery, Mayo Clinic Jacksonville, FL, United States
| | - Jordan J Cochuyt
- Division of Biomedical Statistics and Informatics, Mayo Clinic Jacksonville, FL, United States
| | - Zhuo Li
- Division of Biomedical Statistics and Informatics, Mayo Clinic Jacksonville, FL, United States
| | - Dorin T Colibaseanu
- Division of Colon and Rectal Surgery, Mayo Clinic Jacksonville, FL, United States
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Jennings EG, Dunsiger SI, Bock BC, Hartman SJ, Williams DM, Marcus BH. Setting larger session duration goals is associated with greater future physical activity. PLoS One 2018; 13:e0208644. [PMID: 30532133 PMCID: PMC6287817 DOI: 10.1371/journal.pone.0208644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 11/15/2018] [Indexed: 12/03/2022] Open
Abstract
Many national (US) and International guidelines for physical activity provide guidance that under-active and sedentary adults can begin by accumulating moderate-to-vigorous physical activity (MVPA) in bouts as brief as 10 minutes. This guidance fits well with Goal Setting theory in that goals should be realistic and achievable, and is also consistent with Social Cognitive theory since achieving small goals should boost self-efficacy and thus, encourage continued physical activity. In contrast, Behavioral Economics might suggest that fewer, longer bouts would be more conducive to the adoption of physical activity due to the costs incurred with each separate bout of MVPA. This paper examines patterns of MVPA adoption among a sample of under-active adults from the perspective of goal setting theory and behavioral economics to explore specific strategies to help people who are in the early stages of PA activity adoption. Under-active men and women (N = 225; mean age = 46 ± 10; mean BMI = 28 ± 4.48) who enrolled in a PA intervention participated in a single goal setting session at enrollment. Participants were encouraged to set realistic goals and to increase their activity to meet national recommendations (150 minutes/week of moderate to vigorous physical activity [MVPA]) by the 6-month follow up. This process included identifying a specific frequency goal (days/week) and session duration goal (minutes/day). At baseline, participants reported average weekly MVPA of 14.59 min (± 24), which increased to an average of 140.52 (± 143.55) at 6 months. MVPA goals at baseline averaged 33.24 min/day (± 18.08) and 3.85 days/week (± 1.31). Analyses showed that longer session duration goals set at baseline were associated with more weekly minutes of MVPA at 6 months (b = 1.26, SE = 0.58, t = 2.17, p = 0.03). There was no significant association between goals for number of days per week (frequency) or total minutes of weekly MVPA (minutes x frequency) and MVPA at 6 months. Widely promoted guidelines for uptake of physical activity recommend accumulating physical activity in bouts as short as 10 minutes. This recommendation may ultimately hinder the adoption of physical activity among under-active and sedentary individuals. For the purposes of behavioral adoption of MVPA, more ambitious session duration goals appear to result in higher levels of physical activity participation.
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Affiliation(s)
- Ernestine G. Jennings
- Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Shira I. Dunsiger
- Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Beth C. Bock
- Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Sheri J. Hartman
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - David M. Williams
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Bess H. Marcus
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
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Carr PR, Weigl K, Jansen L, Walter V, Erben V, Chang-Claude J, Brenner H, Hoffmeister M. Healthy Lifestyle Factors Associated With Lower Risk of Colorectal Cancer Irrespective of Genetic Risk. Gastroenterology 2018; 155:1805-1815.e5. [PMID: 30201362 PMCID: PMC6279591 DOI: 10.1053/j.gastro.2018.08.044] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/17/2018] [Accepted: 08/26/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS The combined effects of healthy lifestyle factors on colorectal cancer (CRC) risk are unclear. We aimed to develop a healthy lifestyle score, to investigate the joint effects of modifiable lifestyle factors on reduction of CRC risk and determine whether associations differ with genetic risk. METHODS We collected data from a large population-based case-control study in Germany and used multiple logistic regression analyses to examine associations between the healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness) and CRC risk. We created a genetic risk score, based on 53 risk variants, to investigate the association of the healthy lifestyle score and risk of CRC, stratified by genetic risk. RESULTS We included 4092 patients with CRC and 3032 individuals without CRC (controls) in our analysis. In adjusted models, compared with participants with 0 or 1 healthy lifestyle factor, participants with 2 (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.67-1.06), 3 (OR 0.62; 95% CI 0.50-0.77), 4 (OR 0.53; 95% CI 0.42-0.66), or 5 (OR 0.33; 95% CI 0.26-0.43) healthy lifestyle factors had increasingly lower risks of CRC (P trend <.0001). We found no differences among subgroups stratified by genetic risk score, history of colonoscopy, or family history of CRC. Overall, 45% of CRC cases (95% CI 34%-53%) could be attributed to nonadherence to all 5 healthy lifestyle behaviors. CONCLUSIONS In a large population-based case-control study, we identified a combination of lifestyle factors that appears to reduce risk of CRC, regardless of the patient's genetic profile. These results reinforce the importance of primary prevention of CRC.
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Affiliation(s)
- Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
| | - Korbinian Weigl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Vanessa Erben
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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