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Gupta S, May FP, Kupfer SS, Murphy CC. Birth Cohort Colorectal Cancer (CRC): Implications for Research and Practice. Clin Gastroenterol Hepatol 2024; 22:455-469.e7. [PMID: 38081492 DOI: 10.1016/j.cgh.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
Colorectal cancer (CRC) epidemiology is changing due to a birth cohort effect, first recognized by increasing incidence of early onset CRC (EOCRC, age <50 years). In this paper, we define "birth cohort CRC" as the observed phenomenon, among individuals born 1960 and later, of increasing CRC risk across successive birth cohorts, rising EOCRC incidence, increasing incidence among individuals aged 50 to 54 years, and flattening of prior decreasing incidence among individuals aged 55 to 74 years. We demonstrate birth cohort CRC is associated with unique features, including increasing rectal cancer (greater than colon) and distant (greater than local) stage CRC diagnosis, and increasing EOCRC across all racial/ethnic groups. We review potential risk factors, etiologies, and mechanisms for birth cohort CRC, using EOCRC as a starting point and describing importance of viewing these through the lens of birth cohort. We also outline implications of birth cohort CRC for epidemiologic and translational research, as well as current clinical practice. We postulate that recognition of birth cohort CRC as an entity-including and extending beyond rising EOCRC-can advance understanding of risk factors, etiologies, and mechanisms, and address the public health consequences of changing CRC epidemiology.
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Affiliation(s)
- Samir Gupta
- Section of Gastroenterology, Jennifer Moreno San Diego VA Medical Center, San Diego, California; Division of Gastroenterology, Department of Medicine, and Moores Cancer Center, University of California, La Jolla, California.
| | - Folasade P May
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California; UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California
| | - Sonia S Kupfer
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Caitlin C Murphy
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas
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Hutchinson NT, Wang SS, Dokhanchi J, Johnson RW, Buford TW, Allen JM, Woods JA. Effects of Broad-Spectrum Antibiotic Treatment or Germ-Free Status on Endurance Performance and Exercise Adaptations in Mice. Med Sci Sports Exerc 2023; 55:225-234. [PMID: 36170555 PMCID: PMC9840680 DOI: 10.1249/mss.0000000000003051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE Endurance exercise alters the gut microbiome independently of diet. The extent to which gut microbes are responsible for physiologic adaptations to exercise training is unknown. The purpose of these experiments was to determine the role of gut microbes in performance and muscle adaptation to 6 wk of voluntary wheel running (VWR) in mice. METHODS We depleted microbes with broad-spectrum antibiotic (ABX) treatment and used germ-free (GF) mice to determine effects on adaptations to VWR. Male and female C57Bl/6 mice ( n = 56) were assigned to daily VWR or sedentary conditions. After the intervention, treadmill endurance and glucose tolerance were assessed, and gastrocnemius and soleus tissues were harvested and analyzed for citrate synthase (CS) enzyme activity and expression of exercise training-sensitive genes. RESULTS ABX treatment and GF status resulted in VWR volumes ~22% and 26% lower than controls, respectively. Analysis of variance revealed that, although VWR increased treadmill endurance, ABX had no effect. GF status significantly reduced treadmill performance in trained GF mice after training. VWR increased gastrocnemius CS enzyme activity in all groups, and ABX and GF status did not reduce the VWR effect. VWR also increased muscle expression of PGC1a, but this was not affected by ABX treatment. CONCLUSIONS ABX treatment and GF status reduced VWR behavior but did not affect VWR-induced adaptations in endurance capacity, CS activity, or expression of muscle metabolic genes. However, GF status reduced endurance capacity. These data indicated that reducing microbes in adulthood does not inhibit endurance training adaptations in C57Bl/6 mice, but that GF mice possess a reduced responsiveness to endurance exercise training, perhaps because of a developmental defect associated with lack of microbes from birth.
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Affiliation(s)
- Noah T. Hutchinson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Selena S. Wang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Jack Dokhanchi
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Rodney W. Johnson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Thomas W. Buford
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, AL
| | - Jacob M. Allen
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Jeffrey A. Woods
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
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Christopher CN, Matthews CE, Saint-Maurice PF, Keadle SK. Impact of Moderate-Vigorous Physical Activity Trajectories on Colon Cancer Risk over the Adult Life Course. Cancer Epidemiol Biomarkers Prev 2023; 32:30-36. [PMID: 36306403 PMCID: PMC9839573 DOI: 10.1158/1055-9965.epi-22-0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/22/2022] [Accepted: 10/25/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Moderate-vigorous physical activity (MVPA) reduces colon cancer risk; however, it is unclear how the timing of MVPA throughout the adult life course impacts colon cancer risk. We evaluated whether maintenance and changes in MVPA levels over time are associated with colon cancer risk. METHODS We assessed 293,198 adults ages 50 to 71 years in the NIH-AARP Diet and Health Study. Participants completed baseline health and physical activity questionnaires between 1995 and 1997 and were followed through 2011, (average follow-up of 13.1 years). There were 5,072 colon cancer cases over the study period. Using latent class trajectory models, we identified seven distinct MVPA trajectories across the adult life course (15-18, 19-29, 30-35, and past 10-years) and ran Cox proportional hazards regression models. RESULTS Compared with those who maintained low MVPA levels, those who maintained high and moderate levels of MVPA had a lower risk of colon cancer [HR, 0.85; confidence interval (CI), 0.78-0.93; HR = 0.87; CI, 0.76-1.00)], and those who increased MVPA levels early and later during adulthood had a lower colon cancer risk (HR, 0.90; CI, 0.80-1.01) and (HR, 0.92; CI, 0.80-1.06), respectively. Those who decreased MVPA early in adulthood had an increased risk of colon cancer (HR, 1.12; CI, 1.02-1.23). These associations were stronger in adults ages <65 years at baseline and in men (P < 0.001). CONCLUSIONS Consistent participation in MVPA throughout life may reduce colon cancer risk. IMPACT These findings emphasize that engaging in MVPA throughout adulthood lowers risk of colon cancer.
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Affiliation(s)
- Cami N. Christopher
- Department of Kinesiology and Public Health, California Polytechnic State University San Luis Obispo, San Luis Obispo, CA,Department of Population Health Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Charles E. Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Sarah Kozey Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University San Luis Obispo, San Luis Obispo, CA
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Amirsasan R, Akbarzadeh M, Akbarzadeh S. Exercise and colorectal cancer: prevention and molecular mechanisms. Cancer Cell Int 2022; 22:247. [PMID: 35945569 PMCID: PMC9361674 DOI: 10.1186/s12935-022-02670-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/02/2022] [Indexed: 12/16/2022] Open
Abstract
Exercise and physical activity have been shown to be strongly associated with a decreased incidence rate of various chronic diseases especially numerous human malignancies. A huge number of clinical trials and meta-analysis have demonstrated that exercise is significantly effective in lowering the risk of colorectal cancer. In addition, it is suggested as an effective therapeutic modality against this cancer type. Therefore, in this review, we will review comprehensibly the effects of exercise in preventing, treating, and alleviating the adverse effects of conventional therapeutic options in colorectal cancer. Moreover, the possible mechanisms underlying the positive effects of exercise and physical activity in colorectal cancer, including regulation of inflammation, apoptosis, growth factor axis, immunity, epigenetic, etc. will be also discussed. Exercise is an effective post-treatment management program in colorectal cancer survivals Exercise improves muscle strength, cardiorespiratory fitness, emotional distress, physical activity, fatigue, and sleep quality in colorectal patients undergoing chemotherapy Targeting and modulating insulin-like growth factor (IGF) system, inflammation, apoptosis, immunity, epigenetic, Leptin and Ghrelin, and signaling pathways are major underlying mechanisms for preventive effects of exercise in colorectal cancer
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Affiliation(s)
- Ramin Amirsasan
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran
| | - Maryam Akbarzadeh
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Shabnam Akbarzadeh
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.
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Impact of Diet and Exercise on Colorectal Cancer. Hematol Oncol Clin North Am 2022; 36:471-489. [DOI: 10.1016/j.hoc.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Physical activity and cancer risk. Actual knowledge and possible biological mechanisms. Radiol Oncol 2021; 55:7-17. [PMID: 33885236 PMCID: PMC7877262 DOI: 10.2478/raon-2020-0063] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Scientific evidence has shown that an increase in regular physical activity is associated with a decrease in the development of many types of cancer. Potential mechanisms that link physical activity to reduced cancer risk include a decrease in systemic inflammation, hyperinsulinemia, insulin-like growth factor (IGF-I), sex hormones, pro-inflammatory leptin and other obesity-related cytokines, and a significant increase in anti-inflammatory adiponectin levels. In addition, physical activity improves immune function and the composition and diversity of the gastrointestinal microbiota. Moderate physical activity is important for cancer protection, but the most significant changes in the inflammatory profile are conferred by physical activity performed at higher intensities. Thus, there is a need for further investigation into the type, intensity, and duration of physical activity for the prevention of some types of cancer and the development of effective recommendations. Conclusions There is a strong evidence that physical activity of moderate to vigorous intensity protects against colon and breast cancer, and probably against cancer at all other sites.
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Xie F, You Y, Huang J, Guan C, Chen Z, Fang M, Yao F, Han J. Association between physical activity and digestive-system cancer: An updated systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:4-13. [PMID: 33010525 PMCID: PMC7856558 DOI: 10.1016/j.jshs.2020.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/22/2020] [Accepted: 07/17/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Physical activity (PA) may have an impact on digestive-system cancer (DSC) by improving insulin sensitivity and anticancer immune function and by reducing the exposure of the digestive tract to carcinogens by stimulating gastrointestinal motility, thus reducing transit time. The current study aimed to determine the effect of PA on different types of DSC via a systematic review and meta-analysis. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched for relevant studies in PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. Using a random effects model, the relationship between PA and different types of DSC was analyzed. RESULTS The data used for meta-analysis were derived from 161 risk estimates in 47 studies involving 5,797,768 participants and 55,162 cases. We assessed the pooled associations between high vs. low PA levels and the risk of DSC (risk ratio (RR) = 0.82, 95% confidence interval (95%CI): 0.79-0.85), colon cancer (RR = 0.81, 95%CI: 0.76-0.87), rectal cancer (RR = 0.88, 95%CI: 0.80-0.98), colorectal cancer (RR = 0.77, 95%CI: 0.69-0.85), gallbladder cancer (RR = 0.79, 95%CI: 0.64-0.98), gastric cancer (RR = 0.83, 95%CI: 0.76-0.91), liver cancer (RR = 0.73, 0.60-0.89), oropharyngeal cancer (RR = 0.79, 95%CI: 0.72-0.87), and pancreatic cancer (RR = 0.85, 95%CI: 0.78-0.93). The findings were comparable between case-control studies (RR = 0.73, 95%CI: 0.68-0.78) and prospective cohort studies (RR = 0.88, 95%CI: 0.80-0.91). The meta-analysis of 9 studies reporting low, moderate, and high PA levels, with 17 risk estimates, showed that compared to low PA, moderate PA may also reduce the risk of DSC (RR = 0.89, 95%CI: 0.80-1.00), while compared to moderate PA, high PA seemed to slightly increase the risk of DSC, although the results were not statistically significant (RR = 1.11, 95%CI: 0.94-1.32). In addition, limited evidence from 5 studies suggested that meeting the international PA guidelines might not significantly reduce the risk of DSC (RR = 0.96, 95%CI: 0.91-1.02). CONCLUSION Compared to previous research, this systematic review has provided more comprehensive information about the inverse relationship between PA and DSC risk. The updated evidence from the current meta-analysis indicates that a moderate-to-high PA level is a common protective factor that can significantly lower the overall risk of DSC. However, the reduction rate for specific cancers may vary. In addition, limited evidence suggests that meeting the international PA guidelines might not significantly reduce the risk of DSC. Thus, future studies must be conducted to determine the optimal dosage, frequency, intensity, and duration of PA required to reduce DSC risk effectively.
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Affiliation(s)
- Fangfang Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yanli You
- Department of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Jihan Huang
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Chong Guan
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ziji Chen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Min Fang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Fei Yao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Jia Han
- Department of Physiotherapy and Sport Rehabilitation, Shanghai University of Sport, Shanghai 200438, China.
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Hidayat K, Zhou HJ, Shi BM. Influence of physical activity at a young age and lifetime physical activity on the risks of 3 obesity-related cancers: systematic review and meta-analysis of observational studies. Nutr Rev 2020; 78:1-18. [PMID: 31393566 DOI: 10.1093/nutrit/nuz024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
CONTEXT Excess weight has been linked to increased risks of 13 types of cancers. Physical activity is a non-nutritional modifiable lifestyle factor that is not only crucial for weight control but is also known to regulate hormones and metabolic pathways that may contribute to carcinogenesis. There is solid evidence that being physically active during middle and late adulthood lowers the risks of 3 obesity-related cancers, namely breast cancer, colon cancer, and endometrial cancer. However, the associations between physical activity at a young age (childhood, adolescence, and young adulthood; age 5 to ≤30 yr) and lifetime physical activity and the risks of breast cancer, colon cancer, and endometrial cancer are less defined. OBJECTIVE The present systematic review and meta-analysis of observational studies was performed in accordance with the MOOSE guidelines to determine whether physical activity at a young age and lifetime physical activity may lower the risks of breast cancer, colon cancer, and endometrial cancer. DATA SOURCES The PubMed and Web of Science databases were searched for relevant observational studies published from inception to July 2018. STUDY SELECTION Observational studies (prospective cohort, case-cohort, nested case-control, historical cohort, and case-control) were considered relevant if they investigated the association between physical activity at a young age or lifetime physical activity and the risks of developing selected cancers. DATA EXTRACTION A random-effects meta-analysis was performed to generate the summary relative risk (RR) with 95%CI for the highest vs the lowest category of physical activity of any type. RESULTS Eighty publications were included in the present meta-analysis. Higher physical activity at a young age was associated with lower risks of breast cancer (RR 0.81, 95%CI 0.76, 0.87) and colon cancer (RR 0.67, 95%CI 0.50, 0.88). Similarly, lifetime physical activity was inversely associated with the risks of breast cancer (RR 0.79, 95%CI 0.72, 0.86) and colon cancer (RR 0.75, 95%CI 0.69, 0.82). For breast cancer, menopausal status did not appear to modify the observed inverse association. The benefit with respect to endometrial cancer risk reduction was only observed with higher lifetime physical activity (RR 0.77, 95%CI 0.67, 0.88), not with higher physical activity at a young age (RR 0.89, 95%CI 0.73, 1.07). CONCLUSIONS Being physically active over a lifetime, starting from early childhood, may lower the risks of developing breast cancer, colon cancer, and endometrial cancer.
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Affiliation(s)
- Khemayanto Hidayat
- K. Hidayat, H.-J. Zhou, and B.-M. Shi are with the Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui-Juan Zhou
- K. Hidayat, H.-J. Zhou, and B.-M. Shi are with the Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bi-Min Shi
- K. Hidayat, H.-J. Zhou, and B.-M. Shi are with the Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
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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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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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Dolatkhah R, Somi MH, Shabanloei R, Farassati F, Fakhari A, Dastgiri S. Main Risk Factors Association with Proto-Oncogene Mutations in Colorectal Cancer. Asian Pac J Cancer Prev 2018; 19:2183-2190. [PMID: 30139223 PMCID: PMC6171391 DOI: 10.22034/apjcp.2018.19.8.2183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: Although several factors have been shown to have etiological roles in colorectal cancer, few investigations
have addressed how and to what extent these factors affect the genetics and pathology of the disease. Precise relationships
with specific genetic mutations that could alter signaling pathways involved in colorectal cancer remain unknown.
We therefore aimed to investigate possible links between lifestyle, dietary habits, and socioeconomic factors and specific
mutations that are common in colorectal cancers. Methods: Data were retrieved from a baseline survey of lifestyle factors,
dietary behavior, and SES, as well as anthropometric evaluations during a physical examination, for 100 confirmed
primary sporadic colorectal cancer patients from Northwest Iran. Results: High socioeconomic status was significantly
associated with higher likelihood of a KRAS gene mutation (P < 0.05) (odds ratio: 3.01; 95% CI: 0.69–13.02). Consuming
carbohydrates and alcohol, working less, and having a sedentary lifestyle also increased the odds of having a KRAS
mutation. Conclusion: Although research has not yet described the exact relationships among genetic mutations with
different known risk factors in colorectal cancer, examples of the latter may have an impact on KRAS gene mutations.
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Affiliation(s)
- Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Mahmood S, MacInnis RJ, English DR, Karahalios A, Lynch BM. Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis. Int J Epidemiol 2018; 46:1797-1813. [PMID: 29025130 DOI: 10.1093/ije/dyx137] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 12/11/2022] Open
Abstract
Background Physical activity is associated with reduced risk of colorectal cancer, but most epidemiological studies have focused on occupational and recreational physical activity. The evidence for other domains of activity, and for sedentary behaviour, is limited. Methods Medline, Embase and Web of Science were searched from inception to December 2015 for studies examining domain-specific physical activity or sedentary behaviour and the risk of colon and/or rectal cancer. We extracted maximally adjusted relative risks (RRs) except when RRs not adjusted for body mass index, were also presented. We used random-effects meta-analysis to compute pooled RRs comparing the highest versus the lowest level of exposure. We used meta-regression to assess sources of heterogeneity in estimates. Results We identified 17 cohort and 21 case-control studies, of which 17 had occupational data, 23 had recreational data, three each had data on transport and household physical activity domains, and 6 studies had data on occupational sedentary behaviour. The pooled relative risks (RRs) for colon cancer were 0.74 (95% confidence interval (CI): 0.67, 0.82) for occupational activity, 0.80 (95% CI: 0.71, 0.89) for recreational activity, 0.66 (95% CI: 0.45, 0.98) for transport-related physical activity, 0.85 (95% CI: 0.71, 1.02) for household physical activity, and 1.44 (95% CI: 1.28, 1.62) for occupational sedentary behaviour. For rectal cancer, the pooled RRs were 0.88 (95% CI: 0.79, 0.98) for occupational activity, 0.87 (95% CI: 0.75, 1.01) for recreational activity, 0.88 (95% CI: 0.70, 1.12) for transport-related physical activity, 1.01 (95% CI: 0.80, 1.27) for household physical activity, and 1.02 (95% CI: 0.82, 1.28) for occupational sedentary behaviour. Conclusions In addition to increasing occupational and recreational physical activity, promoting physical activity during transport and reducing sedentary behaviour in the workplace may also be useful colorectal cancer prevention strategies.
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Affiliation(s)
- Shahid Mahmood
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Robert J MacInnis
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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13
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Nunez C, Nair-Shalliker V, Egger S, Sitas F, Bauman A. Physical activity, obesity and sedentary behaviour and the risks of colon and rectal cancers in the 45 and up study. BMC Public Health 2018; 18:325. [PMID: 29510753 PMCID: PMC5840833 DOI: 10.1186/s12889-018-5225-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/27/2018] [Indexed: 01/06/2023] Open
Abstract
Background Obesity and physical activity (PA) are predictors of colon (CC) and rectal (RC) cancers. Prolonged sitting is also emerging as a potential predictor for these cancers. Little knowledge exists about the interactive effects of obesity, PA and prolonged sitting on cancer risk. This analysis assessed independent and interactive effects of PA, body mass index (BMI) and sitting time on CC and RC risks. Methods This analysis used data from a prospective study of 226,584 participants aged 45 years and over in New South Wales (NSW), Australia, who joined the 45 and Up study between 2006 and 2009. Baseline data were linked with data relating to mortality, cancer registration, hospital admission and Department of Human Services to December 2010. Multivariable Cox regression was used to estimate adjusted hazard ratios (referred to as relative risks, RRs) and 95% confidence intervals (Cis). Statistical significance was defined as p < 0.05. Results There were 846 and 369 ascertained cases of CC and RC. BMI was positively associated with CC risk (p = 0.003, P-trend = 0.0006) but not with RC. CC risk was increased in participants in the highest BMI quartile (≥29.4-≤50 kg/m2) compared to the lowest (15- < 23.6 kg/m2), (RR = 1.32, 95% CI:1.08–1.63). PA was associated with CC risk (p = 0.02) but not with RC. Specifically, CC risk was lower in individuals partaking in any amount of vigorous activity (time/week) compared to participants with no engagement (RR = 0.78, 95% CI:0.65–0.93). Sitting time was not associated with CC or RC. We found no evidence of interactive effects of PA, BMI and prolonged sitting on cancer risk. Conclusion This evidence suggests that a healthy weight and vigorous activity are essential to reduce CC risk since these factors may be independent of each other.
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Affiliation(s)
- Carlos Nunez
- Cancer Research Division, Cancer Council NSW, 153 Dowling St, Woolloomooloo, Sydney, NSW, 2011, Australia. .,Sydney School of Public Health, the University of Sydney, Camperdown, Sydney, NSW, 2006, Australia.
| | - Visalini Nair-Shalliker
- Cancer Research Division, Cancer Council NSW, 153 Dowling St, Woolloomooloo, Sydney, NSW, 2011, Australia.,Sydney School of Public Health, the University of Sydney, Camperdown, Sydney, NSW, 2006, Australia.,Faculty of Medicine and Health Science, Macquarie University, Sydney, NSW, 2109, Australia
| | - Sam Egger
- Cancer Research Division, Cancer Council NSW, 153 Dowling St, Woolloomooloo, Sydney, NSW, 2011, Australia
| | - Freddy Sitas
- Sydney School of Public Health, the University of Sydney, Camperdown, Sydney, NSW, 2006, Australia
| | - Adrian Bauman
- Sydney School of Public Health, the University of Sydney, Camperdown, Sydney, NSW, 2006, Australia
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14
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Shaw E, Farris MS, Stone CR, Derksen JWG, Johnson R, Hilsden RJ, Friedenreich CM, Brenner DR. Effects of physical activity on colorectal cancer risk among family history and body mass index subgroups: a systematic review and meta-analysis. BMC Cancer 2018; 18:71. [PMID: 29325535 PMCID: PMC5763991 DOI: 10.1186/s12885-017-3970-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/21/2017] [Indexed: 02/06/2023] Open
Abstract
Background Physical activity is consistently associated with a reduced risk of colorectal cancer in epidemiologic studies. This association among higher risk subgroups, such as those with a first-degree family history of colorectal cancer or high body mass index remains unclear. Methods We searched MEDLINE for studies examining physical activity and colorectal cancer risk among higher risk subgroups through July 11, 2017. Fifteen and three studies were eligible for inclusion for body mass index and first-degree family history of colorectal cancer subgroups, respectively. Estimates of the highest to lowest comparison of physical activity for each subgroup of risk were pooled using random-effects models. Results The pooled associations of physical activity and colorectal cancer risk for those without and with a first-degree family history of colorectal cancer were 0.56 (95% confidence interval (CI) = 0.39–0.80) and 0.72 (95% CI = 0.39–1.32), respectively (pheterogeneity = 0.586). The pooled associations of physical activity and colorectal cancer risk for the low and high body mass index groups were 0.74 (95% CI = 0.66–0.83) and 0.65 (95% CI = 0.53–0.79), respectively (pheterogeneity = 0.389). Conclusions Overall, a stronger relative risk of physical activity on colorectal cancer risk was observed in the higher body mass index group, although the difference was not statistically significant, suggesting an added benefit of physical activity as a cancer prevention strategy in population groups with strong risk factors for colorectal cancer. Additional research among these subgroups is warranted. Electronic supplementary material The online version of this article (10.1186/s12885-017-3970-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eileen Shaw
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Megan S Farris
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jeroen W G Derksen
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Rhys Johnson
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Robert J Hilsden
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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15
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Sedentary work and the risks of colon and rectal cancer by anatomical sub-site in the Canadian census health and environment cohort (CanCHEC). Cancer Epidemiol 2017. [DOI: 10.1016/j.canep.2017.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Sharp L, McDevitt J, Brown C, Carsin AE, Comber H. Association between smoking at diagnosis and cause-specific survival in patients with rectal cancer: Results from a population-based analysis of 10,794 cases. Cancer 2017; 123:2543-2550. [DOI: 10.1002/cncr.30583] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 12/12/2016] [Accepted: 01/05/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Linda Sharp
- Institute of Health & Society; Newcastle University; Newcastle upon Tyne United Kingdom
| | | | | | - Anne-Elie Carsin
- ISGlobal, Centre for Research in Environmental Epidemiology; Barcelona Spain
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17
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Schmid D, Behrens G, Matthews CE, Leitzmann MF. Physical Activity and Risk of Colon Cancer in Diabetic and Nondiabetic US Adults. Mayo Clin Proc 2016; 91:1693-1705. [PMID: 27916155 PMCID: PMC8575013 DOI: 10.1016/j.mayocp.2016.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine whether moderate to vigorous physical activity is associated with a decreased risk of colon cancer in diabetic patients. PATIENTS AND METHODS We evaluated the association between physical activity and colon cancer in 25,753 patients with a self-reported history of diabetes and in 274,965 nondiabetic individuals from the National Institutes of Health-AARP Diet and Health Study who were aged 50 to 71 years in 1995-1996. Moderate to vigorous physical activity was assessed at baseline using a self-administered questionnaire. Follow-up for colon cancer incidence extended to December 31, 2011. RESULTS During 13.0 years of follow-up, 480 diabetic patients and 4151 nondiabetic individuals had development of colon cancer. Among diabetic patients, compared with never/rarely engaging in physical activity, more than 7 h/wk of physical activity exhibited a reduced risk of colon cancer in the age- and sex-adjusted model (hazard ratio [HR], 0.74; 95% CI, 0.56-0.996; P=.16 for trend). This association was attenuated and no longer statistically significant after additional control for other covariates (HR, 0.78; 95% CI, 0.58-1.05; P=.29 for trend). By comparison, physical activity was inversely related to colon cancer risk in nondiabetic individuals (multivariate-adjusted HR, 0.81; 95% CI, 0.73-0.89; P<.001 for trend). CONCLUSION In this investigation of the relationship between physical activity and colon cancer in diabetic patients, we found a statistically significant inverse relationship in the age- and sex-adjusted model, which was no longer statistically significant in the multivariate-adjusted model. A reduced risk was noted among nondiabetic individuals, irrespective of other covariates. Future studies with a larger number of participants are required to explore whether physical activity beneficially affects colon cancer risk among diabetic patients.
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Affiliation(s)
- Daniela Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
| | - Gundula Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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18
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Sehdev A, O'Neil BH. The Role of Aspirin, Vitamin D, Exercise, Diet, Statins, and Metformin in the Prevention and Treatment of Colorectal Cancer. Curr Treat Options Oncol 2016; 16:43. [PMID: 26187794 DOI: 10.1007/s11864-015-0359-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Colorectal cancer (CRC) is a worldwide health problem leading to significant morbidity and mortality. Several strategies based on either lifestyle modifications or pharmacological interventions have been developed in an attempt to reduce the risk of CRC. In this review article, we discuss these interventions including aspirin (and other non-steroidal anti-inflammatory drugs), vitamin D, exercise, diet, statins, and metformin. Depending upon the risk of developing CRC, the current evidence supports the beneficial role of aspirin, vitamin D, diet, and exercise especially in high-risk individuals (advanced adenoma or CRC). However, even with these established interventions, there are significant knowledge gaps such as doses of aspirin and 25-hydroxy vitamin D are not well established. Similarly, there is no convincing data from randomized controlled trials that a high fiber diet or a low animal fat diet reduces the risk of CRC. Some potential interventions, such as statins and metformin, do not have convincing data for clinical use even in high-risk individuals. However, these may have emerging roles in the prevention and treatment of CRC. Greater understanding of molecular mechanisms and the application of genomic tools to risk stratify an individual and tailor the interventions based on that individual's risk will help further advance the field. Some of this work is already underway and is a focus of this article.
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Affiliation(s)
- Amikar Sehdev
- Division of Hematology Oncology, Department of Medicine, Indiana University, 535 Barnhill Dr., RT 130B, Indianapolis, IN, 46202, USA,
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19
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Cook MD, Allen JM, Pence BD, Wallig MA, Gaskins HR, White BA, Woods JA. Exercise and gut immune function: evidence of alterations in colon immune cell homeostasis and microbiome characteristics with exercise training. Immunol Cell Biol 2015; 94:158-63. [PMID: 26626721 DOI: 10.1038/icb.2015.108] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 11/05/2015] [Accepted: 11/05/2015] [Indexed: 12/16/2022]
Abstract
There is robust evidence that habitual physical activity is anti-inflammatory and protective against developing chronic inflammatory disease. Much less is known about the effects of habitual moderate exercise in the gut, the compartment that has the greatest immunological responsibility and interactions with the intestinal microbiota. The link between the two has become evident, as recent studies have linked intestinal dysbiosis, or the disproportionate balance of beneficial to pathogenic microbes, with increased inflammatory disease susceptibility. Limited animal and human research findings imply that exercise may have a beneficial role in preventing and ameliorating such diseases by having an effect on gut immune function and, recently, microbiome characteristics. Emerging data from our laboratory show that different forms of exercise training differentially impact the severity of intestinal inflammation during an inflammatory insult (for example, ulcerative colitis) and may be jointly related to gut immune cell homeostasis and microbiota-immune interactions. The evidence we review and present will provide data in support of rigorous investigations concerning the effects of habitual exercise on gut health and disease.
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Affiliation(s)
- Marc D Cook
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Jacob M Allen
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Brandt D Pence
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Matthew A Wallig
- College of Veterinarian Medicine, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Department of Pathobiology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - H Rex Gaskins
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Department of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Bryan A White
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jeffrey A Woods
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Department of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA
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20
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FRAJACOMO FERNANDOTADEU, KANNEN VINICIUS, DEMINICE RAFAEL, GERALDINO THAISHERRERO, PEREIRA-DA-SILVA GABRIELA, UYEMURA SERGIOAKIRA, JORDÃO-JR ALCEUAFONSO, GARCIA SERGIOBRITTO. Aerobic Training Activates Interleukin 10 for Colon Anticarcinogenic Effects. Med Sci Sports Exerc 2015; 47:1806-13. [DOI: 10.1249/mss.0000000000000623] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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21
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Nam SO, Yotsumoto F, Miyata K, Fukagawa S, Yamada H, Kuroki M, Miyamoto S. Warburg effect regulated by amphiregulin in the development of colorectal cancer. Cancer Med 2015; 4:575-87. [PMID: 25644309 PMCID: PMC4402072 DOI: 10.1002/cam4.416] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 12/16/2014] [Accepted: 12/26/2014] [Indexed: 12/21/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most frequently occurring cancers with high morbidity and mortality worldwide. Amphiregulin (AREG), a member of the epidermal growth factor family and a rational target for CRC therapy, is essential for the three-dimensional structure of tumor formation. To clone the genes associated with increased AREG expression, we performed a cDNA microarray analysis in two CRC cell lines undergoing two-dimensional (2DC) and three-dimensional culture (3DC). Upregulated (>2.0-fold) and downregulated (<0.5-fold) genes in 3DC compared with 2DC were selected. Pathway analysis using DAVID based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway databases revealed a number of genes involved in glycolysis. In CRC cells, glucose elevated the expression of GLUT1 and AREG as well as the activity of the hypoxia-inducible factor 1 (HIF-1) luciferase reporter promoter. The suppression of AREG expression reduced the uptake of glucose and production of lactate. Luciferase assay identified a critical regulatory region for AREG expression between −130 and −180 bp upstream of the start site, which contained a carbohydrate response element (ChoRE). Max-like protein X (MLX) bound to ChoRE and enhanced the expression of AREG. Together these data suggest that AREG plays a pivotal role in the development of CRC through activation of the Warburg effect.
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Affiliation(s)
- Sung Ouk Nam
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan; Central Research Institute for Advanced Molecular Medicine, Fukuoka University, Fukuoka, Japan
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22
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Smoking, alcohol, diabetes, obesity, socioeconomic status, and the risk of colorectal cancer in a population-based case-control study. Cancer Causes Control 2014; 25:1659-68. [PMID: 25301194 DOI: 10.1007/s10552-014-0470-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/25/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Although previous research has identified factors that may determine willingness to participate in research, relatively few studies have attempted to quantify the impact non-participation may have on exposure-disease associations. The aims of this study were to (a) investigate the associations between smoking, alcohol, diabetes, obesity, and socioeconomic status and the risk of colorectal cancer in a case-control study (59.7 and 47.2 % response fractions among cases and controls, respectively); and (b) perform sensitivity analyses to examine the possible influence of non-participation. METHODS Logistic regression was used to estimate the exposure-disease associations. We then investigated the associations between various demographic and health factors and the likelihood that an individual would participate in the case-control study and then performed two sensitivity analyses (sampling weights and multiple imputation) to examine whether non-participation bias may have influenced the exposure-disease associations. RESULTS The exposures alcohol, smoking, and diabetes were associated with an increased risk of colorectal cancer. We found some differences between cases and controls when examining the factors associated with the participation in the study, and in the sensitivity analyses, the exposure-disease associations were slightly attenuated when compared with those from the original analysis. CONCLUSION Non-participation may have biased the risk estimates away from the null, but generally not enough to change the conclusions of the study.
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The sirtuin 3 expression profile is associated with pathological and clinical outcomes in colon cancer patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:871263. [PMID: 25105144 PMCID: PMC4101237 DOI: 10.1155/2014/871263] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/28/2014] [Accepted: 05/29/2014] [Indexed: 12/31/2022]
Abstract
AIM To investigate the correlation between Sirtuin 3 (SIRT3) expression and the clinical outcome of patients with colon cancer. METHODS The tumor specimens from 127 patients with colon cancer were obtained for SIRT3 immunohistochemical staining. Patients were followed up. In in vitro study, SIRT3 gene was inhibited to observe the effects of SIRT3 on the biological behavior of cultured colon cells. RESULTS The SIRT3 expression level was found to be significantly associated with the lymph node metastasis (P < 0.001) and tumor stages (P < 0.001). The colon cancer-specific survival was 64.6% among patients with high SIRT3 expressions and 88.6% among patients with low SIRT3 expressions (log-rank P = 0.016). The overall survival was 80.2% among patients with low SIRT3 expressions and 55.9% among patients with high SIRT3 expressions (log-rank P = 0.002). In vitro study showed that silencing of SIRT3 gene inhibited the proliferation, invasion, and cells migration but increased the apoptosis in the cultured colon cell lines. CONCLUSION This study provides evidence supporting that SIRT3 is closely associated with the clinical outcomes of colon cancer. SIRT3 may be considered as a marker for colon cancer.
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24
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Boyle T, Fritschi L, Platell C, Heyworth J. Lifestyle factors associated with survival after colorectal cancer diagnosis. Br J Cancer 2013; 109:814-22. [PMID: 23787918 PMCID: PMC3738138 DOI: 10.1038/bjc.2013.310] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/29/2013] [Accepted: 05/30/2013] [Indexed: 12/12/2022] Open
Abstract
Background: Aside from tumour stage and treatment, little is known about potential factors that may influence survival in colorectal cancer patients. The aim of this study was to investigate the associations between physical activity, obesity and smoking and disease-specific and overall mortality after a colorectal cancer diagnosis. Methods: A cohort of 879 colorectal cancer patients, diagnosed in Western Australia between 2005 and 2007, were followed up to 30 June 2012. Cox's regression models were used to estimate the hazard ratios (HR) for colorectal cancer-specific and overall mortality associated with self-reported pre-diagnosis physical activity, body mass index (BMI) and smoking. Results: Significantly lower overall and colorectal cancer-specific mortality was seen in females who reported any level of recent physical activity than in females reporting no activity. The colorectal cancer-specific mortality HR for increasing levels of physical activity in females were 0.34 (95% CI=0.15, 0.75), 0.37 (95% CI=0.17, 0.81) and 0.41 (95% CI=0.18, 0.90). Overweight and obese women had almost twice the risk of dying from any cause or colorectal cancer compared with women of normal weight. Females who were current smokers had worse overall and colorectal cancer-specific mortality than never smokers (overall HR=2.64, 95% CI=1.18, 5.93; colorectal cancer-specific HR=2.70, 95% CI=1.16, 6.29). No significant associations were found in males. Conclusion: Physical activity, BMI and smoking may influence survival after a diagnosis of colorectal cancer, with more pronounced results found for females than for males.
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Affiliation(s)
- T Boyle
- Western Australian Institute for Medical Research, The University of Western Australia, Perth, Australia.
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25
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Abstract
Epidemiological evidence continues to accumulate on the benefits of physical activity in relation to cancer risk, progression and mortality. Recent studies suggest that sedentary behavior may independently affect cancer risk; they also focus on factors that may explain associations with physical activity, including cancer risk factors and whether associations exist for precancerous lesions. Despite enormous efforts to examine associations between physical activity and cancer, the literature is hindered by inconsistent assessment of physical activity across studies, and incomplete consideration of variation of effects across population subgroups (for example, defined by body size, age or sex) or tumors subgroups (organ location, receptor status, or molecular subtype), and whether other factors explain study results. Clearly, public health recommendations for appropriate changes in activity levels are needed; unfortunately, at this time, we have no exact physical activity prescription to give to the public.
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Ogino S, Fuchs CS, Giovannucci E. How many molecular subtypes? Implications of the unique tumor principle in personalized medicine. Expert Rev Mol Diagn 2012; 12:621-8. [PMID: 22845482 DOI: 10.1586/erm.12.46] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cancers are complex multifactorial diseases. For centuries, conventional organ-based classification system (i.e., breast cancer, lung cancer, colon cancer, colorectal cancer, prostate cancer, lymphoma, leukemia, and so on) has been utilized. Recently, molecular diagnostics has become an essential component in clinical decision-making. However, tumor evolution and behavior cannot accurately be predicted, despite numerous research studies reporting promising tumor biomarkers. To advance molecular diagnostics, a better understanding of intratumor and intertumor heterogeneity is essential. Tumor cells interact with the extracellular matrix and host non-neoplastic cells in the tumor microenvironment, which is influenced by genomic variation, hormones, and dietary, lifestyle and environmental exposures, implicated by molecular pathological epidemiology. Essentially, each tumor possesses its own unique characteristics in terms of molecular make-up, tumor microenvironment and interactomes within and between neoplastic and host cells. Starting from the unique tumor concept and paradigm, we can better classify tumors by molecular methods, and move closer toward personalized cancer medicine and prevention.
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Affiliation(s)
- Shuji Ogino
- Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
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Ogino S, King EE, Beck AH, Sherman ME, Milner DA, Giovannucci E. Interdisciplinary education to integrate pathology and epidemiology: towards molecular and population-level health science. Am J Epidemiol 2012; 176:659-67. [PMID: 22935517 DOI: 10.1093/aje/kws226] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In recent decades, epidemiology, public health, and medical sciences have been increasingly compartmentalized into narrower disciplines. The authors recognize the value of integration of divergent scientific fields in order to create new methods, concepts, paradigms, and knowledge. Herein they describe the recent emergence of molecular pathological epidemiology (MPE), which represents an integration of population and molecular biologic science to gain insights into the etiologies, pathogenesis, evolution, and outcomes of complex multifactorial diseases. Most human diseases, including common cancers (such as breast, lung, prostate, and colorectal cancers, leukemia, and lymphoma) and other chronic diseases (such as diabetes mellitus, cardiovascular diseases, hypertension, autoimmune diseases, psychiatric diseases, and some infectious diseases), are caused by alterations in the genome, epigenome, transcriptome, proteome, metabolome, microbiome, and interactome of all of the above components. In this era of personalized medicine and personalized prevention, we need integrated science (such as MPE) which can decipher diseases at the molecular, genetic, cellular, and population levels simultaneously. The authors believe that convergence and integration of multiple disciplines should be commonplace in research and education. We need to be open-minded and flexible in designing integrated education curricula and training programs for future students, clinicians, practitioners, and investigators.
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Affiliation(s)
- Shuji Ogino
- Cancer Epidemiology Program, Dana-Farber/Harvard Cancer Center, 450 Brookline Ave., Room JF-215C, Boston, MA 02215, USA.
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Ogino S, Beck AH, King EE, Sherman ME, Milner DA, Giovannucci E. Ogino et Al. Respond to "the 21st century epidemiologist". Am J Epidemiol 2012; 176:672-4. [PMID: 22935516 DOI: 10.1093/aje/kws229] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Shuji Ogino
- Cancer Epidemiology Program, Dana-Farber/Harvard Cancer Center, 450 Brookline Ave., Room JF-215C, Boston, MA 02215, USA.
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Ogino S, King EE, Beck AH, Sherman ME, Milner DA, Giovannucci E. Interdisciplinary education to integrate pathology and epidemiology: towards molecular and population-level health science. Am J Epidemiol 2012. [PMID: 22935517 DOI: 10.1093/aje/kws226.3571252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In recent decades, epidemiology, public health, and medical sciences have been increasingly compartmentalized into narrower disciplines. The authors recognize the value of integration of divergent scientific fields in order to create new methods, concepts, paradigms, and knowledge. Herein they describe the recent emergence of molecular pathological epidemiology (MPE), which represents an integration of population and molecular biologic science to gain insights into the etiologies, pathogenesis, evolution, and outcomes of complex multifactorial diseases. Most human diseases, including common cancers (such as breast, lung, prostate, and colorectal cancers, leukemia, and lymphoma) and other chronic diseases (such as diabetes mellitus, cardiovascular diseases, hypertension, autoimmune diseases, psychiatric diseases, and some infectious diseases), are caused by alterations in the genome, epigenome, transcriptome, proteome, metabolome, microbiome, and interactome of all of the above components. In this era of personalized medicine and personalized prevention, we need integrated science (such as MPE) which can decipher diseases at the molecular, genetic, cellular, and population levels simultaneously. The authors believe that convergence and integration of multiple disciplines should be commonplace in research and education. We need to be open-minded and flexible in designing integrated education curricula and training programs for future students, clinicians, practitioners, and investigators.
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Affiliation(s)
- Shuji Ogino
- Cancer Epidemiology Program, Dana-Farber/Harvard Cancer Center, 450 Brookline Ave., Room JF-215C, Boston, MA 02215, USA.
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Boyle T, Keegel T, Bull F, Heyworth J, Fritschi L. Physical activity and risks of proximal and distal colon cancers: a systematic review and meta-analysis. J Natl Cancer Inst 2012; 104:1548-61. [PMID: 22914790 DOI: 10.1093/jnci/djs354] [Citation(s) in RCA: 206] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although there is convincing epidemiological evidence that physical activity is associated with a reduced risk of colon cancer, it is unclear whether physical activity is differentially associated with the risks of proximal colon and distal colon cancers. We conducted a systematic review and meta-analysis to investigate this issue. METHODS MEDLINE and EMBASE were searched for English-language cohort and case-control studies that examined associations between physical activity and the risks of proximal colon and distal colon cancers. A random-effects meta-analysis was conducted to estimate the summary relative risks (RRs) for the associations between physical activity and the risks of the two cancers. All statistical tests were two-sided. RESULTS A total of 21 studies met the inclusion criteria. The summary relative risk of the main results from these studies indicated that the risk of proximal colon cancer was 27% lower among the most physically active people compared with the least active people (RR = 0.73, 95% confidence interval [CI] = 0.66 to 0.81). An almost identical result was found for distal colon cancer (RR = 0.74, 95% CI = 0.68 to 0.80). CONCLUSION The results of this systematic review and meta-analysis suggest that physical activity is associated with a reduced risk of both proximal colon and distal colon cancers, and that the magnitude of the association does not differ by subsite. Given this finding, future research on physical activity and colon cancer should focus on other aspects of the association that remain unclear, such as whether sedentary behavior and nonaerobic physical activity are associated with the risk of colon cancer.
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Affiliation(s)
- Terry Boyle
- Epidemiology Group, Western Australian Institute for Medical Research, The University of Western Australia, Perth, Australia.
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Boyle T, Bull F, Fritschi L, Heyworth J. Resistance training and the risk of colon and rectal cancers. Cancer Causes Control 2012; 23:1091-7. [PMID: 22562221 DOI: 10.1007/s10552-012-9978-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Although there is convincing evidence that physical activity reduces colon cancer risk, research in this area has focused on aerobic activity. We conducted a case-control study to investigate whether resistance training was associated with the risk of colon and rectal cancers. METHODS Data were collected on various colorectal cancer risk factors, including recreational physical activity performed during three age periods, from 870 cases and 996 controls in Western Australia in 2005-2007. Participants were classified as having never, possibly, or definitely performed resistance training in each age period and over the adult lifetime. The association between resistance training and colon and rectal cancer risk was analyzed using multinomial logistic regression. RESULTS Participants who definitely performed resistance training in their lifetime had a non-significant reduced risk of colon cancer compared with those who did no resistance training (adjusted odds ratio (AOR) = 0.70, 95 % confidence interval (CI) = 0.45-1.11). No association was found for rectal cancer risk (AOR = 1.16, 95 % CI = 0.71-1.87). Performing resistance training was associated with a lower risk of colon cancer in each age period, although none of the relationships were statistically significant. CONCLUSION This study provides some initial evidence, albeit inconclusive, that resistance training may be inversely associated with colon cancer risk.
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Affiliation(s)
- Terry Boyle
- School of Population Health, The University of Western Australia, Crawley, Australia.
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Abstract
Despite the convincing evidence that physical activity reduces the risk of colon cancer, there are some aspects of the association that remain unclear. These include the appropriate timeframe of exposure, whether the intensity of physical activity matters, and whether sedentary behavior is a distinct risk factor. This review summarized the research that has investigated these issues. In terms of timing, physical activity at any age (with the exception of physical activity performed up to and including the late teens) has been shown to be associated with a significantly reduced risk of colon cancer. Physical activity performed between 30 and 50 years of age, as well as long-term or lifetime physical activity, has been most consistently shown to reduce risk. For intensity, research to date suggests that more intense activity (particularly vigorous activity) may be associated with a greater reduction in the risk of colon cancer for males but not for females. Finally, most of the studies that have investigated the effect of sedentary behavior on the risk of colon or colorectal cancer have shown an increased risk, suggesting that sedentary behavior may be a distinct risk factor for colon cancer.
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Affiliation(s)
- Terry Boyle
- School of Population Health, The University of Western Australia, Crawley, and Western Australian Institute for Medical Research, The University of Western Australia, Nedlands, Western Australia, Australia
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