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Murthy SS, Trapani D, Cao B, Bray F, Murthy S, Kingham TP, Are C, Ilbawi AM. Premature mortality trends in 183 countries by cancer type, sex, WHO region, and World Bank income level in 2000-19: a retrospective, cross-sectional, population-based study. Lancet Oncol 2024; 25:969-978. [PMID: 38964357 PMCID: PMC11329430 DOI: 10.1016/s1470-2045(24)00274-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature mortality from non-communicable diseases, including cancer, by 2030. However, there is a paucity of data on premature mortality rates by cancer type. In this study, we examine annual rates of change for cancer-specific premature mortality and classify whether countries are on track to reach SDG 3.4 targets. METHODS This is a retrospective, cross-sectional, population-based study investigating premature mortality trends from 2000-19 using the WHO Global Health Estimates data. All cancers combined and thirteen individual cancers in 183 countries were examined by WHO region, World Bank income level, and sex. The risk of premature mortality was calculated for ages 30-69 years, independent of other competing causes of death, using standard life table methods. The primary objective was to compute average annual rate of change in premature mortality from 2000 to 2019. Secondary objectives assessed whether this annual rate of change would be sufficient to reach SDG 3.4. targets for premature mortality by 2030. FINDINGS This study was conducted using data retrieved for the years 2000-19. Premature mortality rates decreased in 138 (75%) of 183 countries across all World Bank income levels and WHO regions, however only eight (4%) countries are likely to meet the SDG 3.4 targets for all cancers combined. Cancers where early detection strategies exist, such as breast and colorectal cancer, have higher declining premature mortality rates in high-income countries (breast cancer 48 [89%] of 54 and colorectal cancer 45 [83%]) than in low-income countries (seven [24%] of 29 and four [14%]). Cancers with primary prevention programmes, such as cervical cancer, have more countries with declining premature mortality rates (high-income countries 50 [93%] of 54 and low-income countries 26 [90%] of 29). Sex-related disparities in premature mortality rates vary across WHO regions, World Bank income groups, and by cancer type. INTERPRETATION There is a greater reduction in premature mortality for all cancers combined and for individual cancer types in high-income countries compared with lower-middle-income and low-income countries. However, most countries will not reach the SDG 3.4 target. Cancers with early detection strategies in place, such as breast and colorectal cancers, are performing poorly in premature mortality compared with cancers with primary prevention measures, such as cervical cancer. Investments toward prevention, early detection, and treatment can potentially accelerate declines in premature mortality. FUNDING WHO.
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Affiliation(s)
- Shilpa S Murthy
- Department of Surgery, Division of Colon and Rectal Surgery, Yale University School of Medicine, New Haven, CT, USA.
| | - Dario Trapani
- Department of Haematology and Oncology, University of Milan, Milan, Italy; European Institute of Oncology, IRCCS, Milan, Italy
| | - Bochen Cao
- Department of Data and Analytics, WHO, Geneva, Switzerland
| | - Freddie Bray
- Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Shashanka Murthy
- Infectious Disease Institute and Centre of Microbiome Science, Ohio State University, Columbus, OH, USA
| | - Thomas Peter Kingham
- Department of Surgery, Division of Surgical Oncology, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Chandrakanth Are
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Centre, Omaha, NE, USA
| | - André M Ilbawi
- Department of Non-Communicable Diseases, WHO, Geneva, Switzerland
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Gapstur SM, Bouvard V, Nethan ST, Freudenheim JL, Abnet CC, English DR, Rehm J, Balbo S, Buykx P, Crabb D, Conway DI, Islami F, Lachenmeier DW, McGlynn KA, Salaspuro M, Sawada N, Terry MB, Toporcov T, Lauby-Secretan B. The IARC Perspective on Alcohol Reduction or Cessation and Cancer Risk. N Engl J Med 2023; 389:2486-2494. [PMID: 38157507 DOI: 10.1056/nejmsr2306723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Susan M Gapstur
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Véronique Bouvard
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Suzanne T Nethan
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Jo L Freudenheim
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Christian C Abnet
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Dallas R English
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Jürgen Rehm
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Silvia Balbo
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Penny Buykx
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - David Crabb
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - David I Conway
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Farhad Islami
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Dirk W Lachenmeier
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Katherine A McGlynn
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Mikko Salaspuro
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Norie Sawada
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Mary B Terry
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Tatiana Toporcov
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
| | - Béatrice Lauby-Secretan
- From the International Agency for Research on Cancer, Lyon, France (S.M.G., V.B., S.T.N., B.L.-S.); the School of Public Health and Health Professions, University at Buffalo, Buffalo (J.L.F.), and the Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, Columbia University, New York (M.B.T.) - both in New York; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (C.C.A., K.A.M.); Cancer Council Victoria and Melbourne School of Population and Global Health, University of Melbourne, Melbourne (D.R.E.), and the University of Newcastle, Callaghan, NSW (P.B.) - both in Australia; the Centre for Addiction and Mental Health, Toronto (J.R.); the School of Public Health, University of Minnesota, Minneapolis (S.B.); Eskenazi Health and Indiana University School of Medicine, Indianapolis (D.C.); the School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom (D.I.C.); American Cancer Society, Atlanta (F.I.); Chemical and Veterinary Investigation Agency Karlsruhe, Karlsruhe, Germany (D.W.L.); University of Helsinki, Helsinki (M.S.); the Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo (N.S.); and the School of Public Health, Universidade de São Paulo, São Paulo (T.T.)
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Deng JW, Zhou YL, Dai WX, Chen HM, Zhou CB, Zhu CQ, Ma XY, Pan SY, Cui Y, Xu J, Zhao EH, Wang M, Chen JX, Wang Z, Liu Q, Wang JL, Cai GX, Chen YX, Fang JY. Noninvasive predictive models based on lifestyle analysis and risk factors for early-onset colorectal cancer. J Gastroenterol Hepatol 2023; 38:1768-1777. [PMID: 37259282 DOI: 10.1111/jgh.16243] [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: 10/09/2022] [Revised: 05/10/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) incidence has increased among patients aged <50 years. Exploring high-risk factors and screening high-risk populations may help lower early-onset CRC (EO-CRC) incidence. We developed noninvasive predictive models for EO-CRC and investigated its risk factors. METHODS This retrospective multicenter study collected information on 1756 patients (811 patients with EO-CRC and 945 healthy controls) from two medical centers in China. Sociodemographic features, clinical symptoms, medical and family history, lifestyle, and dietary factors were measured. Patients from one cohort were randomly assigned (8:2) to two groups for model establishment and internal validation, and another independent cohort was used for external validation. Multivariable logistic regression, random forest, and eXtreme Gradient Boosting (XGBoost) were performed to establish noninvasive predictive models for EO-CRC. Some variables in the model influenced EO-CRC occurrence and were further analyzed. Multivariable logistic regression analysis yielded adjusted odd ratios (ORs) and 95% confidence intervals (CIs). RESULTS All three models showed good performance, with areas under the receiver operator characteristic curves (AUCs) of 0.82, 0.84, and 0.82 in the internal and 0.78, 0.79, and 0.78 in the external validation cohorts, respectively. Consumption of sweet (OR 2.70, 95% CI 1.89-3.86, P < 0.001) and fried (OR 2.16, 95% CI 1.29-3.62, P < 0.001) foods ≥3 times per week was significantly associated with EO-CRC occurrence. CONCLUSION We established noninvasive predictive models for EO-CRC and identified multiple nongenetic risk factors, especially sweet and fried foods. The model has good performance and can help predict the occurrence of EO-CRC in the Chinese population.
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Affiliation(s)
- Jia-Wen Deng
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lu Zhou
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei-Xing Dai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Hui-Min Chen
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng-Bei Zhou
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chun-Qi Zhu
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-Yue Ma
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Si-Yuan Pan
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yun Cui
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jia Xu
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai, Jiao Tong University, Shanghai, China
| | - En-Hao Zhao
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai, Jiao Tong University, Shanghai, China
| | - Ming Wang
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai, Jiao Tong University, Shanghai, China
| | - Jin-Xian Chen
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai, Jiao Tong University, Shanghai, China
| | - Zheng Wang
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai, Jiao Tong University, Shanghai, China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ji-Lin Wang
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guo-Xiang Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Ying-Xuan Chen
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing-Yuan Fang
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Jin EH, Han K, Shin CM, Lee DH, Kang SJ, Lim JH, Choi YJ. Sex and Tumor-Site Differences in the Association of Alcohol Intake With the Risk of Early-Onset Colorectal Cancer. J Clin Oncol 2023; 41:3816-3825. [PMID: 37315287 PMCID: PMC10419447 DOI: 10.1200/jco.22.01895] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 06/16/2023] Open
Abstract
PURPOSE Given the increasing incidence of early-onset colorectal cancer (CRC; diagnosed before age 50 years) worldwide, it is important to identify modifiable risk factors. We investigated whether alcohol consumption in the young population correlated with an increased early-onset CRC risk that differed by tumor location and sex. PATIENTS AND METHODS We investigated the association between average daily alcohol consumption and the risk of early-onset CRC among 5,666,576 individuals age 20-49 years using data from the Korean National Health Insurance Service (2009-2019). Alcohol consumption levels of nondrinker, light (reference), moderate, and heavy drinker were defined as 0, <10, 10 to <30, and ≥30 g/d for men and 0, <10, 10 to <20, and ≥20 g/d for women, respectively. Multivariate Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) with 95% CIs. RESULTS We identified 8,314 incident early-onset CRC cases during the follow-up period. Moderate and heavy drinkers showed an increased risk of early-onset CRC compared with light drinkers (aHR, 1.09 [95% CI, 1.02 to 1.16] and aHR, 1.20 [95% CI, 1.11 to 1.29], respectively). Subgroup analysis by tumor location showed positive dose-response significance for early-onset distal colon and rectal cancers, but not for proximal colon cancer. The dose-response association between drinking frequency and risk of early-onset CRC was significant, with a 7%, 14%, and 27% increased risk for 1-2, 3-4, and ≥5 d/wk compared with nondrinkers, respectively. CONCLUSION Excessive alcohol consumption increases the risk of CRC onset before age 50 years. Thus, effective interventions are required to discourage alcohol consumption among young people and to tailor CRC screening approaches for high-risk individuals.
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Affiliation(s)
- Eun Hyo Jin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Joo Hyun Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Yoon Jin Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Yin R, Yang Y, Chang Y, Tang L, Hu Q, Yang J, Cheng C, Xiao L, Zhang F. Association Between Alcohol Expectancy and Drinking Behaviors in Summer Vacation and Last Year Among College Students. Int J Gen Med 2023; 16:2679-2692. [PMID: 37398513 PMCID: PMC10314789 DOI: 10.2147/ijgm.s413193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background Drinking in summer vacation, as an important part of college students' drinking behavior, has rarely been studied. At present, there is no research to explore the association between alcohol expectancy and college students' drinking behavior during the summer vacation. Methods A total of 487 college students were selected from three universities in Chongqing from July 30, 2017, to August 30, 2017, by cluster sampling. The electronic questionnaires were distributed to complete the anonymous survey related to drinking. The questionnaire on drinking mainly included baseline characteristics, influencing factors related to drinking, drinking behavior in the last year and summer vacation, and alcohol expectancy. Independent sample t-test and one-way ANOVA were used for multi-factor analysis. Multi-level logistic regression analysis and ordered logistic regression analysis were used for multivariate analysis. Results The past drinking rate in the study group was 86.24%. In the past year, the drinking rate and binge drinking rate of college students were 63.24% and 23.20%. In summer drinking, these two indicators were 29.57% and 8.42%, respectively. About 92.50% of the moderate and heavy drinking groups among college students had drinking behavior during the summer vacation. The average negative expectancy among college students was 3.26 ± 0.87 while the average positive expectancy was 2.63 ± 0.66. In drinking last year, positive expectancy was a risk factor for occasional and light drinking compared with those of non-drinkers (P<0.05). In summer vacation drinking, compared with those of non-drinkers, negative expectancy was a protective factor for occasional drinking (OR: 1.847, 95% CI: 1.293-2.638), negative expectancy and positive expectancy were both influencing factors for light drinking (P<0.05). Conclusion The drinking rate in the study group was at a high level in the past. The association between alcohol expectancy and drinking behavior among college students would be different according to the period and amount of drinking.
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Affiliation(s)
- Ruoyun Yin
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuan Yang
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yujiao Chang
- Department of Infection, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lei Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qian Hu
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jian Yang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Chong Cheng
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lei Xiao
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Fan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
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Ni P, Lansdorp-Vogelaar I, Zauber AG, Cao Y. Elucidating the Drivers for the Rising Incidence of Early-Onset Colorectal Cancer: How Ecologic Studies Could Help and What Is Next. Cancer Epidemiol Biomarkers Prev 2023; 32:164-166. [PMID: 36744311 DOI: 10.1158/1055-9965.epi-22-1126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 02/07/2023] Open
Abstract
The incidence of colorectal cancer diagnosed before age 50, often referred to as early-onset colorectal cancer, has been increasing, whereas the overall colorectal cancer incidence has declined. Elucidating the drivers for the rising burden of early-onset colorectal cancer is a priority in cancer epidemiology and prevention. In this issue of Cancer Epidemiology, Biomarkers & Prevention, Chen and colleagues demonstrated that ecologic studies are a helpful method to reveal emerging risk factors at the population level and concluded that alcohol use might be a potential contributor to the rising incidence of early-onset colorectal cancer. Moving forward, because of the observed birth cohort effect in early-onset colorectal cancer, where younger generations have a steeper increase, hypothesis-driven investigations on emerging risk factors in recent generations, especially during early life, are warranted. Ultimately, the identified risk factors could be integrated with well-established microsimulation models of colorectal cancer, powerful tools that can simultaneously capture population-level secular changes in risk factors, relative risk estimates for each risk factor, and the natural history of colorectal cancer. This would allow us to quantitatively estimate the explained and unexplained portion of the rising incidence of early-onset colorectal cancer by calendar period and birth cohorts, and to help identify priorities in etiologic research, prevention, and early detection. See related article by Chen et al., p. 217.
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Affiliation(s)
- Peiyun Ni
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ann G Zauber
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
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7
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Chen Y, Yang B, Zhao J, Ross RP, Stanton C, Zhang H, Chen W. Exploiting lactic acid bacteria for colorectal cancer: a recent update. Crit Rev Food Sci Nutr 2022; 64:5433-5449. [PMID: 36530047 DOI: 10.1080/10408398.2022.2154742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer in the world. Currently, chemotherapy and radiotherapy used to treat CRC exhibit many side effects, hence, it is an urgent need to design effective therapies to prevent and treat CRC. Lactic acid bacteria (LAB) can regulate gut microbiota, intestinal immunity, and intestinal mechanical barrier, which is becoming a hot product for the prevention and treatment of CRC, whereas comprehensive reviews of their anti-CRC mechanisms are limited. This review systematically reveals the latest incidence, mortality, risk factors, and molecular mechanisms of CRC, then summarizes the roles of probiotics in alleviating CRC in animal and clinical studies and critically reviews the possible mechanisms by which these interventions exert their activities. It then shows the limitations in mechanisms and clinical studies, and the suggestions for future research are also put forward, which will play an important role in guiding and promoting the basic and clinical research of remising CRC by LAB and the development of LAB products.
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Affiliation(s)
- Yang Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Bo Yang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- International Joint Research Center for Probiotics & Gut Health, Jiangnan University, Wuxi, China
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- International Joint Research Center for Probiotics & Gut Health, Jiangnan University, Wuxi, China
| | - R Paul Ross
- International Joint Research Center for Probiotics & Gut Health, Jiangnan University, Wuxi, China
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Catherine Stanton
- International Joint Research Center for Probiotics & Gut Health, Jiangnan University, Wuxi, China
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Teagasc Food Research Centre, Cork, Ireland
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, China
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, China
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Dhawan R, Shay D, Zhao YC, Lu Y, Giovannucci E. Comment on Murphy et al: maternal obesity, pregnancy weight gain, and birth weight and risk of colorectal cancer. Gut 2022; 71:2611-2612. [PMID: 35197322 DOI: 10.1136/gutjnl-2022-327148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Ravi Dhawan
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Denys Shay
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Yu Chen Zhao
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Yujia Lu
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA .,Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Yoo JE, Han K, Shin DW, Kim D, Kim BS, Chun S, Jeon KH, Jung W, Park J, Park JH, Choi KS, Kim JS. Association Between Changes in Alcohol Consumption and Cancer Risk. JAMA Netw Open 2022; 5:e2228544. [PMID: 36001313 PMCID: PMC9403779 DOI: 10.1001/jamanetworkopen.2022.28544] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IMPORTANCE Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood. OBJECTIVE To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged ≥40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020. EXPOSURES Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (<15 g/d), moderate (15-29.9 g/d), and heavy (≥30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer. MAIN OUTCOMES AND MEASURES The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer). RESULTS Among the 4 513 746 participants (mean [SD] age, 53.6 [9.6] years; 2 324 172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk. CONCLUSIONS AND RELEVANCE Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.
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Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong-seong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Keun Hye Jeon
- Department of Family Medicine, Cha Gumi Medical Center, Cha University, Gumi-si, Gyeongsangbuk-do, Republic of Korea
| | - Wonyoung Jung
- Department of Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jinsung Park
- Department of Urology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Jin Ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, Adhikari S, Advani SM, Afzal MS, Aghaie Meybodi M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alhalaiqa FAN, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Alvand S, Alvis-Guzman N, Amini S, Ancuceanu R, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Arabloo J, Aryannejad A, Asghari Jafarabadi M, Athari SS, Ausloos F, Ausloos M, Awedew AF, Awoke MA, Ayana TM, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Badiye AD, Bagherieh S, Bahadory S, Baig AA, Baker JL, Banach M, Barrow A, Berhie AY, Besharat S, Bhagat DS, Bhagavathula AS, Bhala N, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bjørge T, Bodicha BBA, Braithwaite D, Brenner H, Calina D, Cao C, Cao Y, Carreras G, Carvalho F, Cerin E, Chakinala RC, Cho WCS, Chu DT, Conde J, Costa VM, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Danielewicz A, Demeke FM, Demissie GD, Desai R, Dhamnetiya D, Dianatinasab M, Diaz D, Didehdar M, Doaei S, Doan LP, Dodangeh M, Eghbalian F, Ejeta DD, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Enyew DB, Eyayu T, Ezzeddini R, Fakhradiyev IR, Farooque U, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fattahi H, Fattahi N, Fereidoonnezhad M, Fernandes E, Fetensa G, Filip I, Fischer F, Foroutan M, Gaal PA, Gad MM, Gallus S, Garg T, Getachew T, Ghamari SH, Ghashghaee A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Gizaw AT, Glasbey JC, Golechha M, Goleij P, Gonfa KB, Gorini G, Guha A, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Haque S, Hariri S, Hasaballah AI, Hassanipour S, Hay SI, Herteliu C, Holla R, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Humayun A, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Islami F, Iwagami M, Jahani MA, Jakovljevic M, Javaheri T, Jayawardena R, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jozwiak JJ, Kabir A, Kalhor R, Kamath A, Kapoor N, Karaye IM, Karimi A, Kauppila JH, Kazemi A, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khanali J, Khayamzadeh M, Khodadost M, Kim H, Kim MS, Kisa A, Kisa S, Kolahi AA, Koohestani HR, Kopec JA, Koteeswaran R, Koyanagi A, Krishnamoorthy Y, Kumar GA, Kumar M, Kumar V, La Vecchia C, Lami FH, Landires I, Ledda C, Lee SW, Lee WC, Lee YY, Leong E, Li B, Lim SS, Lobo SW, Loureiro JA, Lunevicius R, Madadizadeh F, Mahmoodpoor A, Majeed A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mantovani LG, Martorell M, Masoudi S, Mathur P, Meena JK, Mehrabi Nasab E, Mendoza W, Mentis AFA, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Mijena GFW, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Misra S, Mohammad KA, Mohammadi E, Mohammadi S, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Mokhtari Z, Molokhia M, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh R, Moraga P, Morgado-da-Costa J, Mubarik S, Mulita F, Naghavi M, Naimzada MD, Nam HS, Natto ZS, Nayak BP, Nazari J, Nazemalhosseini-Mojarad E, Negoi I, Nguyen CT, Nguyen SH, Noor NM, Noori M, Noori SMA, Nuñez-Samudio V, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Okati-Aliabad H, Olagunju AT, Olagunju TO, Ong S, Ostroff SM, Padron-Monedero A, Pakzad R, Pana A, Pandey A, Pashazadeh Kan F, Patel UK, Paudel U, Pereira RB, Perumalsamy N, Pestell RG, Piracha ZZ, Pollok RCG, Pourshams A, Pourtaheri N, Prashant A, Rabiee M, Rabiee N, Radfar A, Rafiei S, Rahman M, Rahmani AM, Rahmanian V, Rajai N, Rajesh A, Ramezani-Doroh V, Ramezanzadeh K, Ranabhat K, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Rastegar M, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezazadeh-Khadem S, Roshandel G, Saber-Ayad MM, Saberzadeh-Ardestani B, Saddik B, Sadeghi H, Saeed U, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Salimi A, Salimzadeh H, Samadi P, Samaei M, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sathian B, Satpathy M, Schneider IJC, Šekerija M, Sepanlou SG, Seylani A, Sha F, Shafiee SM, Shaghaghi Z, Shahabi S, Shaker E, Sharifian M, Sharifi-Rad J, Sheikhbahaei S, Shetty JK, Shirkoohi R, Shobeiri P, Siddappa Malleshappa SK, Silva DAS, Silva Julian G, Singh AD, Singh JA, Siraj MS, Sivandzadeh GR, Skryabin VY, Skryabina AA, Socea B, Solmi M, Soltani-Zangbar MS, Song S, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabibian E, Taheri M, TaheriAbkenar Y, Taherkhani A, Talaat IM, Tan KK, Tbakhi A, Tesfaye B, Tiyuri A, Tollosa DN, Touvier M, Tran BX, Tusa BS, Ullah I, Ullah S, Vacante M, Valadan Tahbaz S, Veroux M, Vo B, Vos T, Wang C, Westerman R, Woldemariam M, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yu C, Yuce D, Yunusa I, Zadnik V, Zahir M, Zare I, Zhang ZJ, Zoladl M. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:627-647. [PMID: 35397795 PMCID: PMC9192760 DOI: 10.1016/s2468-1253(22)00044-9] [Citation(s) in RCA: 197] [Impact Index Per Article: 98.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. METHODS Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. FINDINGS Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. INTERPRETATION The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. FUNDING Bill & Melinda Gates Foundation.
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Giovannucci E. Molecular Biologic and Epidemiologic Insights for Preventability of Colorectal Cancer. J Natl Cancer Inst 2022; 114:645-650. [PMID: 34978574 PMCID: PMC9086743 DOI: 10.1093/jnci/djab229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/30/2021] [Accepted: 12/16/2021] [Indexed: 11/12/2022] Open
Abstract
The etiology of colorectal cancer (CRC) has been informed from both a molecular biology perspective, which concerns the study of the nature, timing, and consequences of mutations in driver genes, and epidemiology, which focuses on identifying risk factors for cancer. For the most part, these fields have developed independently, and it is thus important to consider them in a more integrated manner. The molecular mutational perspective has stressed the importance of mutations due to replication of adult stem cells, and the molecular fingerprint of most CRCs does not suggest the importance of direct carcinogens. Epidemiology has identified numerous modifiable risk factors that account for most CRCs, most of which are not direct mutagens. The distribution of CRCs across the large bowel is not uniform, which is possibly caused by regional differences in the microbiota. Some risk factors are likely to act through or interact with the microbiota. The mutational perspective informs when risk factors may begin to operate in life and when they may cease to operate. Evidence from the mutational model and epidemiology supports that CRC risk factors begin early in life and may contribute to the risk of early-onset CRC. Later in carcinogenesis, there may be a "point of no return" when sufficient mutations have accumulated, and some risk factors do not affect cancer risk. This period may be at least 5-15 years for some risk factors. A more precise knowledge of timing of risk factor to cancer is required to inform preventive efforts.
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Affiliation(s)
- Edward Giovannucci
- Correspondence to: Edward Giovannucci, ScD, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA (e-mail: )
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Bassett JK, MacInnis RJ, Yang Y, Hodge AM, Lynch BM, English DR, Giles GG, Milne RL, Jayasekara H. Alcohol intake trajectories during the life course and risk of alcohol-related cancer: a prospective cohort study. Int J Cancer 2022; 151:56-66. [PMID: 35182083 DOI: 10.1002/ijc.33973] [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: 09/28/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/10/2022]
Abstract
We examined associations between sex-specific alcohol intake trajectories and alcohol-related cancer risk using data from 22,756 women and 15,701 men aged 40-69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10-year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage-specific frequency and quantity, was used to estimate group-based sex-specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol-related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2,303 incident alcohol-related cancers were diagnosed during 485,525 person-years in women and 789 during 303,218 person-years in men. For men, compared with lifetime abstention, heavy intake (mean≥60 g/day) at age 20-39 followed by either an early (from age 40-49) (early decreasing heavy; HR=1.75, 95% CI: 1.25-2.44) or late decrease (from age 60-69) (late decreasing heavy; HR=1.94, 95% CI: 1.28-2.93), and moderate intake (mean<60 g/day) at age 20-39 increasing to heavy intake in middle-age (increasing heavy; HR=1.45, 95% CI: 1.06-1.97) were associated with increased risk of alcohol-related cancer. For women, compared with lifetime abstention, increasing intake from age 20 (increasing moderate) was associated with increased alcohol-related cancer risk (HR=1.25, 95% CI: 1.06-1.48). Similar associations were observed for colorectal (men) and breast cancer. Heavy drinking during early adulthood might increase cancer risk later in life. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Yi Yang
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Harindra Jayasekara
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Man J, Zhang T, Yin X, Chen H, Zhang Y, Zhang X, Chen J, Yang X, Lu M. Spatiotemporal Trends of Colorectal Cancer Mortality Due to Low Physical Activity and High Body Mass Index From 1990 to 2019: A Global, Regional and National Analysis. Front Med (Lausanne) 2022; 8:800426. [PMID: 35083251 PMCID: PMC8784601 DOI: 10.3389/fmed.2021.800426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/10/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Understanding the spatiotemporal trends of colorectal cancer (CRC) deaths caused by low physical activity (LPA) and high body mass index (BMI) is essential for the prevention and control of CRC. We assessed patterns of LPA and high BMI-induced CRC deaths from 1990 to 2019 at global, regional, and national levels. Methods: Data on CRC deaths due to LPA and high BMI was downloaded from the Global Burden of Disease 2019 Study. We calculated estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the CRC age-standardized mortality rate (ASMR) due to LPA and high BMI. Results: In 2019, CRC deaths due to LPA and high BMI were estimated as 58.66 thousand and 85.88 thousand, and the corresponding ASMRs were 0.77/100,000 and 1.07/100,000, with EAPCs of−0.39 [95% confidence interval (CI):−0.49,−0.29] and 0.64[95% CI: 0.57, 0.71] from 1990 to 2019 respectively. Since 1990, the ASMR of CRC attributable to LPA and high BMI has been on the rise in many geographic regions, especially in low middle and middle sociodemographic index (SDI) regions. Thirteen countries had a significant downward trend in CRC ASMR attributed to LPA, with EAPCs < −1. And, only 4 countries had a significant downward trend in CRC ASMR attributable to high BMI, with EAPCs < −1. Countries with a higher baseline burden in 1990 and a higher SDI in 2019 had a faster decline in ASMR due to high BMI and LPA. Conclusions: The burden of CRC caused by LPA and high BMI is on the rise in many countries. Countries should adopt a series of measures to control the local prevalence of obesity and LPA in order to reduce disease burden, including CRC.
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Affiliation(s)
- Jinyu Man
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaolin Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuening Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiaqi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ming Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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