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Takada M, Hirouchi J, Kujiraoka I, Takahara S, Schneider T, Kai M. Temporal changes in cumulative mortality risks of cancer, by occupation, in the working population of Japan from 1995 to 2020: a benchmark for radiation risk comparison. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011514. [PMID: 38422516 DOI: 10.1088/1361-6498/ad2ebc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/29/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study was to provide benchmark data for discussing the tolerability of cancer risk associated with occupational radiation exposure. It focused on differences in cancer mortality risk by occupation among Japan's working population and examined baseline cancer mortality risks and its variations from 1995 through 2020. Data were collected every five years from national vital statistics sources. By focusing on the same types of cancer among radiation induced effects, cumulative mortality risks were calculated for colorectal, lung, and breast cancer (females only) for those aged 15-74. The average cumulative mortality risk for the working population in Japan has decreased by 30%-60% over the past 25 years. Service workers and male managers were at an average risk, among all workers, while clerical workers and transportation and manufacturing workers had about half the average risk. The risks were higher for professionals and female managers, about 1.5-2 times the average for professionals and up to 5 times the average for female managers. The decrease in the average cancer mortality risk in the working population as a baseline suggests that risk tolerance in society might have changed over time. Since differences in mortality by occupation were confirmed, the usefulness of occupational data as a benchmark needs further investigation, as high-risk/low-risk occupations vary by country and region. The results of this study contribute to put radiation risks into perspective with the background risk of cancer.
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Affiliation(s)
- Momo Takada
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Jun Hirouchi
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Ikuo Kujiraoka
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Shogo Takahara
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Thierry Schneider
- Nuclear Protection Evaluation Centre (CEPN), Fontenay-aux-Roses, France
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Hatime Z, El Kinany K, Huybrechts I, Murphy N, Gunter MJ, Khalis M, Meimouna SD, Boudouaya HA, Benslimane A, El Asri A, Abkari M, Bendahhou K, Ismaili MZ, El Rhazi K. Association of Physical Activity and Sedentary Behavior with Colorectal Cancer Risk in Moroccan Adults: A Large-Scale, Population-Based Case-Control Study. Asian Pac J Cancer Prev 2022; 23:1859-1866. [PMID: 35763624 PMCID: PMC9587816 DOI: 10.31557/apjcp.2022.23.6.1859] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical activity has been associated with a lower risk of colorectal cancer in studies mainly conducted in high-income countries, while sedentary behavior has been suggested to increase CRC risk. In this study, we aimed to investigate the role of physical activity and sedentary behavior on CRC risk in the Moroccan population. METHODS A case-control study was conducted involving 1516 case-control pairs, matched on age, sex and center in five university hospital centers. A structured questionnaire was used to collect information on socio-demographics, lifestyle habits, family history of CRC, and non-steroidal anti-inflammatory drug (NSAID) use. Information on physical activity and sedentary behavior were collected by the Global Physical Activity Questionnaire (GPAQ). For each activity (work, household, and recreational activities), a metabolic equivalent (MET) was calculated using GPAQ recommendations. Conditional logistic regression models were used to assess the association between physical activity, sedentary behavior and the risk of overall CRC, colon cancer, and rectal cancer taking into account other CRC risk factors. RESULTS High level of physical activity was associated with lower risk of rectal cancer, colon cancer, and overall CRC, the adjusted odds ratios (ORa) for the highest versus the lowest level of activity were 0.67 (95% CI: 0.54-0.82), 0.77 (95% CI: 0.62-0.96), and 0.72 (95% CI: 0.62-0.83), respectively. In contrast, sedentary behavior was positively associated with rectal cancer risk (ORa=1.19, 95% CI: 1.01-1.40), but was unrelated to colon cancer risk (ORa=1.02, 95% CI: 0.87-1.20). CONCLUSION We found an inverse association between physical activity and CRC risk in the Moroccan population, and a positive association between sedentary behavior and rectal cancer risk. Considering that one-third of the total population studied had a sedentary lifestyle, these results may be used to improve strategies of public health suitable for Moroccan population.
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Affiliation(s)
- Zineb Hatime
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Khaoula El Kinany
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Inge Huybrechts
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Marc J Gunter
- School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco.
| | - Mohamed Khalis
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Sidi Deoula Meimouna
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Hanae Abir Boudouaya
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Abdelilah Benslimane
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Achraf El Asri
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | | | | | | | - Karima El Rhazi
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
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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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Eshak ES, Noda H, Tamakoshi A, Iso H. Walking time, sports activity, job type, and body posture during work in relation to incident colorectal cancer: the JACC prospective cohort study. Cancer Causes Control 2022; 33:473-481. [PMID: 35048204 DOI: 10.1007/s10552-021-01542-x] [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: 09/11/2020] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE An inverse association between physical activity and colorectal cancer (CRC) has been suggested. We aimed to assess the specific and combined effects of leisure-time and occupational physical activities on CRC risk among Japanese adults. METHODS Using Cox proportional hazard models, we tested whether walking time, sports activity, body posture during work, and job type-or the combination of these variables-were associated with CRC incidence in a prospective cohort of 26,897 Japanese adults aged 40-79 years. RESULTS During a median 17-year follow-up (1990-2009) period, we ascertained 423 incident cases of CRC (267 colon and 156 rectum cancer). Time spent walking suggested a dose-response inverse relationship with CRC risk (p-trend = 0.051). Manual labor was associated with lower CRC risk when compared to office work with HRs (95% CIs) of 0.74 (0.56-0.97) for CRC and 0.68 (0.48-0.96) for colon cancer. Compared to sitting, moving during work tended to be inversely associated with rectal cancer risk, especially after censoring early incident cases within 3 years after baseline; HR (95% CI) = 0.63 (0.40-0.99). Combining walking and job type suggested mutual and synergistic benefits on the risk of colon cancer (p-interaction = 0.03). Compared to office workers walking < 1 h/day, the HR (95% CI) of colon cancer was 0.48 (0.23-0.98), 0.61 (0.42-0.89), and 0.59 (0.41-0.87) in office workers walking ≥ 1 h/day, non-office workers walking < 1 h/day, and non-office workers walking ≥ 1 h/day, respectively. CONCLUSION The time spent walking, job type, and posture during work were independently associated with the reduced incident CRC risk among Japanese men and women.
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Affiliation(s)
- Ehab S Eshak
- Department of Public Health and Community Medicine, Faculty of Medicine, Minia University, Main Road, Shalaby land, Minia, 61519, Egypt. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, 7-15 Kita-Ku, Sapporo, 060-8638, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
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Saleem S, Aleem I, Zeshan M, Bakar MA, Atiq A, Tahseen M, Mahmood MT, Hassan S, Syed AA, Hussain M, Ahmad AH, Khattak S, Yusuf MA. Body Mass Index and Other Risk Factors Effects on Colon Cancer Prognosis in Pakistan. JOURNAL OF CANCER & ALLIED SPECIALTIES 2022; 8:477. [PMID: 37197568 PMCID: PMC10187604 DOI: 10.37029/jcas.v8i2.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/30/2022] [Indexed: 05/19/2023]
Abstract
Introduction Asian developing countries share the burden of colorectal cancer (CRC) with rising mortality rates. This prospective study aims to apprehend the clinical relevance of age, gender, lifestyle choices (dietary habits and addiction) and body mass index (BMI) to the occurrence and progression of colon cancer (CC). Methods A cohort of non-cancer (NC) and CC patients of South-Central Asian origin registered for screening colonoscopy or surgery at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan, from 2015 to 2020 was identified. BMI (Kg/m2) was classified according to the World Health Organization criteria as underweight (<18.5 Kg/m2), normal weight (18.5-24.9 Kg/m2) and overweight (≥25 Kg/m2). Results Among 236 participants, 99 (41.9%) belonged to the NC group, and 137 (58.1 %) participants had CC Overall, participants included 74 women and 162 men aged 20-85 years (mean ± SD; 49.9 ± 14.9). Notably, 46.0% of cancer patients had a family history of cancer. There was a direct relationship between CC with abnormal BMI (underweight and overweight), positive smoking history and positive family history of cancer. Conclusion Being underweight or overweight is a potential risk factor for CC patients. The overall survival in patients with CC is clinically associated with lifestyle choices before CC diagnosis. A balanced diet, walking and other forms of exercise should be strongly recommended to the community and those undergoing screening colonoscopy.
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Affiliation(s)
- Saira Saleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
- Correspondence: Saira Saleem, Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan. E-mail:
| | - Iffat Aleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Zeshan
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aribah Atiq
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Tahseen
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mohammad Tariq Mahmood
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Sadia Hassan
- Department of Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aamir Ali Syed
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mudassar Hussain
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Asad Hayat Ahmad
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Shahid Khattak
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammed Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
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Ghrouz I, El Sharif N. Diet and Genetic Risk Factors of Colorectal Cancer in Palestine: A Case-Control Study. Nutr Cancer 2021; 74:2460-2469. [PMID: 34875940 DOI: 10.1080/01635581.2021.2013507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To add evidence to the limited data available on colorectal cancer (CRC) from Palestine, we examine the risk factors associated with CRC using a matched hospital-based case-control study. A structured questionnaire was used to collect data from 105 cases and 105 controls. A multivariable conditional regression model was used to adjust for the association between study factors and CRC risk. In the model, compared with controls, cases from villages were significantly less likely to have CRC (Adjusted Odds Ratio, AOR = 0.194); taking aspirin lowered the likelihood of CRC by 24%; and having a multiple birth sibling by 33%. Also, the likelihood of CRC was lowered significantly by consuming five servings of fruits/vegetables per week or more (5-6 servings: AOR = 0.21, 7-8 servings per week: AOR = 0.04). However, cases had a significantly higher likelihood of CRC if they consumed 2-4 servings of grilled red meat per week (AOR = 4.25); smoked (AOR = 4.38); had a sedentary lifestyle (AOR = 2.53); reported parental consanguinity (AOR = 3.88); or had a family history of cancer (AOR = 6.39). Our results confirmed the association between CRC and red meat intake and smoking, and proved that parental consanguinity and family history of cancer are also risk factors for CRC.
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Affiliation(s)
- Issa Ghrouz
- Faculty of Public Health, Al Quds University, Abu Dis Campus, Jerusalem, Palestine
| | - Nuha El Sharif
- Faculty of Public Health, Al Quds University, Abu Dis Campus, Jerusalem, Palestine
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Schumacher AJ, Chen Q, Attaluri V, McLemore EC, Chao CR. Metabolic Risk Factors Associated with Early-Onset Colorectal Adenocarcinoma: A Case-Control Study at Kaiser Permanente Southern California. Cancer Epidemiol Biomarkers Prev 2021; 30:1792-1798. [PMID: 34301728 DOI: 10.1158/1055-9965.epi-20-1127] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/22/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The incidence of early-onset colorectal cancer (eoCRC) diagnosed among individuals under age 50 has been rising. However, risk factors for eoCRC are unclear. We investigated whether metabolic abnormalities are risk factors for eoCRC adenocarcinoma. METHODS Invasive colorectal adenocarcinoma cases diagnosed between ages 15 and 49 from 2008 to 2018 at Kaiser Permanente Southern California (KPSC) were identified. Those with a history of inflammatory bowel disease were excluded. Noncancer controls were selected 5:1 for each case matched by age, sex, and length of membership prior to index date. Data were collected from KSPC's electronic medical records. The exposures of interest included obesity, type II diabetes, hypertension, and dyslipidemia, assessed from ≥1 year prior to eoCRC diagnosis/index date. Conditional logistic regressions were used to evaluate the associations between these metabolic risk factors and risk of eoCRC adenocarcinoma, adjusting for race/ethnicity, smoking, family history, neighborhood socioeconomic status, and health care utilization. RESULTS A total of 1,032 cases and 5,128 controls were included. Risk of colorectal adenocarcinoma was significantly associated with obesity [odds ratio (OR) = 1.41; 95% confidence interval (CI), 1.15-1.74], but not diabetes, hypertension or dyslipidemia. In analysis stratified by tumor location, obesity was significantly associated with risk of colon adenocarcinoma OR = 1.56 (1.17-2.07), but its association with rectal adenocarcinoma was less clear OR = 1.19 (0.85-1.68). No significant interaction was detected between obesity and age (≥40 vs. <40), and obesity and sex. CONCLUSIONS Obesity was associated with risk for eoCRC adenocarcinoma. IMPACT This finding could help inform early-onset colorectal adenocarcinoma screening and prevention recommendations.See related commentary by Hayes, p. xxx.
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Affiliation(s)
- Andrew J Schumacher
- Department of Radiation Oncology, Torrance Memorial Medical Center, Torrance, California
| | - Qiaoling Chen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Vikram Attaluri
- Department of General Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Elisabeth C McLemore
- Department of General Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Chun R Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
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Lee J, Lee J, Ahn J, Lee DW, Kim HR, Kang MY. Association of sedentary work with colon and rectal cancer: systematic review and meta-analysis. Occup Environ Med 2021; 79:277-286. [PMID: 33910983 DOI: 10.1136/oemed-2020-107253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES There has been no research on sedentary behaviour in the occupational domain that occupies a large portion of the daily life. METHODS We conducted a meta-analysis to investigate the association between sedentary work and colorectal cancer. We searched PubMed, Embase and Cochrane databases up to 12 August 2020 for peer-reviewed journal articles that assessed the association between sedentary work and colon or rectal cancer. Pooled estimates of ORs were obtained using random effects models. Statistical tests for publication bias, heterogeneity and sensitivity analysis were applied. RESULTS Of the 5 381 studies initially identified, 23 studies with 64 reports were eligible for inclusion. Sedentary work significantly increased the risk of colon cancer (pooled OR=1.21, 95% CI 1.11 to 1.31, p value ≤0.0001) and rectal cancer (pooled OR=1.08, 95% CI 1.00 to 1.16, p value=0.0395). The adjustment for leisure time physical activity attenuated the association and made the risk estimates non-significant for sedentary behaviour, but the association was independent of sex, control of body mass index and assessment of sedentary behaviour. CONCLUSIONS We found evidence of association between sedentary work and the risk of colon or rectal cancer. Limiting excessive sedentary work could be an important means of preventing colon and rectal cancer.
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Affiliation(s)
- JaeYong Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jongin Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Preventive Medicine, Occupational & Environmental Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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Scott AR, Stoltzfus KC, Tchelebi LT, Trifiletti DM, Lehrer EJ, Rao P, Bleyer A, Zaorsky NG. Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015. JAMA Netw Open 2020; 3:e2027738. [PMID: 33258907 PMCID: PMC7709088 DOI: 10.1001/jamanetworkopen.2020.27738] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Previous studies have demonstrated that adolescents and young adults (AYAs) with cancer are a distinct cancer population; however, research on long-term epidemiological trends and characteristics of cancers in AYAs is lacking. OBJECTIVE To characterize the epidemiology of cancer in AYAs aged 15 to 39 years with respect to (1) patient demographic characteristics, (2) frequencies of cancer types, and (3) cancer incidence trends over time. DESIGN, SETTING, AND PARTICIPANTS This retrospective, serial cross-sectional, population-based study used registry data from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 1973, to December 31, 2015 (SEER 9 and SEER 18). The study population was from geographically distinct US regions, chosen to represent the racial and ethnic heterogeneity of the country. Initial analyses were performed from January 1 to August 31, 2019. MAIN OUTCOMES AND MEASURES Incidence rates and descriptive epidemiological statistics for patients aged 15 to 39 years with invasive cancer. RESULTS A total of 497 452 AYAs diagnosed from 1973 to 2015 were included in this study, with 293 848 (59.1%) female and 397 295 (79.9%) White participants. As AYAs aged, an increase in the relative incidence of carcinomas and decrease in the relative incidence of leukemias, lymphomas, germ cell and trophoblastic neoplasms, and neoplasms of the central nervous system occurred. Among the female AYAs, 72 564 (24.7%) were diagnosed with breast carcinoma; 48 865 (16.6%), thyroid carcinoma; and 33 828 (11.5%), cervix and uterus carcinoma. Among the male AYAs, 37 597 (18.5%) were diagnosed with testicular cancer; 20 850 (10.2%), melanoma; and 19 532 (9.6%), non-Hodgkin lymphoma. The rate of cancer in AYAs increased by 29.6% from 1973 to 2015, with a mean annual percentage change (APC) per 100 000 persons of 0.537 (95% CI, 0.426-0.648; P < .001). Kidney carcinoma increased at the greatest rate for both male (APC, 3.572; 95% CI, 3.049-4.097; P < .001) and female (APC, 3.632; 95% CI, 3.105-4.162; P < .001) AYAs. CONCLUSIONS AND RELEVANCE In this cross-sectional, US population-based study, cancer in AYAs was shown to have a unique epidemiological pattern and is a growing health concern, with many cancer subtypes having increased in incidence from 1973 to 2015. Continued research on AYA cancers is important to understanding and addressing the distinct health concerns of this population.
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Affiliation(s)
- Alyssa R. Scott
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Kelsey C. Stoltzfus
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Leila T. Tchelebi
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
| | | | - Eric J. Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Pooja Rao
- Division of Hematology and Oncology, Department of Pediatrics, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Archie Bleyer
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
- McGovern Medical School, University of Texas, Houston, Texas
| | - Nicholas G. Zaorsky
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
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11
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Moskowitz JE, Doran AG, Lei Z, Busi SB, Hart ML, Franklin CL, Sumner LW, Keane TM, Amos-Landgraf JM. Integration of genomics, metagenomics, and metabolomics to identify interplay between susceptibility alleles and microbiota in adenoma initiation. BMC Cancer 2020; 20:600. [PMID: 32600361 PMCID: PMC7322931 DOI: 10.1186/s12885-020-07007-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/26/2020] [Indexed: 02/08/2023] Open
Abstract
Background Colorectal cancer (CRC) is a multifactorial disease resulting from both genetic predisposition and environmental factors including the gut microbiota (GM), but deciphering the influence of genetic variants, environmental variables, and interactions with the GM is exceedingly difficult. We previously observed significant differences in intestinal adenoma multiplicity between C57BL/6 J-ApcMin (B6-Min/J) from The Jackson Laboratory (JAX), and original founder strain C57BL/6JD-ApcMin (B6-Min/D) from the University of Wisconsin. Methods To resolve genetic and environmental interactions and determine their contributions we utilized two genetically inbred, independently isolated ApcMin mouse colonies that have been separated for over 20 generations. Whole genome sequencing was used to identify genetic variants unique to the two substrains. To determine the influence of genetic variants and the impact of differences in the GM on phenotypic variability, we used complex microbiota targeted rederivation to generate two Apc mutant mouse colonies harboring complex GMs from two different sources (GMJAX originally from JAX or GMHSD originally from Envigo), creating four ApcMin groups. Untargeted metabolomics were used to characterize shifts in the fecal metabolite profile based on genetic variation and differences in the GM. Results WGS revealed several thousand high quality variants unique to the two substrains. No homozygous variants were present in coding regions, with the vast majority of variants residing in noncoding regions. Host genetic divergence between Min/J and Min/D and the complex GM additively determined differential adenoma susceptibility. Untargeted metabolomics revealed that both genetic lineage and the GM collectively determined the fecal metabolite profile, and that each differentially regulates bile acid (BA) metabolism. Metabolomics pathway analysis facilitated identification of a functionally relevant private noncoding variant associated with the bile acid transporter Fatty acid binding protein 6 (Fabp6). Expression studies demonstrated differential expression of Fabp6 between Min/J and Min/D, and the variant correlates with adenoma multiplicity in backcrossed mice. Conclusions We found that both genetic variation and differences in microbiota influences the quantitiative adenoma phenotype in ApcMin mice. These findings demonstrate how the use of metabolomics datasets can aid as a functional genomic tool, and furthermore illustrate the power of a multi-omics approach to dissect complex disease susceptibility of noncoding variants.
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Affiliation(s)
- Jacob E Moskowitz
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, 65201, USA.,Present Address: F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Anthony G Doran
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, CB10 1SD, UK
| | - Zhentian Lei
- Department of Biochemistry, MU Metabolomics Center, University of Missouri Bond Life Sciences Center, Columbia, MO, 65201, USA
| | - Susheel B Busi
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, 65201, USA
| | - Marcia L Hart
- Mutant Mouse Resource and Research Center, University of Missouri, 4011 Discovery Drive, Columbia, MO, 65201, USA
| | - Craig L Franklin
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, 65201, USA.,Mutant Mouse Resource and Research Center, University of Missouri, 4011 Discovery Drive, Columbia, MO, 65201, USA
| | - Lloyd W Sumner
- Department of Biochemistry, MU Metabolomics Center, University of Missouri Bond Life Sciences Center, Columbia, MO, 65201, USA
| | - Thomas M Keane
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, CB10 1SD, UK
| | - James M Amos-Landgraf
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, 65201, USA. .,Mutant Mouse Resource and Research Center, University of Missouri, 4011 Discovery Drive, Columbia, MO, 65201, USA.
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12
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Clouston SA, Acker J, Rubin MS, Chae DH, Link BG. Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms. Heliyon 2020; 6:e03484. [PMID: 32190753 PMCID: PMC7068626 DOI: 10.1016/j.heliyon.2020.e03484] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/14/2019] [Accepted: 02/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fundamental cause theory posits that social conditions strongly influence the risk of health risks. This study identifies risk mechanisms that social conditions associated with socioeconomic status (SES) and race/ethnicity shape in the production of colorectal cancer (CRC) mortality. METHODS Two large datasets in the United States examining behavioral and medical preventive factors (N = 4.63-million people) were merged with population-level mortality data observing 761,100 CRC deaths among 3.31-billion person-years of observation to examine trends in CRC mortality from 1999-2012. Analyses examined the changing role of medical preventions and health behaviors in catalyzing SES and racial/ethnic inequalities in CRC mortality. RESULTS Lower SES as well as Black, Hispanic, Asian/Pacific Islander, and Native American race/ethnicity were associated with decreased access to age-appropriate screening and/or increased prevalence of behavioral risk factors. Analyses further revealed that SES and racial/ethnic inequalities were partially determined by differences in engagement in two preventive factors: use of colonoscopy, and participation in physical activity. DISCUSSION Social inequalities were not completely determined by behavioral risk factors. Nevertheless, a more equitable distribution of preventive medicines has the potential to reduce both the risk of, and social inequalities in, CRC mortality.
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Affiliation(s)
- Sean A.P. Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Julia Acker
- Family Community Medicine, University of California, San Francisco, CA, USA
| | - Marcie S. Rubin
- Section of Social and Behavioral Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - David H. Chae
- Center for Health Ecology and Equity Research, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - Bruce G. Link
- Department of Sociology and School of Public Policy, University of California – Riverside, Riverside, CA, USA
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13
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Jee H, Kim JH. Gender difference in colorectal cancer indicators for exercise interventions: the National Health Insurance Sharing Service-Derived Big Data Analysis. J Exerc Rehabil 2020; 15:811-818. [PMID: 31938703 PMCID: PMC6944878 DOI: 10.12965/jer.1938692.346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/20/2019] [Indexed: 12/01/2022] Open
Abstract
We aimed to examine various characterized features and effects of gender-associated different parameters including exercise on the prevalence of colorectal cancer by using data from the National Health Insurance Sharing Service Database (NHISS DB). Data from NHISS were collected on Koreans aged from 40 to 85 years and were subjected to thematic analysis. The colorectal cancer codes (C19, C20, D011, and D012) from Korean Standard Classification of Disease and Causes of Death selected a target study group, and t-test and logistic regression were used. As results, the age was higher for men who had colorectal cancer than the noncancer group; however, high and low blood pressure, hemoglobin, and age had lower values for the cancer group compared to their counterparts in women. Only total cholesterol in men and waist size in women between cancer and noncancer groups were shown to have significant differences. Serum glutamic pyruvic transaminase and alanine aminotransaminase (SGPT_ALT) showed significant differences for both sexes. In exercise-related parameter, the response number 2 (1–2 times/wk, 0.535 for odd ratio) in women and response number 3 (3–4 times/wk, 0.466 for odd ratio) in men were associated with a reduced incidence of colon cancer. There was a difference in parameters in colorectal cancer patients over 40 years old for both sexes, but not in SGPT_ALT. Regular physical activity might be one of strong factors affecting or predicting colorectal cancer incidence.
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Affiliation(s)
- Hyunseok Jee
- Department of Sports Science, Hannam University, Daejeon, Korea.,School of Kinesiology, Yeungnam University, Gyeongsan, Korea
| | - Jong-Hee Kim
- Department of Physical Education, Hanyang University, Seoul, Korea
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14
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Zhang X, Ashcraft KA, Betof Warner A, Nair SK, Dewhirst MW. Can Exercise-Induced Modulation of the Tumor Physiologic Microenvironment Improve Antitumor Immunity? Cancer Res 2019; 79:2447-2456. [PMID: 31068341 DOI: 10.1158/0008-5472.can-18-2468] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/10/2019] [Accepted: 03/05/2019] [Indexed: 12/12/2022]
Abstract
The immune system plays an important role in controlling cancer growth. However, cancers evolve to evade immune detection. Immune tolerance and active immune suppression results in unchecked cancer growth and progression. A major contributor to immune tolerance is the tumor physiologic microenvironment, which includes hypoxia, hypoglucosis, lactosis, and reduced pH. Preclinical and human studies suggest that exercise elicits mobilization of leukocytes into circulation (also known as "exercise-induced leukocytosis"), especially cytotoxic T cells and natural killer cells. However, the tumor physiologic microenvironment presents a significant barrier for these cells to enter the tumor and, once there, properly function. We hypothesize that the effect of exercise on the immune system's ability to control cancer growth is linked to how exercise affects the tumor physiologic microenvironment. Normalization of the microenvironment by exercise may promote more efficient innate and adaptive immunity within the tumor. This review summarizes the current literature supporting this hypothesis.
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Affiliation(s)
- Xiaojie Zhang
- Duke University Medical Center, Durham, North Carolina
| | | | | | - Smita K Nair
- Duke University Medical Center, Durham, North Carolina
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15
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Young-age onset colorectal cancer in Brazil: Analysis of incidence, clinical features, and outcomes in a tertiary cancer center. Curr Probl Cancer 2019; 43:477-486. [PMID: 30826126 DOI: 10.1016/j.currproblcancer.2019.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/12/2018] [Accepted: 01/29/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent studies report increasing incidence of colorectal cancer (CRC) in the young-age population, but data concerning clinical behavior, pathologic findings, and prognosis are controversial for this group. Early recognition of CRC in young patients is a challenge and diagnosis at advanced stage is clearly associated with worse outcomes. MATERIALS AND METHODS We retrospectively reviewed medical records of 5806 patients diagnosed with CRC between January/2011 and November/2016 and identified 781 patients aged less than 50-years-old. RESULTS We found an absolute increasing in the incidence of CRC in patients <50 years old of 1.88%-2.23% annually, with a relative increasing of 35.3% between 2011 and 2016. Median age was 42 years, 57.4% were female and 20.9% reported family history of CRC. Left-sided tumors were more frequent and the majority of patients were symptomatic. The most common stages at diagnosis were III (34.1%) and IV (37.3%). The median overall survival (OS) for stage IV was 25 months (95% CI 20.7-29.3) and was not reached for Stages I-III (P < 0.001). Family history of CRC was independently associated with better OS in stage IV(P = 0.02). For stages I-III, wild-type KRAS, family history of CRC, and absence of angiolymphatic invasion were associated with better OS (P = 0.02, P = 0.01 and P < 0.001, respectively). CONCLUSIONS In our cohort, the incidence of early-onset CRC is increasing over the past years. Young patients were more likely to be diagnosed with metastatic disease, left-sided and/or rectum site and symptoms at presentation. These findings highlight the emerging importance of young-age onset CRC and the need to discuss strategies to early diagnosis.
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16
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Rim CH, Kim CY, Yang DS, Yoon WS. Clinical Significance of Gender and Body Mass Index in Asian Patients with Colorectal Cancer. J Cancer 2019; 10:682-688. [PMID: 30719166 PMCID: PMC6360425 DOI: 10.7150/jca.28495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022] Open
Abstract
Objective: Colorectal cancer is a disease closely associated with anthropometric values. This study aimed to evaluate the clinical relevance of gender and body mass index (BMI) with colorectal cancer using a Korean nationwide cohort. Methods: Data of colorectal cancer cohorts between 2012 and 2013 were acquired from the Health Insurance Review and Assessment Service. All patients underwent surgery due to colorectal cancers. Stage IV patients were excluded due to possible clinical heterogeneity. BMI was classified with the World Health Organization criteria. Results: A total of 31,756 patients were analyzed. The underweight group had 33% higher risk of stage III disease (p<0.001). The overweight and obese groups had 20% and 19% lower risk of stage III (p<0.001 and p=0.002, respectively). The underweight and obese groups had higher risk of longest hospitalization period quartile (≥19 days), with odds ratio of 2.26 (p<0.001) and 1.33 (p<0.001), respectively. The overweight group had a 22% lower risk of the longest hospitalization period quartile (p=0.002). Females had 12% lower risk of distal cancer than males (p<0.001). There was no significant relationship between cancer stage and gender. The proportions of patients who were <50 years and ≥70 years old were higher in the females, and the proportions of patients in their 50s and 60s were higher in the males. Conclusions: Cancer stages and hospitalization period varied depending on BMI. Disease location and the age distribution were affected by gender.
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Affiliation(s)
- Chai Hong Rim
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Gyeonggi-do, Republic of Korea
| | - Chul Yong Kim
- Department of Radiation Oncology, Anam Hospital, Korea University Medical College, Seoul, Republic of Korea
| | - Dae Sik Yang
- Department of Radiation Oncology, Guro Hospital, Korea University Medical College, Seoul, Republic of Korea
| | - Won Sup Yoon
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Gyeonggi-do, Republic of Korea
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17
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Mauri G, Sartore-Bianchi A, Russo AG, Marsoni S, Bardelli A, Siena S. Early-onset colorectal cancer in young individuals. Mol Oncol 2018; 13:109-131. [PMID: 30520562 PMCID: PMC6360363 DOI: 10.1002/1878-0261.12417] [Citation(s) in RCA: 332] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/01/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022] Open
Abstract
Treatment of young adults with colorectal cancer (CRC) represents an unmet clinical need, especially as diagnosis in this population might lead to the greatest loss of years of life. Since 1994, CRC incidence in individuals younger than 50 years has been increasing by 2% per year. The surge in CRC incidence in young adults is particularly alarming as the overall CRC frequency has been decreasing. Early-onset CRC are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher prevalence of signet ring cell histology, and left colon-sided location of the primary tumor. Among EO-CRC, approximately 30% of patients are affected by tumors harboring mutations causing hereditary cancer predisposing syndromes, and 20% have familial CRC. Most notably, the remaining 50% of EO-CRC patients have neither hereditary syndromes nor familial CRC, thus representing a formidable challenge for research. In this review article we summarize epidemiology, clinical and molecular features, heredity and outcome of treatments of EO-CRC, and provide considerations for future perspectives.
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Affiliation(s)
- Gianluca Mauri
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano (La Statale), Milan, Italy
| | - Andrea Sartore-Bianchi
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano (La Statale), Milan, Italy
| | | | - Silvia Marsoni
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano (La Statale), Milan, Italy.,FIRC Institute of Molecular Oncology (IFOM), Milan, Italy
| | - Alberto Bardelli
- Department of Oncology, University of Turin, Italy.,Candiolo Cancer Institute - FPO, IRCCS, Turin, Italy
| | - Salvatore Siena
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano (La Statale), Milan, Italy
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18
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Oyeyemi SO, Braaten T, Licaj I, Lund E, Benjaminsen Borch K. Physical activity patterns and the risk of colorectal cancer in the Norwegian Women and Cancer study: a population-based prospective study. BMC Cancer 2018; 18:1216. [PMID: 30514263 PMCID: PMC6280381 DOI: 10.1186/s12885-018-5092-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction Colorectal cancer (CRC) remains the second most common cancer in women worldwide. Physical activity (PA) has been associated with reduced risk of CRC; however, this has been demonstrated more consistently in men, while results of studies in women have been largely equivocal. We aimed to further examine the relationship between PA patterns and the risk of CRC in women, using repeated measurements. Methods We followed participants of the Norwegian Women and Cancer (NOWAC) Study - a nationally representative cohort. Baseline information was available for 79,184 women, and we used this information in addition to follow-up information collected 6–8 years later, for repeated measurement analysis. At enrollment, participants were cancer-free and aged 30–70 years, with a median age of 51 years. We used Cox proportional hazards regression to compute hazard ratios (HRs) and 95% confidence intervals (CIs). Results During an average of 14.6 years of follow-up and 1.16 million person-years, 885 cases of colon and 426 cases of rectal cancer were identified through linkage to the Norwegian Cancer Registry (median age at diagnosis: 65 years). We found no association between PA level and the risk of colon cancer in baseline or repeated measurements analyses when comparing women with PA level 1–2 to those with PA level 5–6 (reference) (baseline: HR = 0.90, 95% CI 0.66–1.23, p-trend = 0.76; repeated measurements: HR = 0.78, 95% CI 0.55–1.10, p-trend = 0.27). Results were the same when comparing PA level 9–10 to the reference level (baseline: HR = 0.80, 95% CI 0.56–1.12, p-trend = 0.76; repeated measurements: HR = 0.82, 95% CI 0.58–1.16, p-trend = 0.27). Similarly, we found no association between PA levels and the risk of rectal cancer. Conclusions Women may need to look beyond PA in order to reduce their risk of CRC.
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Affiliation(s)
- Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.,Clinical Research Department, Centre François Baclesse, Normandie University, UNICAEN, INSERM, U1086, Caen, France
| | - Eiliv Lund
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
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19
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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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20
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Talibov M, Sormunen J, Hansen J, Kjaerheim K, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Benzene exposure at workplace and risk of colorectal cancer in four Nordic countries. Cancer Epidemiol 2018; 55:156-161. [PMID: 29980027 DOI: 10.1016/j.canep.2018.06.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this case-control study was to assess the effect of occupational benzene exposure on the risk of colorectal cancer, including its subtypes. METHODS The study included 181,709 colon cancer and 109,227 rectal cancer cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway and Sweden. Cases were identified from the Nordic Occupational Cancer Study (NOCCA) cohort. Five controls per case were selected from the same cohort, matched for country, birth year, and sex. Occupational benzene exposure for each study participant was estimated by linking their job titles to country specific job-exposure matrices. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by using conditional logistic regression models. The results were adjusted for physical strain at work, formaldehyde, ionizing radiation and wood dust. RESULTS Increased risk was observed for all colorectal cancer (OR = 1.12, 95% CI 1.05-1.18) for the high decile of cumulative benzene exposure, indicating a statistically significant dose-response relationship. This excess risk was mainly seen in ascending colon (OR = 1.27, 95% CI 1.13-1.43), and transversal colon (OR = 1.21, 95% CI 1.01-1.41). The ORs in the highest exposure category were markedly higher in women than in men in all subsites of colon and rectum. CONCLUSION This study showed an association between workplace benzene exposure and colorectal cancer. The risk was restricted to ascending and transversal colon, and was the strongest among women.
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Affiliation(s)
- Madar Talibov
- Faculty of Social/Health Sciences, University of Tampere, Tampere, Finland; International Agency for Research on Cancer, Environment and Radiation Section, Lyon, France.
| | - Jorma Sormunen
- Faculty of Social/Health Sciences, University of Tampere, Tampere, Finland; Tampere University Hospital, Department of Oncology, Tampere, Finland.
| | - Johnni Hansen
- The Danish Cancer Society Research Center, Copenhagen, Denmark.
| | | | | | - Per Sparen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Eero Pukkala
- Faculty of Social/Health Sciences, University of Tampere, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
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21
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Abar L, Vieira AR, Aune D, Sobiecki JG, Vingeliene S, Polemiti E, Stevens C, Greenwood DC, Chan DSM, Schlesinger S, Norat T. Height and body fatness and colorectal cancer risk: an update of the WCRF-AICR systematic review of published prospective studies. Eur J Nutr 2018; 57:1701-1720. [PMID: 29080978 PMCID: PMC6060816 DOI: 10.1007/s00394-017-1557-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 06/25/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE There is no published dose-response meta-analysis on the association between height and colorectal cancer risk (CRC) by sex and anatomical sub-site. We conducted a meta-analysis of prospective studies on the association between height and CRC risk with subgroup analysis and updated evidence on the association between body fatness and CRC risk. METHODS PubMed and several other databases were searched up to November 2016. A random effects model was used to calculate dose-response summary relative risks (RR's). RESULTS 47 studies were included in the meta-analyses including 50,936 cases among 7,393,510 participants. The findings support the existing evidence regarding a positive association of height, general and abdominal body fatness and CRC risk. The summary RR were 1.04 [95% (CI)1.02-1.05, I² = 91%] per 5 cm increase in height, 1.02 [95% (CI)1.01-1.02, I² = 0%] per 5 kg increase in weight, 1.06 [95% (CI)1.04-1.07, I² = 83%] per 5 kg/m2 increase in BMI, 1.02 [95% (CI)1.02-1.03, I² = 4%] per 10 cm increase in waist circumference, 1.03 [95% (CI)1.01-1.05, I² = 16%] per 0.1 unit increase in waist to hip ratio. The significant association for height and CRC risk was similar in men and women. The significant association for BMI and CRC risk was stronger in men than in women. CONCLUSION The positive association between height and risk of CRC suggests that life factors during childhood and early adulthood might play a role in CRC aetiology. Higher general and abdominal body fatness during adulthood are risk factors of CRC and these associations are stronger in men than in women.
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Affiliation(s)
- Leila Abar
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
| | - Ana Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Jakub G Sobiecki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Snieguole Vingeliene
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Elli Polemiti
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Christophe Stevens
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Darren C Greenwood
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Doris S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Sabrina Schlesinger
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
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Physical activity, sedentary time, and risk of colorectal cancer: the Singapore Chinese Health Study. Eur J Cancer Prev 2018; 26:469-475. [PMID: 28542077 DOI: 10.1097/cej.0000000000000369] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Singapore has experienced a marked increase in colorectal cancer incidence over the past 40 years. Evidence from prospective studies in Western Europe and the USA suggests that low physical activity and high amounts of sedentary time are associated with increased colorectal cancer risk. The aim of this study is to evaluate these relationships in an Asian population. The Singapore Chinese Health Study enrolled 63 257 adults between 1993 and 1998. At enrollment, participants reported past year physical activity and time spent sitting. Incident colorectal cancers (n=1994) were identified through 31 December 2014. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for potential confounders. Any strenuous-vigorous or moderate physical activity was reported by 13.7 and 22.1% of the cohort, respectively. Strenuous-vigorous physical activity was associated with statistically significant reduced colorectal cancer risk (HR=0.85; 95% CI: 0.74-0.99 for ≥0.5 h/week vs. none), but moderate was not. In analysis stratified by time spent watching television, an inverse relationship between moderate physical activity and colorectal cancer risk (HR=0.86; 95% CI: 0.72-1.01 for ≥0.5 h/week vs. none) was observed for those who reported at least 3 h/day sitting watching television (Pinteraction=0.042). Participation in strenuous-vigorous physical activity, such as jogging, swimming, or heavy manual labor, was associated with reduced colorectal cancer risk among Singapore Chinese. Further research on physical activity and sedentary behaviors, independently and in combination, and colorectal cancer risk in Asian populations is needed.
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Physical activity, sedentary time, and risk of colorectal cancer: the Singapore Chinese Health Study. Eur J Cancer Prev 2018. [PMID: 28542077 DOI: 10.1097/cej.0000000000000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Singapore has experienced a marked increase in colorectal cancer incidence over the past 40 years. Evidence from prospective studies in Western Europe and the USA suggests that low physical activity and high amounts of sedentary time are associated with increased colorectal cancer risk. The aim of this study is to evaluate these relationships in an Asian population. The Singapore Chinese Health Study enrolled 63 257 adults between 1993 and 1998. At enrollment, participants reported past year physical activity and time spent sitting. Incident colorectal cancers (n=1994) were identified through 31 December 2014. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for potential confounders. Any strenuous-vigorous or moderate physical activity was reported by 13.7 and 22.1% of the cohort, respectively. Strenuous-vigorous physical activity was associated with statistically significant reduced colorectal cancer risk (HR=0.85; 95% CI: 0.74-0.99 for ≥0.5 h/week vs. none), but moderate was not. In analysis stratified by time spent watching television, an inverse relationship between moderate physical activity and colorectal cancer risk (HR=0.86; 95% CI: 0.72-1.01 for ≥0.5 h/week vs. none) was observed for those who reported at least 3 h/day sitting watching television (Pinteraction=0.042). Participation in strenuous-vigorous physical activity, such as jogging, swimming, or heavy manual labor, was associated with reduced colorectal cancer risk among Singapore Chinese. Further research on physical activity and sedentary behaviors, independently and in combination, and colorectal cancer risk in Asian populations is needed.
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Ullah MF, Fleming CA, Mealy K. Changing trends in age and stage of colorectal cancer presentation in Ireland - From the nineties to noughties and beyond. Surgeon 2018; 16:350-354. [PMID: 29680182 DOI: 10.1016/j.surge.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/13/2018] [Accepted: 03/18/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Recent studies report incidence of colorectal (CRC) in younger adults (<50 years old) is increasing, and these patients are more likely to present with advanced disease. We performed a population-based analysis of these trends in an Irish population. METHODS A retrospective analysis was performed of all patients with histologically confirmed CRC in Ireland, using data from the National Cancer Registry of Ireland (NCRI) [1994-2012, inclusive]. Trends in age-adjusted CRC incidence and stage at presentation were tabulated. Total and average age-adjusted annual percentage change (APC) in CRC rates were calculated using regression analysis, with age adjusted to the European standard population for trend analysis. RESULTS A total of 39,528 cases were included. Throughout the entire study period the most common age of presentation was 70-79 years (32.5%, n = 12 829) with Stage II (27.5%, n = 10 851) CRC. Overall, an increase in incidence of CRC of 2.1% was observed. A significantly increased incidence in patients aged 20-29 years (APC = 9.17%; total change = 4.2%; p = 0.003) was identified from 1994 to 2012. Overall, in patients <50 years, the incidence of stage I colorectal cancer at presentation significantly reduced from 23.5% to 11.6% (p = 0.01). This was associated with a significant parallel rise in stage IV disease (11%-23%, p = 0.02) in this age group. CONCLUSION Increasing incidence of CRC in younger patient groups is observed in an Irish population, with an increase in advanced staged disease at presentation seen. Further studies should focus on identifying causality for this trend and identify potential targets for prevention going forward.
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Affiliation(s)
- M F Ullah
- Department of General Surgery, Wexford General Hospital, Ireland
| | - C A Fleming
- Department of General Surgery, Wexford General Hospital, Ireland.
| | - K Mealy
- Department of General Surgery, Wexford General Hospital, Ireland
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Gabriel E, Attwood K, Al-Sukhni E, Erwin D, Boland P, Nurkin S. Age-related rates of colorectal cancer and the factors associated with overall survival. J Gastrointest Oncol 2018; 9:96-110. [PMID: 29564176 DOI: 10.21037/jgo.2017.11.13] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The purpose of this study was to identify differences in both demographic and pathologic factors associated with the age-related rates of colorectal cancer (CRC) and overall survival (OS). Methods The National Cancer Data Base (NCDB), 2004-2013, was queried for patients with CRC. Patients were stratified by age (≤50 vs. ≥60 years). Multivariable analysis was performed to identify factors associated with OS. Results A total of 670,030 patients were included; 488,121 with colon, and 181,909 with rectal or rectosigmoid cancer. For colon cancer, patients ≤50 years had higher proportions of pathologic stage III and IV disease than patients ≥60 (III: 33.7% vs. 28.6%, IV: 25.5% vs. 14.3%, respectively; P≤0.001). Similar differences were found for patients with rectal cancer (III: 35.8% vs. 28.6%, IV: 16.5% vs. 11.6%, respectively for age ≤50 and ≥60 years; P≤0.001). More aggressive pathologic factors were identified in the ≤50 cohort and were associated with worse OS, including higher tumor grade, lymphovascular invasion (LVI), perineural invasion (PNI), and elevated serum carcinoembryonic antigen (CEA). Disparities associated with OS were also identified for both colon and rectal cancer. For patients ≤50 with CRC, African-American and Hispanic race, lower income and lower education were associated with increased risk of mortality compared to the ≥60 cohort. Conclusions There are clear differences in biological factors and in racial and socioeconomic disparities of patients with early onset CRC. Earlier screening should be seriously considered in patients under 50 years who are African-American and Hispanic, as these populations present with more aggressive and advanced disease.
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Affiliation(s)
- Emmanuel Gabriel
- Department of Surgery, Section of Surgical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Kristopher Attwood
- Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Eisar Al-Sukhni
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Deborah Erwin
- Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Patrick Boland
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Steven Nurkin
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
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Gunathilake MN, Lee J, Cho YA, Oh JH, Chang HJ, Sohn DK, Shin A, Kim J. Interaction between physical activity, PITX1 rs647161 genetic polymorphism and colorectal cancer risk in a Korean population: a case-control study. Oncotarget 2018; 9:7590-7603. [PMID: 29484135 PMCID: PMC5800927 DOI: 10.18632/oncotarget.24136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/26/2017] [Indexed: 12/31/2022] Open
Abstract
This study assessed the interaction between physical activity and colorectal cancer (CRC) risk based on a polymorphism in the paired-like homeodomain 1 (PITX1) gene in Koreans. In total, 923 cases and 1,846 controls were enrolled at the National Cancer Center, Korea. Subjects who did regular exercise showed a significantly reduced risk of CRC than those did not exercise regularly (OR = 0.37, 95% CI = 0.30-0.45). Subjects in the highest tertile of metabolic equivalents of task (MET)-minutes per week showed a significantly lower risk of CRC (OR = 0.62, 95% CI = 0.48-0.79, p-trend < 0.001). In the dominant model, minor allele carriers showed a significantly higher risk of CRC than subjects homozygous for the major allele (OR = 1.46, 95% CI = 1.18-1.80). The PITX1 genetic variant showed significant interactions with regular exercise and CRC risk (p-interaction = 0.018) and colon cancer risk (p-interaction = 0.029) among all subjects. Subjects who carried at least one minor allele and did not regularly exercise showed a greater risk of CRC (OR = 1.81, 95% CI = 1.37-2.41). Subjects who were homozygous for the major allele with high physical activity showed a significantly reduced risk of CRC (OR = 0.56, 95% CI = 0.38-0.82). Thus, individuals with PITX1 genetic variants can have benefit from physical activity regarding prevention of CRC risk in a Korean population.
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Affiliation(s)
- Madhawa Neranjan Gunathilake
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Jeonghee Lee
- Department of Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Young Ae Cho
- Department of Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Hee Jin Chang
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 10408, South Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul 03080, South Korea
| | - Jeongseon Kim
- Department of Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
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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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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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Gabriel E, Ostapoff K, Attwood K, Al-Sukhni E, Boland P, Nurkin S. Disparities in the Age-Related Rates of Colorectal Cancer in the United States. Am Surg 2017. [DOI: 10.1177/000313481708300631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The incidence of colorectal cancer (CRC) among Americans under the age of 50 years is increasing. The purpose of this study was to identify racial and socioeconomic disparities associated with this trend. The National Cancer Data Base was used to identify patients with CRC from 1998 to 2011. Patients were stratified by age (<50 versus >60 years), with ages 50 to 60 years omitted from the analysis to minimize overlapping trends between the two age groups. Relative frequencies (RFs) by year were plotted against demographic variables. Changes in RF over time and intervals from diagnosis to treatment (including surgery and chemotherapy) were compared. A total of 1,213,192 patients were studied; 885,510 patients with colon cancer and 327,682 with rectal or rectosigmoid cancer. Patients <50 years had higher RF for stage III/IV CRC compared with >60 years, with the highest rate of increase in stage III colon cancer (0.198% per year). Patients <50 years had higher RF for CRC if they were African-American or Hispanic. Hispanic patients <50 years had the highest rates of increase for both colon (RF = 0.300% per year) and rectal cancer (RF = 0.248% per year). Compared with race, other variables including education and income were not found to have as strong an association on age-related rates of CRC. No clinically significant differences were observed for time from diagnosis to treatment in either age group. Important racial disparities are associated with differences in age-related CRC rates, warranting further investigation to develop improved strategies for the earlier detection of CRC in these populations.
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Affiliation(s)
| | | | | | | | - Patrick Boland
- Medical Oncology, Roswell Park Cancer Institute, Buffalo, New York
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Ma P, Yao Y, Sun W, Dai S, Zhou C. Daily sedentary time and its association with risk for colorectal cancer in adults: A dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2017; 96:e7049. [PMID: 28562564 PMCID: PMC5459729 DOI: 10.1097/md.0000000000007049] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sedentary behavior is emerging as an independent risk factor for health. However, previous studies have indicated that sedentary behaviors are associated with the colorectal cancer risk, but presented controversial results.Studies in PubMed and EMBASE were searched update to February 2017 to identify and quantify the potential dose-response association between daily sedentary time and colorectal cancer.Twenty-eight eligible studies involving a total of 47,84,339 participants with 46,071 incident cases were included in this meta-analysis. Our results showed statistically significant association between prolong television viewing time and colorectal cancer (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.09-1.24, P < .001). Additionally, we obtained the best fit at an inflection point of 2 hours per day in piecewise regression analysis, the summary relative risk (RR) of colorectal cancer for an increase of 2 hours per day television viewing was 1.07 (95% CI 1.05-1.10, P < .001). Furthermore, prolong occupational sitting time was correlated with a significantly higher risk of colorectal cancer (OR 1.15, 95% CI 1.08-1.22, P < .001), increasing 2 hours per day of occupational sitting time per day was associated with a 4% incremental in the risk of colorectal cancer (RR 1.04, 95% CI 1.01-1.08). Additionally, prolong total sitting time was associated with a significantly higher risk of colorectal cancer (OR 1.06, 95% CI 1.03-1.09, P < .001). Increasing 2 hours of total sitting time per day was associated with a 2% incremental in the risk of colorectal cancer (RR 1.02, 95% CI 1.01-1.06). Subgroup meta-analyses in study design, study quality, number of participants, and number of cases showed consistent with the primary findings.Prolonged television viewing, occupational sitting time, and total sitting time are associated with increased risks of colorectal cancer.
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Mandal P. Potential biomarkers associated with oxidative stress for risk assessment of colorectal cancer. Naunyn Schmiedebergs Arch Pharmacol 2017; 390:557-565. [PMID: 28229171 DOI: 10.1007/s00210-017-1352-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/30/2017] [Indexed: 02/07/2023]
Abstract
Cells are continuously threatened by the damage caused by reactive oxygen/nitrogen species (ROS/RNS), which are produced during physiological oxygen metabolism. In our review, we will summarize the latest reports on the role of oxidative stress and oxidative stress-induced signaling pathways in the etiology of colorectal cancer. The differences in ROS generation may influence the levels of oxidized proteins, lipids, and DNA damage, thus contributing to the higher susceptibility of colon. Reactive species (RS) of various types are formed and are powerful oxidizing agents, capable of damaging DNA and other biomolecules. Increased formation of RS can promote the development of malignancy, and the "normal" rates of RS generation may account for the increased risk of cancer development in the aged. In this review, we focus on the role of oxidative stress in the etiology of colorec-tal cancer and discuss free radicals and free radical-stimulated pathways in colorectal carcinogenesis.
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Affiliation(s)
- Paramita Mandal
- Department of Zoology, The University of Burdwan, Burdwan, 713104, West Bengal, India.
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Perceived physical strain at work and incidence of colorectal cancer: A nested case–control study. Cancer Epidemiol 2016; 43:100-4. [DOI: 10.1016/j.canep.2016.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/23/2016] [Accepted: 07/04/2016] [Indexed: 11/22/2022]
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Golshiri P, Rasooli S, Emami M, Najimi A. Effects of Physical Activity on Risk of Colorectal Cancer: A Case-control Study. Int J Prev Med 2016; 7:32. [PMID: 26952161 PMCID: PMC4763467 DOI: 10.4103/2008-7802.175991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 12/20/2015] [Indexed: 12/14/2022] Open
Abstract
Background: The prevalence of colorectal cancer (CRC) is rapidly increasing in Iran. It holds the most prevalent cancer after skin, breast, and gastric cancers among the Iranian population. The current study was designed to investigate the effects of leisure time, occupational and household physical activity as well as exercise on the risk of CRC in the Iranian population. Methods: In this population-based case–control study, 100 individuals with a recent diagnosis of CRC who were eligible for the study were recruited between 2006 and 2008. The control groups were selected from patients’ companions (excluding first- and second-degree relatives) without past history of cancer or any physical disability. Physical activity of the participants was evaluated using a Kriska retrospective physical activity questionnaire. The relation between CRC and physical activity was assessed via logistic regression model and calculating the odds ratio (OR) as well as a confidence interval (CI) of 95%. Results: According to the findings, the adjusted OR of occupational (OR = 0.98, 95%, CI: 0.95–1.02) and house holding physical activities (OR = 1.03, 95% CI: 0.99–1.08) were not significantly different between the case and control groups for women (P > 0.05). The risk of CRC shows a significant reduction in individuals with moderate leisure physical activities compared to those with minimal activities (OR = 0.82, CI 95%: 0.73–0.98). Conclusions: The study suggests that the risk of CRC will decrease in individuals with higher leisure physical activities (especially with an increase in hours of brisk walking during the day).
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Affiliation(s)
- Parastoo Golshiri
- Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Rasooli
- Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadhasan Emami
- Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Pour-Sina-Hakim Research Center, Isfahan, Iran
| | - Arash Najimi
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Liu L, Shi Y, Li T, Qin Q, Yin J, Pang S, Nie S, Wei S. Leisure time physical activity and cancer risk: evaluation of the WHO's recommendation based on 126 high-quality epidemiological studies. Br J Sports Med 2015; 50:372-8. [PMID: 26500336 DOI: 10.1136/bjsports-2015-094728] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The WHO has concluded that physical activity reduces the risk of numerous diseases. However, few systemic reviews have been performed to assess the role of leisure time physical activity (LTPA) in lowering the risk of cancer in a dose-dependent manner and furthermore the suitability of recommendation of physical activity by the WHO. METHODS A systematic review and meta-analysis was designed to estimate cancer risk by LTPA in binary comparison and in a dose-dependent manner. MEDLINE and Web of Science were searched up to 30 December 2014 without language restrictions. Reference lists were reviewed for potential articles. RESULTS A total of 126 studies were recruited into the meta-analysis. Overall, the total cancer risk was reduced by 10% in people who undertook the most LTPA as compared with those who did the least. Dose-response meta-analysis indicated that the current WHO recommendation (equal to an average of 10 metabolic equivalents of energy hours per week) induced a 7% (95% CI 5% to 9%) cancer reduction. Moreover, the protective role of LTPA against cancer becomes saturated at 20 metabolic equivalents of energy hours per week, with a relative risk of 0.91 (95% CI 0.88 to 0.93). Subanalyses results based on cancer types showed that LTPA only exhibited significant protection against breast cancer and colorectal cancer. CONCLUSIONS Our meta-analysis indicates that the current WHO recommendation of physical activity can result in a 7% reduction in cancer risk, which is mainly attributed to its protective role against breast cancer and colorectal cancer. Furthermore, two-fold of current recommendation level is considered to give its saturated protection against cancer.
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Affiliation(s)
- Li Liu
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yun Shi
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Qin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuo Pang
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, Cantor SB, Chang GJ. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surg 2015; 150:17-22. [PMID: 25372703 DOI: 10.1001/jamasurg.2014.1756] [Citation(s) in RCA: 674] [Impact Index Per Article: 74.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE The overall incidence of colorectal cancer (CRC) has been decreasing since 1998 but there has been an apparent increase in the incidence of CRC in young adults. OBJECTIVE To evaluate age-related disparities in secular trends in CRC incidence in the United States. DESIGN, SETTING, AND PATIENTS A retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) CRC registry. Age at diagnosis was analyzed in 15-year intervals starting at the age of 20 years. SEER*Stat was used to obtain the annual cancer incidence rates, annual percentage change, and corresponding P values for the secular trends. Data were obtained from the National Cancer Institute's SEER registry for all patients diagnosed as having colon or rectal cancer from January 1, 1975, through December 31, 2010 (N = 393 241). MAIN OUTCOME AND MEASURE Difference in CRC incidence by age. RESULTS The overall age-adjusted CRC incidence rate decreased by 0.92% (95% CI, -1.14 to -0.70) between 1975 and 2010. There has been a steady decline in the incidence of CRC in patients age 50 years or older, but the opposite trend has been observed for young adults. For patients 20 to 34 years, the incidence rates of localized, regional, and distant colon and rectal cancers have increased. An increasing incidence rate was also observed for patients with rectal cancer aged 35 to 49 years. Based on current trends, in 2030, the incidence rates for colon and rectal cancers will increase by 90.0% and 124.2%, respectively, for patients 20 to 34 years and by 27.7% and 46.0%, respectively, for patients 35 to 49 years. CONCLUSIONS AND RELEVANCE There has been a significant increase in the incidence of CRC diagnosed in young adults, with a decline in older patients. Further studies are needed to determine the cause for these trends and identify potential preventive and early detection strategies.
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Affiliation(s)
- Christina E Bailey
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Chung-Yuan Hu
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Y Nancy You
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Brian K Bednarski
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | | | - John M Skibber
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Scott B Cantor
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston
| | - George J Chang
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
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Tayyem RF, Shehadeh IN, Abumweis SS, Bawadi HA, Hammad SS, Bani-Hani KE, Al-Jaberi TM, Alnusair MM. Physical inactivity, water intake and constipation as risk factors for colorectal cancer among adults in Jordan. Asian Pac J Cancer Prev 2014; 14:5207-12. [PMID: 24175802 DOI: 10.7314/apjcp.2013.14.9.5207] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity has been found to play a role in cancer prevention. The purpose of this matched case-control study was to investigate the association between physical activity levels, water intake, constipation and colorectal cancer (CRC). MATERIALS AND METHODS Two hundred and thirty-two patients diagnosed with CRC (125 male, 107 female) were enrolled in this case-control study. Cases were matched to 271 population controls (137 male, 134 female). RESULTS Drinking more than 4 cups of water daily decreased the risk of CRC by 33-42%; however, this effect was non-significant. Having constipation was found to be a significant risk factor for developing CRC with an OR=6.284 (95%CI=2.741-14.40). With reference to sedentary behavior, minimum activity (600-3000 Metabolic Equivalents Task (MET)) had 43% protection against CRC and the level of Health Enhancing Physical Activity OR was 0.58 (at 95%CI; 0.37-0.92). A significant negative association was found between CRC and physical activity levels expressed as both METs and MET-hours/week (p for trend=0.017 and 0.03, respectively). Among females, a significant trend of reduction in CRC by 62% was observed with increasing the level of physical activity expressed in MET (p for trend=0.04). CONCLUSIONS The risk of CRC may be reduced by adopting a healthy lifestyle and practicing physically activity regularly, especially among females. Consuming adequate amounts of water and healthy bowel motility could also reduce the risk of CRC.
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Affiliation(s)
- Reema Fayez Tayyem
- Department of Clinical Nutrition and Dietetic, The Hashemite University, Zarqa, Jordan E-mail :
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Lynch BM, Boyle T. Distinguishing sedentary from inactive: implications for meta-analyses. Br J Cancer 2014; 111:2202-3. [PMID: 24569462 PMCID: PMC4260011 DOI: 10.1038/bjc.2014.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- B M Lynch
- 1] Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia [2] Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - T Boyle
- Epidemiology Group, Harry Perkins Institute for Medical Research, The University of Western Australia, Perth, Western Australia, Australia
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Cong YJ, Gan Y, Sun HL, Deng J, Cao SY, Xu X, Lu ZX. Association of sedentary behaviour with colon and rectal cancer: a meta-analysis of observational studies. Br J Cancer 2013; 110:817-26. [PMID: 24263062 PMCID: PMC3915109 DOI: 10.1038/bjc.2013.709] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/12/2013] [Accepted: 10/16/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sedentary behaviour is ubiquitous in modern society. Emerging studies have focused on the health consequences of sedentary behaviour, including colorectal cancer, but whether sedentary behaviour is associated with the risks of colon and rectal cancer remains unclear. No systematic reviews have applied quantitative techniques to independently compute summary risk estimates. We aimed to conduct a meta-analysis to investigate this issue. METHODS We searched PubMed, Embase, and Google Scholar databases up to May 2013 to identify cohort and case-control studies that evaluated the association between sedentary behaviour and colon or rectal cancer. A random-effect model was used to pool the results of included studies. Publication bias was assessed by using Begg's funnel plot. RESULTS Twenty-three studies with 63 reports were included in our meta-analysis. These groups included 4,324,462 participants (27,231 colon cancer cases and 13,813 rectal cancer cases). Sedentary behaviour was significantly associated with colon cancer (relative risk (RR): 1.30, 95% confidence interval (CI): 1.22-1.39) but did not have a statistically significant association with rectal cancer (RR 1.05, 95% CI, 0.98-1.13). Subgroup analyses suggested that the odds ratio (OR) of colon cancer was 1.46 (95% CI: 1.22-1.68) in the case-control studies, and the RR was 1.27 (95% CI: 1.18-1.36) in the cohort studies, the OR of rectal cancer was 1.06 (95% CI: 0.85-1.33) in the case-control studies, and the RR was 1.06 (95% CI, 1.01-1.12) in the cohort studies. CONCLUSION Sedentary behaviour is associated with an increased risk of colon cancer. Subgroup analyses suggest a positive association between sedentary behaviour and risk of rectal cancer in cohort studies. Reducing sedentary behaviour is potentially important for the prevention of colorectal cancer.
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Affiliation(s)
- Y J Cong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - H L Sun
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - J Deng
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - S Y Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - X Xu
- 1] School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China [2] Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Z X Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Schottenfeld D, Beebe-Dimmer JL, Buffler PA, Omenn GS. Current Perspective on the Global and United States Cancer Burden Attributable to Lifestyle and Environmental Risk Factors. Annu Rev Public Health 2013; 34:97-117. [DOI: 10.1146/annurev-publhealth-031912-114350] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- David Schottenfeld
- School of Public Health,
- Department of Epidemiology,
- Medical School, Department of Internal Medicine,
| | - Jennifer L. Beebe-Dimmer
- Karmanos Cancer Institute, Division of Population Studies and Disparities Research,
- Department of Oncology, Wayne State University, Detroit, Michigan 48201;
| | - Patricia A. Buffler
- School of Public Health, Department of Epidemiology, University of California, Berkeley, California 94720;
| | - Gilbert S. Omenn
- School of Public Health,
- Medical School, Department of Internal Medicine,
- Departments of Computational Medicine and Bioinformatics, Human Genetics, University of Michigan, Ann Arbor, Michigan 48109; ,
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Ping Y, Ogushi Y, Okada Y, Haruki Y, Okazaki I, Ogawa T. Lifestyle and colorectal cancer: A case-control study. Environ Health Prev Med 2012; 3:146-51. [PMID: 21432494 DOI: 10.1007/bf02931705] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/1997] [Accepted: 07/08/1998] [Indexed: 10/21/2022] Open
Abstract
A case-control study has been conducted to investigate the relationship between lifestyle and risk of colorectal cancer. Cases are one hundred patients diagnosed with colon and rectal cancer in Tokai University Hospital between 1986 and 1994. Three controls per case were individually matched by age, sex, local areas and date of health checkups at the Automated Multi-phasic Health Testing and Services (AMHTS ) Center of the hospital. The results were analyzed by multi-factorial logistic regression models. Positive history of maternal cancer, large consumption of alcohol, frequent consumption of potato products and white-collar job were predominant risk factors while frequent intake of seaweed was a protective factor. Frequent intakes of dairy foods and lack of exercise showed no significant tendency to increase risk of colorectal cancer. Smoking habits, intakes of meat and egg were shown not to be related to this disease. These findings suggest that family history of cancer and dietary factors play a key role in causation and prevention of colorectal cancer.
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Affiliation(s)
- Y Ping
- Department of Medical Informatics, School of Medicine, Tokai University, Bohseidai, Isehara, 259-1193, Kanagawa, Japan
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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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Laake I, Carlsen MH, Pedersen JI, Weiderpass E, Selmer R, Kirkhus B, Thune I, Veierød MB. Intake oftransfatty acids from partially hydrogenated vegetable and fish oils and ruminant fat in relation to cancer risk. Int J Cancer 2012; 132:1389-403. [DOI: 10.1002/ijc.27737] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 07/02/2012] [Indexed: 11/09/2022]
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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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Erbach M, Mehnert H, Schnell O. Diabetes and the risk for colorectal cancer. J Diabetes Complications 2012; 26:50-5. [PMID: 22321219 DOI: 10.1016/j.jdiacomp.2011.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 11/14/2011] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus has been reported to be associated with an increased risk for colorectal cancer. The review analyzes current epidemiological data on the association of diabetes and the risk for colorectal cancer. Hyperinsulinemia, hyperglycemia, and inflammation are suggested to play a key role in the pathophysiology of cancer in diabetes. Data regarding potential treatment-related risks, particularly in conjunction with the use of insulin and insulin analogues, are also presented. Furthermore, the impact of glycemic control and cardiorespiratory fitness on cancer prognosis is considered. Finally, the preventive potential of aspirin and other nonsteroidal anti-inflammatory drugs, and the recommendations concerning colonoscopy-screening are presented.
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Affiliation(s)
- Michael Erbach
- Diabetes Research Group, Helmholtz Center, Munich-Neuherberg, Germany
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Timing and intensity of recreational physical activity and the risk of subsite-specific colorectal cancer. Cancer Causes Control 2011; 22:1647-58. [PMID: 21922204 DOI: 10.1007/s10552-011-9841-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 09/02/2011] [Indexed: 02/07/2023]
Abstract
PURPOSE Although there is convincing evidence that physical activity reduces colon cancer risk, there are important questions that remain unanswered about the association. These include the timing and intensity of activity required to optimally reduce risk, and whether physical activity has a different effect on cancers at different sites within the colon. We conducted a case-control study to investigate these issues. METHODS A case-control study of colorectal cancer was conducted in Western Australia in 2005-2007. Data were collected on various risk factors. The estimated effects of recreational physical activity on the risk of cancers of the distal colon, proximal colon, and rectum were analyzed using multinomial logistic regression. This analysis included 870 cases and 996 controls. RESULTS The risk of distal colon cancer was reduced by performing a high level of vigorous-intensity activity between the ages 19 and 34 years (women), 35 and 50 years (men), after the age of 51 years (men and women), and consistently over the adult lifetime (men and women). The risk of rectal cancer was reduced by performing a high level of vigorous activity between the ages 35 and 50 years (men), and consistently over the adult lifetime (men). Proximal colon cancer risk was not associated with physical activity in any of the age periods or over the adult lifetime. Moderate intensity activity did not reduce the risk of colorectal cancer. CONCLUSION Physical activity may have a greater effect on the risk of distal colon cancer than proximal colon cancer. Vigorous physical activity is required to reduce colorectal cancer risk.
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Abstract
There is growing interest in the role of sedentary behavior as a risk factor for poor health, independent of physical activity (PA). To guide the spectrum of descriptive, analytic, and intervention studies on sedentary behavior, the authors advocate a behavioral epidemiology framework. This 5-phase framework is useful because it outlines a series of sequential stages important for developing, evaluating, and diffusing interventions to reduce sedentary behavior and improve population health. Studies of sedentary behavior and health outcomes (phase I) have found consistent evidence that excessive use of screen-based media is linked to overweight and obesity in children, and there is some evidence among adults that overall sedentary time is associated with risk factors for cardiometabolic disease, some cancers, and mortality. Biological mechanisms to explain possible relationships have started to emerge but are mostly based on animal models. Obtaining valid and reliable measurements of sedentary behavior (phase II) remains a research priority because self-reports are prone to recall bias, and it appears that sedentary habits do not appear to be well represented by measures of individual behaviors such as TV viewing. Studies have identified few modifiable correlates of sedentary behavior (phase III), although research appears to be limited to studies of TV viewing or to scenarios in which sedentary behavior is defined as an absence of PA. Rigorous intervention research (phase IV) has focused almost exclusively on reducing self-reported TV viewing among children and adolescents, and there is consistent evidence that these interventions are efficacious. There appear to be no interventions focused exclusively on reducing sedentary behavior of adults. Translation studies (phase V) are absent because the underlying evidence is still emerging. Future research should focus on examining causal associations between sedentary behavior and health, developing objective measures of domain-specific sitting time, and identifying modifiable correlates of sedentary behavior that can be used as leverage points for behavioral interventions.
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Affiliation(s)
- Simon J. Marshall
- School of Exercise & Nutritional Sciences, San Diego State University (SJM)
- Department of Family & Preventive Medicine, University of California San Diego (ER), San Diego, California
| | - Ernesto Ramirez
- School of Exercise & Nutritional Sciences, San Diego State University (SJM)
- Department of Family & Preventive Medicine, University of California San Diego (ER), San Diego, California
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Saw CLL, Kong ANT. Nuclear factor-erythroid 2-related factor 2 as a chemopreventive target in colorectal cancer. Expert Opin Ther Targets 2011; 15:281-95. [PMID: 21261563 DOI: 10.1517/14728222.2011.553602] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Numerous epidemiological studies have linked consumption of cruciferous vegetables to a reduced risk of colorectal cancer (CRC) in individuals. It is currently well accepted that chronic inflammation is a contributing factor in 15 - 20% malignancies including CRC. Many chemopreventive compounds are effective in preclinical systems and many ongoing clinical trials are showing promising findings. Many of these compounds could activate the antioxidant responsive element (ARE), a critical regulatory element for Phase II protective/detoxification and antioxidative stress enzymes mediated by nuclear factor-erythroid 2-related factor 2 (Nrf2). Recently, Nrf2 has emerged as a novel target for the prevention of CRC. AREAS COVERED A full literature search was performed using PubMed with the key words 'ARE, Nrf2, colon, colorectal cancer, chemoprevention, cancer prevention', and all relevant publications are included. EXPERT OPINION The use of Nrf2 knockout mice has provided key insights into the toxicological and chemopreventive importance of this pathway. Mounting evidence has revealed that Nrf2 is a critical regulator of inflammation as well, a major driving force for CRC progression and formation. Targeting the Nrf2/ARE pathway may present a novel therapeutic approach for the treatment of not only colorectal inflammatory diseases but the frequent subsequent development of CRC as well.
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Affiliation(s)
- Constance Lay Lay Saw
- Rutgers, The State University of New Jersey, Ernest Mario School of Pharmacy, Department of Pharmaceutics, 160 Frelinghuysen Road, Piscataway, NJ 08854, USA
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Friedenreich CM, Neilson HK, Lynch BM. State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer 2011; 46:2593-604. [PMID: 20843488 DOI: 10.1016/j.ejca.2010.07.028] [Citation(s) in RCA: 284] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 05/14/2010] [Accepted: 07/15/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Physical activity is a modifiable lifestyle risk factor that has the potential to reduce the risk of most major cancer sites. METHODS We examined the strength, consistency, dose-response and biological plausibility of an association between physical activity and risk of colon, breast, endometrium, lung, prostate, ovarian, gastric, rectal, pancreatic, bladder, testicular, kidney and haematological cancers. We also estimated the population-attributable risk (PAR) for physical inactivity and cancer in 15 European countries. RESULTS There is convincing or probable evidence for a beneficial effect of physical activity on the risk of colon, breast and endometrial cancers. The evidence is weaker for ovarian, lung and prostate cancers and generally either null or insufficient for all remaining cancers. Several hypothesised biological mechanisms include a likely effect of physical activity on insulin resistance, body composition, sex steroid hormones and a possible effect on vitamin D, adipokines, inflammation and immune function. Somewhere between 165,000 and 330,000 cases of the six major cancers (breast, colon, lung, prostate, endometrium and ovarian) could have been prevented in 2008 in Europe alone if the population had maintained sufficient levels of physical activity. CONCLUSION There is strong and consistent evidence that physical activity reduces the risk of several of the major cancer sites, and that between 9% and 19% of cancer cases could be attributed to lack of sufficient physical activity in Europe. Public health recommendations for physical activity and cancer prevention generally suggest 30-60 min of moderate or vigorous-intensity activity done at least 5d per week.
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Affiliation(s)
- Christine M Friedenreich
- Department of Population Health Research, Alberta Health Services, 1331 29 St NW, Calgary, Alberta, Canada.
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Occupational sitting and health risks: a systematic review. Am J Prev Med 2010; 39:379-88. [PMID: 20837291 DOI: 10.1016/j.amepre.2010.05.024] [Citation(s) in RCA: 322] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 04/25/2010] [Accepted: 05/29/2010] [Indexed: 11/21/2022]
Abstract
CONTEXT Emerging evidence suggests that sedentary behavior (i.e., time spent sitting) may be negatively associated with health. The aim of this study was to systematically review the evidence on associations between occupational sitting and health risks. EVIDENCE ACQUISITION Studies were identified in March-April 2009 by literature searches in PubMed, PsycINFO, CENTRAL, CINAHL, EMBASE, and PEDro, with subsequent related-article searches in PubMed and citation searches in Web of Science. Identified studies were categorized by health outcome. Two independent reviewers assessed methodologic quality using a 15-item quality rating list (score range 0-15 points, higher score indicating better quality). Data on study design, study population, measures of occupational sitting, health risks, analyses, and results were extracted. EVIDENCE SYNTHESIS 43 papers met the inclusion criteria (21% cross-sectional, 14% case-control, 65% prospective); they examined the associations between occupational sitting and BMI (n=12); cancer (n=17); cardiovascular disease (CVD, n=8); diabetes mellitus (DM, n=4); and mortality (n=6). The median study-quality score was 12 points. Half the cross-sectional studies showed a positive association between occupational sitting and BMI, but prospective studies failed to confirm a causal relationship. There was some case-control evidence for a positive association between occupational sitting and cancer; however, this was generally not supported by prospective studies. The majority of prospective studies found that occupational sitting was associated with a higher risk of DM and mortality. CONCLUSIONS Limited evidence was found to support a positive relationship between occupational sitting and health risks. The heterogeneity of study designs, measures, and findings makes it difficult to draw definitive conclusions at this time.
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