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Tomlinson MM, Pugh F, Nail AN, Newton JD, Udoh K, Abraham S, Kavalukas S, Guinn B, Tamimi RM, Laden F, Iyer HS, States JC, Ruther M, Ellis CT, DuPré NC. Heavy-metal associated breast cancer and colorectal cancer hot spots and their demographic and socioeconomic characteristics. Cancer Causes Control 2024; 35:1367-1381. [PMID: 38916703 PMCID: PMC11461597 DOI: 10.1007/s10552-024-01894-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/01/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Cancer registries offer an avenue to identify cancer clusters across large populations and efficiently examine potential environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI)) in breast and colorectal carcinogenesis is largely unknown. Historically marginalized communities are disproportionately exposed to metals, which could explain cancer disparities. We examined area-based metal exposures and odds of residing in breast and colorectal cancer hotspots utilizing state tumor registry data and described the characteristics of those living in heavy metal-associated cancer hotspots. METHODS Breast and colorectal cancer hotspots were mapped across Kentucky, and area-based ambient metal exposure to cadmium, arsenic, nickel, and chromium(VI) were extracted from the 2014 National Air Toxics Assessment for Kentucky census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between ambient metal concentrations and odds of residing in cancer hotspots, independent of individual-level and neighborhood risk factors. RESULTS Higher ambient metal exposures were associated with higher odds of residing in breast and colorectal cancer hotspots. Populations in breast and colorectal cancer hotspots were disproportionately Black and had markers of lower socioeconomic status. Furthermore, adjusting for age, race, tobacco and neighborhood factors did not significantly change cancer hotspot ORs for ambient metal exposures analyzed. CONCLUSION Ambient metal exposures contribute to higher cancer rates in certain geographic areas that are largely composed of marginalized populations. Individual-level assessments of metal exposures and cancer disparities are needed.
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Affiliation(s)
- Madeline M Tomlinson
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Felicia Pugh
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
- Louisville Metro Department of Public Health and Wellness, Center for Health Equity, Louisville, KY, USA
| | - Alexandra N Nail
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Johnnie D Newton
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Karen Udoh
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Stephie Abraham
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Sandy Kavalukas
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Brian Guinn
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medical, New York, NY, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology and Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - J Christopher States
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY, USA
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA
| | - Matthew Ruther
- Department of Urban and Public Affairs, College of Arts and Sciences, University of Louisville, Louisville, KY, USA
| | - C Tyler Ellis
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA
| | - Natalie C DuPré
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA.
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA.
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Sedani AE, Obidike OJ, Ewing AP, Rifelj KK, Kim J, Wright S, Carothers S, Mullins RR, Pesmen C, Ly-Gallagher P, Rogers CR. #CRCandMe: results of a pre-post quasi-experimental study of a mass media campaign to increase early-onset colorectal cancer awareness in Utah and Wisconsin. Am J Cancer Res 2024; 14:3873-3884. [PMID: 39267680 PMCID: PMC11387877 DOI: 10.62347/pgym7724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/05/2024] [Indexed: 09/15/2024] Open
Abstract
Overall colorectal cancer (CRC) incidence and mortality have been decreasing for several decades; however, since the early 1990s CRC incidence rates have nearly doubled among adults aged under 50 years. This study pilot-tested a community-based mass-media campaign aimed at improving knowledge and awareness of early-onset CRC in this population. The campaign (#CRCandMe) was deployed from June to September 2023 in Utah and Wisconsin. To evaluate its success (reach) and inform future campaigns, key performance indicators were defined (e.g., impressions, website traffic). To evaluate change in knowledge in the target population, the knowledge and awareness of participants recruited via consumer panels was assessed at baseline (n=235) and follow-up (n=161). The number of correct answers for each of seven knowledge items was calculated at baseline (pre-intervention) and follow-up (post-intervention). McNemar's test was employed to assess significant differences in the seven knowledge items between the two timepoints. The campaign delivered over 26.7 million impressions and nearly 43,000 clicks. A 15-second video ad received 221,985 plays, with 57,270 users watching to completion. Pre-survey results revealed that while 74% of participants were able to correctly identify CRC signs, only 18% could identify risk factors. Knowledge scores slightly improved from baseline to follow-up, with statistically significance for the question related to CRC signs (P=0.0004). This study demonstrated wide reach and may inform future larger-scale interventions and public health initiatives aimed at reducing CRC incidence and improving health outcomes for at-risk adults aged under 50 years.
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Affiliation(s)
- Ami E Sedani
- Institute for Health and Equity, Medical College of WisconsinMilwaukee, WI, USA
| | - Ogechi Jessica Obidike
- Department of Health Policy and Management, Fielding School of Public Health, University of CaliforniaLos Angeles, CA, USA
| | - Aldenise P Ewing
- College of Public Health, Division of Epidemiology, The Ohio State UniversityColumbus, OH, USA
| | - Kelly K Rifelj
- Institute for Health and Equity, Medical College of WisconsinMilwaukee, WI, USA
| | | | | | | | | | | | | | - Charles R Rogers
- Institute for Health and Equity, Medical College of WisconsinMilwaukee, WI, USA
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Gupta S, May FP, Kupfer SS, Murphy CC. Birth Cohort Colorectal Cancer (CRC): Implications for Research and Practice. Clin Gastroenterol Hepatol 2024; 22:455-469.e7. [PMID: 38081492 PMCID: PMC11304405 DOI: 10.1016/j.cgh.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
Colorectal cancer (CRC) epidemiology is changing due to a birth cohort effect, first recognized by increasing incidence of early onset CRC (EOCRC, age <50 years). In this paper, we define "birth cohort CRC" as the observed phenomenon, among individuals born 1960 and later, of increasing CRC risk across successive birth cohorts, rising EOCRC incidence, increasing incidence among individuals aged 50 to 54 years, and flattening of prior decreasing incidence among individuals aged 55 to 74 years. We demonstrate birth cohort CRC is associated with unique features, including increasing rectal cancer (greater than colon) and distant (greater than local) stage CRC diagnosis, and increasing EOCRC across all racial/ethnic groups. We review potential risk factors, etiologies, and mechanisms for birth cohort CRC, using EOCRC as a starting point and describing importance of viewing these through the lens of birth cohort. We also outline implications of birth cohort CRC for epidemiologic and translational research, as well as current clinical practice. We postulate that recognition of birth cohort CRC as an entity-including and extending beyond rising EOCRC-can advance understanding of risk factors, etiologies, and mechanisms, and address the public health consequences of changing CRC epidemiology.
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Affiliation(s)
- Samir Gupta
- Section of Gastroenterology, Jennifer Moreno San Diego VA Medical Center, San Diego, California; Division of Gastroenterology, Department of Medicine, and Moores Cancer Center, University of California, La Jolla, California.
| | - Folasade P May
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California; UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California
| | - Sonia S Kupfer
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Caitlin C Murphy
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas
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Buchalter RB, Kamath SD, Nair KG, Liska D, Khorana AA, Schmit SL. Novel Hot and Cold Spots of Young-Onset Colorectal Cancer Mortality in United States Counties. Gastroenterology 2022; 163:1101-1103.e3. [PMID: 35728692 PMCID: PMC9509470 DOI: 10.1053/j.gastro.2022.06.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/25/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022]
Affiliation(s)
- R Blake Buchalter
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, and, Population and Cancer Prevention Program, Case Comprehensive Cancer Center, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio.
| | - Suneel D Kamath
- Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio
| | - Kanika G Nair
- Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio
| | - David Liska
- Population and Cancer Prevention Program, Case Comprehensive Cancer Center, and, Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio
| | - Alok A Khorana
- Population and Cancer Prevention Program, Case Comprehensive Cancer Center, and, Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio
| | - Stephanie L Schmit
- Population and Cancer Prevention Program, Case Comprehensive Cancer Center, and, Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, and, Edward J. DeBartolo Jr Family Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, Ohio
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Brooks E, Islam JY, Perdue DG, Petersen E, Camacho-Rivera M, Kennedy C, Rogers CR. The Black Panther, Masculinity Barriers to Medical Care, and Colorectal Cancer Screening Intention Among Unscreened American Indian/Alaska Native, Black, and White Men. Front Public Health 2022; 10:814596. [PMID: 35462819 PMCID: PMC9019156 DOI: 10.3389/fpubh.2022.814596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/15/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To determine if masculinity barriers to medical care and the death from colorectal cancer (CRC) of actor Chadwick Boseman (The Black Panther) influenced CRC early-detection screening intent among unscreened American Indian/Alaska Native (AIAN) and Non-Hispanic-Black (Black) men compared with Non-Hispanic-White (White) men. Methods Using a consumer-panel, we surveyed U.S. men aged 18-75 years (N = 895) using the 24-item Masculinity Barriers to Medical Care (MBMC) scale. We calculated the median score to create binary exposures to evaluate associations with CRC screening intent and conducted multivariable logistic regression to evaluate independent associations stratified by race/ethnicity. Results Overall, Black respondents were most likely to have a high MBMC score (55%) compared to White (44%) and AIAN (51%) men (p = 0.043). AIAN men were least likely to report CRC screening intent (51.1%) compared with Black (68%) and White men (64%) (p < 0.001). Black men who reported the recent death of Chadwick Boseman increased their awareness of CRC were more likely (78%) to report intention to screen for CRC compared to those who did not (56%) (p < 0.001). Black men who exhibited more masculinity-related barriers to care were more likely to intend to screen for CRC (OR: 1.76, 95% CI: 0.98-3.16) than their counterparts, as were Black men who reported no impact of Boseman's death on their CRC awareness (aOR: 2.96, 95% CI: 1.13-7.67). Conversely, among AIAN men, those who exhibited more masculinity-related barriers to care were less likely to have CRC screening intent (aOR: 0.47, 95% CI: 0.27-0.82) compared with their counterparts. Conclusions Masculinity barriers to medical care play a significant role in intention to screen for CRC. While Black men were most likely to state that The Black Panther's death increased their awareness of CRC, it did not appear to modify the role of masculine barriers in CRC screening intention as expected. Further research is warranted to better understand how masculine barriers combined with celebrity-driven health-promotion interventions influence the uptake of early-detection screening for CRC. Impact Our study provides formative data to develop behavioral interventions focused on improving CRC screening completion among diverse men.
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Affiliation(s)
- Ellen Brooks
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Jessica Y Islam
- Center for Immunization and Infections in Cancer, Cancer Epidemiology Program, H. Lee Moffitt Cancer and Research Institute, Tampa, FL, United States
| | | | - Ethan Petersen
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Carson Kennedy
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Charles R Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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Rogers CR, Korous KM, Brooks E, De Vera MA, Tuuhetaufa F, Lucas T, Curtin K, Pesman C, Johnson W, Gallagher P, Moore JX. Early-Onset Colorectal Cancer Survival Differences and Potential Geographic Determinants Among Men and Women in Utah. Am Soc Clin Oncol Educ Book 2022; 42:1-16. [PMID: 35522914 PMCID: PMC9327138 DOI: 10.1200/edbk_350241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
By 2030, early-onset colorectal cancer (EOCRC) is expected to become the leading cancer-related cause of death for people age 20 to 49. To improve understanding of this phenomenon, we analyzed the geographic determinants of EOCRC in Utah by examining county-level incidence and mortality. We linked data from the Utah Population Database to the Utah Cancer Registry to identify residents (age 18-49) diagnosed with EOCRC between 2000 and 2020, and we used spatial empirical Bayes smoothing to determine county-level hotspots. We identified 1,867 EOCRC diagnoses (52.7% in male patients, 69.2% in non-Hispanic White patients). Ten counties (34%) were classified as hotspots, with high EOCRC incidence or mortality. Hotspot status was unrelated to incidence rates, but non-Hispanic ethnic-minority men (incidence rate ratio, 1.49; 95% CI, 1.15-1.91), Hispanic White men and women (incidence rate ratio, 2.24; 95% CI, 2.00-2.51), and Hispanic ethnic-minority men and women (incidence rate ratio, 4.59; 95% CI, 3.50-5.91) were more likely to be diagnosed with EOCRC. After adjustment for income and obesity, adults living in hotspots had a 31% higher hazard for death (HR, 1.31; 95% CI, 1.02-1.69). Survival was poorest for adults with a late-stage diagnosis living in hotspots (chi square (1) = 4.0; p = .045). Adults who were married or who had a life partner had a lower hazard for death than single adults (HR, 0.73; 95% CI, 0.58-0.92). The risk for EOCRC is elevated in 34% of Utah counties, warranting future research and interventions aimed at increasing screening and survival in the population age 18 to 49.
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Affiliation(s)
- Charles R. Rogers
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Kevin M. Korous
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Mary A. De Vera
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Fa Tuuhetaufa
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Todd Lucas
- Division of Public Health, Michigan State University College of Human Medicine, Flint, MI
| | - Karen Curtin
- Department of Internal Medicine, Huntsman Cancer Institute, Utah Population Database Shared Resource, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Wenora Johnson
- Patient-Centered Outcomes Research Institute, Chicago, IL
| | | | - Justin X. Moore
- Medical College of Georgia, Georgia Cancer Center, Cancer Prevention, Control, & Population Health, Augusta University, Augusta, GA
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Rogers CR, Brooks E, Curtin K, De Vera MA, Qeadan F, Rogers TN, Petersen E, Gallagher P, Pesmen C, Johnson W, Henley C, Hickman W, Newcomb E, Korous KM, Handley MA. Protocol for #iBeatCRC: a community-based intervention to increase early-onset colorectal cancer awareness using a sequential explanatory mixed-methods approach. BMJ Open 2021; 11:e048959. [PMID: 34862279 PMCID: PMC8647393 DOI: 10.1136/bmjopen-2021-048959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Th last two decades have seen a twofold increase in colorectal cancer (CRC) incidence among individuals under the recommended screening age of 50 years. Although the origin of this early-onset CRC (EOCRC) spike remains unknown, prior studies have reported that EOCRC harbours a distinct molecular and clinical phenotype in younger individuals. The sharp increase in EOCRC incidence rates may be attributable to a complex interplay of factors, including race; lifestyle; and ecological, sociodemographic and geographical factors. However, more research that address psychosocial experiences and accounts for lifestyle-related behaviours before, during and after an EOCRC diagnosis are warranted. This study aims to develop and pilot test a theory-driven, community-based intervention to increase awareness of EOCRC, reduce its associated risk factors and improve early detection among adults aged 18-49 years. METHODS AND ANALYSIS Guided by the Behaviour Change Wheel, we will use a multistage mixed-methods study design. We will pilot a sequential mixed-methods intervention study as follows: (1) First, we will analyse linked quantitative data from the Utah Cancer Registry and National Cancer Institute Surveillance, Epidemiology and End Results registry, linked to state-wide demographic and vital records in the Utah Population Database to identify EOCRC hotspots in Utah by examining the EOCRC incidence and survival variance explained by personal and county-level factors. (2) Next, we will conduct one-on-one interviews with 20 EOCRC survivors residing in EOCRC hotspots to ascertain psychosocial and lifestyle challenges that accompany an EOCRC diagnosis. (3) Finally, we will consider existing evidence-based approaches, our integrated results (quantitative +qualitative) and community action board input to design a community-based intervention to increase EOCRC awareness that can feasibly be delivered by means of outdoor mass media, and via social media. We will pilot the multicomponent media campaign with a quasiexperimental design among 17 EOCRC hotspot residents and 17 EOCRC 'coldspot' residents. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of Utah Institutional Review Board (IRB_00138357). Signed informed consent will be obtained from all participants prior to any data collection. Study results will be disseminated through CRC community blogs, targeted infographics, conference presentations at national and international professional conferences and publications in peer-reviewed journals. Final intervention-specific data will be available on reasonable request from the corresponding author. TRIAL REGISTRATION NUMBER NCT04715074.
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Affiliation(s)
- Charles R Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ellen Brooks
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Karen Curtin
- Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fares Qeadan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Tiana N Rogers
- Sorenson Impact Center, University of Utah Eccles School of Business, Salt Lake City, Utah, USA
| | - Ethan Petersen
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Curt Pesmen
- BoCo Media, Boulder, Colorado, USA
- Fight Colorectal Cancer, Alexandria, Virginia, USA
| | | | | | | | | | - Kevin M Korous
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Margaret A Handley
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Medicine, University of California San Francisco, San Francisco, California, USA
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The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review. Cancers (Basel) 2021; 13:cancers13235933. [PMID: 34885046 PMCID: PMC8657307 DOI: 10.3390/cancers13235933] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary This systematic review sifted through the exogenous dietary and lifestyle risk factors associated with early-onset colorectal cancer, going through the putative involvement of these exogenous risk factors in epigenetic and microbiota modifications. Given the burden of early-onset colorectal cancer and its globally increasing trend with scant literature on its pathogenesis, we believe it would be of benefit to highlight the importance of further systematic and large studies. Indeed, dietary and lifestyle modification could complement colorectal screening for early-onset colorectal cancer prevention. Abstract The incidence of early-onset colorectal cancer, defined as colorectal cancer occurring in young adults under the age of 50, is increasing globally. Knowledge of the etiological factors in young adults is far from complete. Questionable eoCRCs’ exogenous factors are represented by processed meat, sugary drinks, alcohol, Western dietary pattern, overweight and obesity, physical inactivity, and smoking, though with heterogeneous results. Therefore, we performed a systematic review to summarize the current evidence on the role of diet and lifestyle as eoCRC risk factors. We systematically searched PubMed, Scopus, and EMBASE up to July 2021, for original studies evaluating diet, alcohol, physical activity, BMI, and smoking in eoCRC and included twenty-six studies. Indeed, the exogenous factors could represent modifiable key factors, whose recognition could establish areas of future interventions through public health strategies for eoCRC primary prevention. Additionally, we discussed the role of additional non-modifiable risk factors, and of epigenetic regulation and microbiota as mediators of the eoCRC triggered by diet and lifestyle.
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Hyams T, Mueller N, Curbow B, King-Marshall E, Sultan S. Screening for colorectal cancer in people ages 45-49: research gaps, challenges and future directions for research and practice. Transl Behav Med 2021; 12:198-202. [PMID: 34184736 DOI: 10.1093/tbm/ibab079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Travis Hyams
- National Cancer Institute, Division of Cancer Control and Population Sciences, Office of the Director, Rockville, MD, USA.,Department of Behavioral and Community Health, University of Maryland, College Park, School of Public Health, College Park, MD USA
| | - Nora Mueller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Barbara Curbow
- Department of Behavioral and Community Health, University of Maryland, College Park, School of Public Health, College Park, MD USA
| | - Evelyn King-Marshall
- Department of Behavioral and Community Health, University of Maryland, College Park, School of Public Health, College Park, MD USA
| | - Shahnaz Sultan
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA
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Disparities in Early-Onset Colorectal Cancer. Cells 2021; 10:cells10051018. [PMID: 33925893 PMCID: PMC8146231 DOI: 10.3390/cells10051018] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 02/06/2023] Open
Abstract
The incidence and mortality of early-onset colorectal cancer (CRC) are increasing in the United States (US) and worldwide. In the US, there are notable disparities in early-onset CRC burden by race/ethnicity and geography. African Americans, Hispanic/Latinos, and populations residing in specific regions of the Southern U.S. are disproportionately affected with CRC diagnosed at younger ages, while less is known about disparities in other countries. Reasons for these disparities are likely multi-factorial and potentially implicate differences in health determinants including biology/genetics, diet/environment, individual health behaviors, and access to high-quality health services, as well as social and policy factors. This review summarizes current understanding of early-onset CRC disparities and identifies specific research areas that will inform evidence-based interventions at individual, practice, and policy levels to reduce the global burden of this disease.
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