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Gao L, Cao Y, Cao X, Shi X, Lei M, Su X, Liu Y. Machine learning-based algorithms to predict severe psychological distress among cancer patients with spinal metastatic disease. Spine J 2023; 23:1255-1269. [PMID: 37182703 DOI: 10.1016/j.spinee.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/12/2023] [Accepted: 05/08/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND CONTEXT Metastatic spinal disease is an advanced stage of cancer patients and often suffer from terrible psychological health status; however, the ability to estimate the risk probability of this adverse outcome using current available data is very limited. PURPOSE The goal of this study was to propose a precise model based on machine learning techniques to predict psychological status among cancer patients with spinal metastatic disease. STUDY DESIGN/SETTING A prospective cohort study. PATIENT SAMPLE A total of 1043 cancer patients with spinal metastatic disease were included. OUTCOME MEASURES The main outcome was severe psychological distress. METHODS The total of patients was randomly divided into a training dataset and a testing dataset on a ratio of 9:1. Patients' demographics, lifestyle choices, cancer-related features, clinical manifestations, and treatments were collected as potential model predictors in the study. Five machine learning algorithms, including XGBoosting machine, random forest, gradient boosting machine, support vector machine, and ensemble prediction model, as well as a logistic regression model were employed to train and optimize models in the training set, and their predictive performance was assessed in the testing set. RESULTS Up to 21.48% of all patients who were recruited had severe psychological distress. Elderly patients (p<0.001), female (p =0.045), current smoking (p=0.002) or drinking (p=0.003), a lower level of education (p<0.001), a stronger spiritual desire (p<0.001), visceral metastasis (p=0.005), and a higher Eastern Cooperative Oncology Group (ECOG) score (p<0.001) were significantly associated with worse psychological health. With an area under the curve (AUC) of 0.865 (95% CI: 0.788-0.941) and an accuracy of up to 0.843, the gradient boosting machine algorithm performed best in the prediction of the outcome, followed by the XGBooting machine algorithm (AUC: 0.851, 95% CI: 0.768-0.934; Accuracy: 0.826) and ensemble prediction (AUC: 0.851, 95% CI: 0.770-0.932; Accuracy: 0.809) in the testing set. In contrast, the AUC of the logistic regression model was only 0.836 (95% CI: 0.756-0.916; Accuracy: 0.783). CONCLUSIONS Machine learning models have greater predictive power and can offer useful tools to identify individuals with spinal metastatic disease who are experiencing severe psychological distress.
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Affiliation(s)
- Le Gao
- Department of Oncology, Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, No. 8 Dongdajie Street, Fengtai District, Beijing, China
| | - Yuncen Cao
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Xuyong Cao
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Xiaolin Shi
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318 Chaowang Road, Hangzhou, 310005, China
| | - Mingxing Lei
- Department of Orthopedic Surgery, Hainan Hospital of PLA General Hospital, No. 80 Jianglin Road, Haitang District, Sanya, 572022, China; National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, No. 28 Fuxing Road, Haidian District, Beijing, 100039, China.
| | - Xiuyun Su
- Intelligent Medical Innovation Institute, Southern University of Science and Technology Hospital, No. 6019 Xili Liuxian Avenue, Nanshan District, Shenzhen, 518071, China.
| | - Yaosheng Liu
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China; National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, No. 28 Fuxing Road, Haidian District, Beijing, 100039, China.
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Yoon K, Shin CM, Han K, Jung JH, Jin EH, Lim JH, Kang SJ, Choi YJ, Lee DH. Risk of cancer in patients with insomnia: Nationwide retrospective cohort study (2009-2018). PLoS One 2023; 18:e0284494. [PMID: 37083623 PMCID: PMC10121030 DOI: 10.1371/journal.pone.0284494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
PURPOSE To investigate the association between insomnia and the risk of various cancers using the Korean National Health Insurance Service database. MATERIALS AND METHODS Patients who underwent a national health examination in 2009 were followed-up until 2018. Newly-diagnosed cancers were collected one year after the baseline. Insomnia was defined as having a diagnosis of F510 or G470 within one year prior to enrollment. The incidence of various cancers was compared between patients with and without insomnia. RESULTS In the overall study population (N = 3,982,012), the risk for any type of cancer was not different between controls and insomnia patients (adjusted hazard ratio [aHR]: 0.990). However, it was different by age; insomnia increased the risk of any cancer in younger age groups (20-39y and 40-59y, aHR:1.310 and 1.139, respectively) but it significantly decreased the risk in the 60-79y age group (aHR: 0.939). In cancer type, colorectal cancer risk was lower (aHR: 0.872, P < 0.0001), whereas leukemia risk was higher (aHR: 1.402, P < 0.0001) in patients with insomnia than in those without it, regardless of sex. In men, the risk of stomach cancer was lower (aHR: 0.882, P = 0.0003), and the risks of lung (aHR:1.114, P = 0.0005), kidney (aHR 1.226, P = 0.0107), and prostate (aHR:1.101, P = 0.0028) cancers were higher in insomnia patients than in control patients. In women, insomnia patients compared to control patients showed a lower risk of ovarian cancer (aHR:0.856, P = 0.0344, respectively), while they had a higher risk of oral (aHR:1.616, P = 0.002), thyroid (aHR:1.072, P = 0.0192), and nerve (aHR: 1.251, P = 0.016) cancers. CONCLUSION Insomnia is associated with an increased or decreased risk of some cancers, depending on age, cancer type and sex.
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Affiliation(s)
- Kichul Yoon
- Department of Internal Medicine, Seonam Hospital, Seoul, South Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Jin Hyung Jung
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun Hyo Jin
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - Joo Hyun Lim
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - Yoon Jin Choi
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Sleep pattern, healthy lifestyle and colorectal cancer incidence. Sci Rep 2022; 12:18317. [PMID: 36316431 PMCID: PMC9622719 DOI: 10.1038/s41598-022-21879-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Researchers have identified an association between lifestyle factors and colorectal cancer (CRC) risk. This study examined the relationship between sleep patterns and CRC events. 392,252 individuals were sampled from the UK Biobank. Chronotype, sleep duration, insomnia, snoring, and excessive daytime sleepiness were combined to measure a healthy sleep score. A number of healthy sleep factors were defined, along with factors for healthy lifestyle scores. Using Cox proportional hazards regression, computed hazard ratios (HRs) were used to examine the associations between sleep patterns, healthy lifestyles, and the incidence of CRC. Healthy sleep scores were inversely associated with CRC events. The HRs for CRC were 0.90 (95% CI, 0.88-0.92) and 0.95 (95% CI, 0.92-0.98) for a 1-point healthy sleep score increase among males and females. When analyzing sleep components, sleeping 7-8 h/day, no frequent insomnia, no snoring, and no frequent daytime sleepiness were independently associated with a 9%, 14%, 8%, and 14% lower risk of CRC, respectively, whilst healthy lifestyle scores were inversely associated with CRC incidence across all models. Sleep pattern and lifestyle are significantly correlated with CRC risk. The healthier the subject's lifestyle and sleep pattern, the lower their CRC risk.
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Wu E, Ni JT, Xie T, Tao L. Noncausal effects of genetic predicted depression and colorectal cancer risk: A Mendelian randomization study. Medicine (Baltimore) 2022; 101:e30177. [PMID: 36042675 PMCID: PMC9410676 DOI: 10.1097/md.0000000000030177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Depression has been associated with colorectal cancer (CRC) in observational studies. However, the causality of depression on CRC risk remained unknown. This study aimed to evaluate the potential causal association between genetic variants related to depression and the risk of CRC using Mendelian randomization (MR). Two-sample MR analysis using summary data was performed to examine whether depression was causally associated with CRC risk. We used 2 sets of instrumental variables (IV) from the genome-wide association study results for analysis. A set of IV related to major depressive disorder contain 44 single-nucleotide polymorphisms. Another set of IV was related to major depression, including 53 single-nucleotide polymorphisms. Summary data of CRC was from the FinnGen consortium. Based on the results of MR using inverse-variance weighted method, we found that genetically determined major depressive disorder (odds ratio = 1.06, 95% confidence interval = 0.77-1.45) or major depression (odds ratio = 0.77, 95% confidence interval = 0.57-1.04) did not causally increase CRC risk. The results of MR-Egger and the weighted median method are consistent with the inverse-variance weighted method. The two-sample MR analysis showed that depression is not causally associated with CRC risk. Further research is needed to investigate the association between depression and CRC.
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Affiliation(s)
- E. Wu
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Jun-Tao Ni
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tian Xie
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Lin Tao
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lin Tao, School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China (e-mail: ; )
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Oancea SC, de Oliveira GD, Sukumaran P, Vogeltanz-Holm N, Nucci LB. The association between alcohol consumption and self-reported current depression among adults residing in Brazil. J Public Health (Oxf) 2021; 43:e204-e212. [PMID: 33367910 DOI: 10.1093/pubmed/fdaa220] [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: 11/18/2019] [Revised: 05/13/2020] [Accepted: 11/06/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of the current study was to investigate the association between binge and heavy drinking and self-reported current depression (SRCD) in a representative population-based sample of adults residing in Brazil. METHODS The sample for this study was based on the 2013 Brazilian National Health Survey. SRCD was accessed using the Patient Health Questionnaire (PHQ-8), a valid eight-item depression measure for population-based studies instrument. The association between binge/heavy drinking and SRCD was investigated using weighted and adjusted multivariable logistic regression models. RESULTS Out of the final study sample of 59 399 Brazilians, 47.2% were young adults, 34.6% were middle age adults and 52.4% were females. The prevalence of binge drinking was 13.8%, of heavy drinking was 3.2% and SRCD was 7.6%. There was a significant weighted and adjusted association between binge drinking and SRCD among young and middle age females (OR = 1.5, 95% CI:1.1-2.0 and OR = 0.6, 95% CI:0.4-0.8, respectively) and between heavy drinking and SRCD among young and middle age males (OR = 1.8, 95% CI:1.2-2.8 and OR = 2.5, 95% CI:1.5-4.1, respectively). CONCLUSIONS The possible protective factor of binge drinking for SRCD among middle-aged Brazilian females needs to be further investigated and understood. Longitudinal research is needed to provide further evidence of associations found in this study.
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Affiliation(s)
- S C Oancea
- Department of Population Health, University of North Dakota: School of Medicine and Health Sciences, Grand Forks, ND 58202-9037, USA
| | - G D de Oliveira
- Department of Research, Inbox Produtora, Rua Major Solon, São Paulo 13024-091, Brazil
| | - P Sukumaran
- Department of Population Health, University of North Dakota: School of Medicine and Health Sciences, Grand Forks, ND 58202-9037, USA
| | - N Vogeltanz-Holm
- Center for Health Promotion and Prevention Research, University of North Dakota: School of Medicine and Health Sciences, Grand Forks, ND 58202-9037, USA
| | - L B Nucci
- Pontifical Catholic University of Campinas, Center for Life Sciences, Postgraduate Program in Health Sciences. Av. John Boyd Dunlop, São Paulo 13060-904, Brazil
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Hu N, Ma Y, He J, Zhu L, Cao S. Alcohol consumption and incidence of sleep disorder: A systematic review and meta-analysis of cohort studies. Drug Alcohol Depend 2020; 217:108259. [PMID: 32927195 DOI: 10.1016/j.drugalcdep.2020.108259] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/09/2020] [Accepted: 08/23/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the association between alcohol consumption and incidence of sleep disorder. METHODS PubMed, EMBASE and OVID were searched systematically until March 2020 for cohort studies quantitatively investigating the effect of alcohol on incident sleep disorder. We conducted a random-effects meta-analysis to calculate the summary ORs (odds ratios) and 95 %CIs (confidence intervals) on the incidence of sleep disorder in relation to alcohol consumption. RESULTS The pooled analysis of eleven included cohort studies demonstrated that general drinking was significantly associated with incidence of sleep disorder (OR:1.37, 95 %CI:1.22,1.54,I² = 0.0 %) while heavy drinking was not (OR:1.22, 95 %CI:0.94,1.60, I² = 81.1 %). (general drinking (women <24 g/day; men <48 g/day; < 4 times/week), heavy drinking (women ≥24 g/day; men ≥48 g/day; ≥ 4times/week)). CONCLUSIONS Findings from the present systematic review and meta-analyses showed that there was no evidence that alcohol consumption diminished sleep problems, and some evidence that general drinking might increase the sleep problems, but further study is necessary.
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Affiliation(s)
- Nan Hu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yibin Ma
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jie He
- Wuhan Union Hospital of China, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Lichen Zhu
- Wuhan Union Hospital of China, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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WANG W, DONG Z, ZHANG X, LI W, LI P, CHEN X. Dietary and the Risk of Sporadic Colorectal Cancer in China: A Case-control Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1327-1335. [PMID: 30320007 PMCID: PMC6174056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND High-fat diets have been considered a risk factor for sporadic colorectal cancer (CRC) in Western countries. However, data for this phenomenon are lacking in China. The purpose of this study was to comprehensively evaluate the association between diet and the risk for sporadic CRC in Shandong Province, China. METHODS In this case-control study, 317 patients with sporadic CRC and 317 controls were collected in Shandong Province, China. All the samples were collected on the basis of rigorous screening criteria. The data were analyzed using a χ2 test, univariate or multivariate conditional logistic regression, and stratified analysis. RESULTS Multivariate logistic regression showed that the following are risk factors for sporadic CRC (all P<0.05): consumption of pork, fried food or barbecued meat; high Body Mass Index (BMI); alcohol abuse; psychosis; and the presence of a factory causing pollution near the home. Moreover, univariate analysis revealed the following qualities were also positively associated with CRC (all P<0.05): intake of animal oil, consuming brawn and kipper, smoking, exhibiting frequent anger, and poor sleep quality. Eating fresh fruit was inversely correlated with the incidence of CRC (P=0.012). Further stratified analysis demonstrated that BMI and the consumption of fried food, barbecued meat, or garlic were correlated with colon cancer. However, alcohol abuse and psychosis were related to an increased risk for rectal cancer. CONCLUSION Dietary factors are related to sporadic CRC in Shandong Province. Future interventions should focus on reducing the related risk factors while advocating for practice of the protective factors.
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Affiliation(s)
- Wenfei WANG
- Humanistic Medicine Research Center, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China
| | - Zhaogang DONG
- Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China
| | - Xin ZHANG
- Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China
| | - Wei LI
- Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China
| | - Peilong LI
- Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China
| | - Xiaoyang CHEN
- Humanistic Medicine Research Center, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China,Corresponding Author:
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D’Arcy M, Stürmer T, Lund JL. The importance and implications of comparator selection in pharmacoepidemiologic research. CURR EPIDEMIOL REP 2018; 5:272-283. [PMID: 30666285 PMCID: PMC6338470 DOI: 10.1007/s40471-018-0155-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Pharmacoepidemiologic studies employing large databases are critical to evaluating the effectiveness and safety of drug exposures in large and diverse populations. Because treatment is not randomized, researchers must select a relevant comparison group for the treatment of interest. The comparator group can consist of individuals initiating: (1) a similarly indicated treatment (active comparator), (2) a treatment used for a different indication (inactive comparator) or (3) no particular treatment (non-initiators). Herein we review recent literature and describe considerations and implications of comparator selection in pharmacoepidemiologic studies. RECENT FINDINGS Comparator selection depends on the scientific question and feasibility constraints. Because pharmacoepidemiologic studies rely on the choice to initiate or not initiate a specific treatment, rather than randomization, they are at-risk for confounding related to the comparator choice including: by indication, disease severity and frailty. We describe forms of confounding specific to pharmacoepidemiologic studies and discuss each comparator along with informative examples and a case study. We provide commentary on potential issues relevant to comparator selection in each study, highlighting the importance of understanding the population in whom the treatment is given and how patient characteristics are associated with the outcome. SUMMARY Advanced statistical techniques may be insufficient for reducing confounding in observational studies. Evaluating the extent to which comparator selection may mitigate or induce systematic bias is a critical component of pharmacoepidemiologic studies.
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Affiliation(s)
- Monica D’Arcy
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer L. Lund
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Rossi M, Jahanzaib Anwar M, Usman A, Keshavarzian A, Bishehsari F. Colorectal Cancer and Alcohol Consumption-Populations to Molecules. Cancers (Basel) 2018; 10:E38. [PMID: 29385712 PMCID: PMC5836070 DOI: 10.3390/cancers10020038] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is a major cause of morbidity and mortality, being the third most common cancer diagnosed in both men and women in the world. Several environmental and habitual factors have been associated with the CRC risk. Alcohol intake, a common and rising habit of modern society, is one of the major risk factors for development of CRC. Here, we will summarize the evidence linking alcohol with colon carcinogenesis and possible underlying mechanisms. Some epidemiologic studies suggest that even moderate drinking increases the CRC risk. Metabolism of alcohol involves ethanol conversion to its metabolites that could exert carcinogenic effects in the colon. Production of ethanol metabolites can be affected by the colon microbiota, another recently recognized mediating factor to colon carcinogenesis. The generation of acetaldehyde and alcohol's other metabolites leads to activation of cancer promoting cascades, such as DNA-adduct formation, oxidative stress and lipid peroxidation, epigenetic alterations, epithelial barrier dysfunction, and immune modulatory effects. Not only does alcohol induce its toxic effect through carcinogenic metabolites, but alcoholics themselves are predisposed to a poor diet, low in folate and fiber, and circadian disruption, which could further augment alcohol-induced colon carcinogenesis.
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Affiliation(s)
- Marco Rossi
- Division of Digestive Diseases, Hepatology, and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Muhammad Jahanzaib Anwar
- Division of Digestive Diseases, Hepatology, and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Ahmad Usman
- Division of Digestive Diseases, Hepatology, and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Ali Keshavarzian
- Division of Digestive Diseases, Hepatology, and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Faraz Bishehsari
- Division of Digestive Diseases, Hepatology, and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
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Wu JC, Tsai ML, Lai CS, Lo CY, Ho CT, Wang YJ, Pan MH. Polymethoxyflavones prevent benzo[a]pyrene/dextran sodium sulfate-induced colorectal carcinogenesis through modulating xenobiotic metabolism and ameliorate autophagic defect in ICR mice. Int J Cancer 2017; 142:1689-1701. [PMID: 29197069 DOI: 10.1002/ijc.31190] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/01/2017] [Accepted: 11/28/2017] [Indexed: 12/27/2022]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are widespread environmental carcinogenic pollutants and they have become an important issue in food contamination. Dietary intake of PAHs has been recognized as a major route of human exposure. However, the mechanisms behind dietary PAH-induced colorectal cancer (CRC) remain unclear. Several studies have shown that polymethoxyflavones (PMFs) are effective in preventing carcinogen-induced CRC or colitis. In this study, we investigated the preventive effect of PMFs on benzo[a]pyrene/dextran sulfate sodium (BaP/DSS)-induced colorectal tumorigenesis in ICR mice. We found that PMFs significantly prevented BaP/DSS-induced colorectal tumor formation. BaP mutagenic metabolite and DNA adducts were found to be reduced in colonic tissue in the PMFs-treated groups through the modulation of BaP metabolism. At the molecular level, the results of RNA-sequencing indicated that PMFs ameliorated BaP/DSS-induced abnormal molecular mechanism change including activated inflammation, downregulated anti-oxidation targets, and induced metastasis genes. The autophagic defect caused by BaP/DSS-induced tumorigenesis was improved by pretreatment with PMFs. We found BaP/DSS-induced CRC may be a Wnt/β-catenin independent process. Additionally, consumption of PMFs extracts also altered the composition of gut microbiota and made it similar to that in the control group by increasing butyrate-producing probiotics and decreasing CRC-related bacteria. BaP in combination with DSS significantly induced colorectal tumorigenesis through induced DNA adduct formation, abnormal gene expression, and imbalanced gut microbiota composition. PMFs were a powerful preventive agent that suppressed BaP/DSS-induced CRC via modulating multiple pathways as well as ameliorating autophagic defect. These results demonstrated for the first time the chemopreventive efficacy and comprehensive mechanisms of dietary PMFs for preventing BaP/DSS-induced colorectal carcinogenesis.
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Affiliation(s)
- Jia-Ching Wu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan
| | - Mei-Ling Tsai
- Department of Seafood Science, National Kaohsiung Marine University, Kaohsiung, 811, Taiwan
| | - Ching-Shu Lai
- Department of Seafood Science, National Kaohsiung Marine University, Kaohsiung, 811, Taiwan
| | - Chih-Yu Lo
- Department of Food Science, National Chiayi University, no. 300 Syuefu Road, Chiayi, 600, Taiwan
| | - Chi-Tang Ho
- Department of Food Science, Rutgers University, New Brunswick, NJ, 08901
| | - Ying-Jan Wang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan.,Department of food safety/Hygiene and risk management, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan
| | - Min-Hsiung Pan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 40402, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan.,Institute of Food Science and Technology, National Taiwan University, Taipei, 10617, Taiwan
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Fujiwara M, Inagaki M, Nakaya N, Fujimori M, Higuchi Y, Kakeda K, Uchitomi Y, Yamada N. Association between serious psychological distress and nonparticipation in cancer screening and the modifying effect of socioeconomic status: Analysis of anonymized data from a national cross-sectional survey in Japan. Cancer 2017; 124:555-562. [PMID: 29076156 DOI: 10.1002/cncr.31086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/19/2017] [Accepted: 09/28/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND It is unclear whether individuals who have serious psychological distress (SPD) are less likely to participate in screening tests for gastric cancer, lung cancer, and other types of cancer. Of the few studies that have examined the association between SPD and participation in cancer screening, none have reported modifying effects of educational, marital, or employment status. METHODS The authors analyzed a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan., including individuals aged <69 years who met the national program criteria for each type of cancer screening (colorectal, gastric, and lung cancers, n = 29,926; breast cancer, n = 15,423; and cervical cancer, n = 24,735). SPD was defined as a score of 13 or greater on the Kessler 6 scale. Logistic regression analyses were conducted to examine the association between SPD and participation in cancer screening, and multivariate analyses stratified by socioeconomic status also were conducted. RESULTS SPD was significantly associated with a lower odds ratio (OR) for participation in screening for colorectal cancer (OR, 0.743; 95% confidence interval [CI], 0.638-0.866), gastric cancer (OR, 0.823; 95% CI, 0.717-0.946), and lung cancer (OR, 0.691; 95% CI, 0.592-0.807). Only educational status significantly modified the effect of SPD on participation in these 3 types of cancer screening (P < .05). CONCLUSIONS Individuals with SPD, especially those with lower education levels, were less likely to participate in screening for colorectal, gastric, and lung cancers. Individuals with SPD should be encouraged and supported to participate in cancer screening tests. Cancer 2018;124:555-62. © 2017 American Cancer Society.
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Affiliation(s)
- Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Maiko Fujimori
- Division of Cohort Consortium Research, Epidemiology and Prevention Group/Division of Health Care Research, QOL Research Group,Center for Public Health Sciences,National Cancer Center, Tokyo, Japan
| | - Yuji Higuchi
- Department of Psychiatry, Taiyo Hills Hospital, Okayama, Japan
| | - Kyoko Kakeda
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
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Rogers CR, Robinson CD, Arroyo C, Obidike OJ, Sewali B, Okuyemi KS. Colorectal Cancer Screening Uptake's Association With Psychosocial and Sociodemographic Factors Among Homeless Blacks and Whites. HEALTH EDUCATION & BEHAVIOR 2017; 44:928-936. [PMID: 28978252 DOI: 10.1177/1090198117734284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The homeless represent an extremely disadvantaged population that fare worse than minority groups in access to preventive services and health, and minority groups fare worse than Whites. Early detection screening for colorectal cancer (CRC) saves lives, but empirical data about CRC screening practices among homeless Blacks and Whites are limited. Psychosocial risk factors may serve as a barrier to CRC screening completion among homeless Black individuals. A secondary data analysis of a randomized clinical trial for smoking cessation among homeless smokers was conducted to determine whether psychosocial factors and sociodemographic factors were more highly associated with CRC screening uptake among homeless Blacks than among their White counterparts. Study participants ( N = 124) were surveyed on their CRC screening status, sociodemographic variables, and psychosocial correlate measures including anxiety, depression, hopelessness, depression severity, and perceived stress. Associations between these factors were examined with logistic regression. White participants who were currently disabled/unable to work were 6.2 times more likely to ever receive CRC screening than those who were employed. Black participants with public health insurance coverage were 90% less likely to ever obtain CRC screening than participants without health insurance. Black and White participants had similar levels of anxiety symptoms, depression, and hopelessness, yet depression was the only psychosocial variable negatively associated with CRC screening status. Black and White participants with symptoms of depression were 58% less likely to complete screening than those without depression. Mental health risk and sociodemographic factors may serve as barriers to CRC screening among homeless Blacks and Whites.
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Affiliation(s)
| | | | | | | | - Barrett Sewali
- 5 Uganda National Expanded Programme on Immunisation, Kampala, Uganda, Africa
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13
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Wang KS, Liu X, Ategbole M, Xie X, Liu Y, Xu C, Xie C, Sha Z. Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening. Asian Pac J Cancer Prev 2017; 18:2581-2589. [PMID: 28952708 PMCID: PMC5720670 DOI: 10.22034/apjcp.2017.18.9.2581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions.
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Affiliation(s)
- Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, Johnson City, TN 37614,For Correspondence:
| | - Xuefeng Liu
- Department of Systems Leadership and Effectiveness Science, School of Nursing, University of Michigan, Ann Arbor, MI 48109-5482
| | - Muyiwa Ategbole
- Department of Biostatistics and Epidemiology, College of Public Health, Johnson City, TN 37614
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN 37614
| | - Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, Johnson City, TN 37614
| | - Chun Xu
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX 78520
| | - Changchun Xie
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45267
| | - Zhanxin Sha
- School of Kinesiology, College of Health, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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14
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Reyes ME, Ye Y, Zhou Y, Liang A, Kopetz S, Rodriquez MA, Wu X, Hildebrandt MAT. Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis. Qual Life Res 2016; 26:319-330. [PMID: 27492454 DOI: 10.1007/s11136-016-1381-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the mediators of health-related quality of life (HR-QoL) in colorectal cancer (CRC) patients and effect on overall survival. METHODS We analyzed baseline (within 1 year of diagnosis) SF-12v1 questionnaire data from 3734 CRC patients and assessed the differences in mental composite scores (MCS) and physical composite scores (PCS) by socio-demographics and risks of poor HR-QoL by these factors. Hazard ratios were generated using univariate Cox regression for MCS and PCS dichotomized using the normalized scoring-based mean of 50 and survival estimates generated using the Kaplan-Meier method. RESULTS Differences in MCS and PCS were identified by sex, age, education level, alcohol use, tobacco use, and stage. Race, marital status, and cancer site differed only by PCS. Being female, never married, former alcohol user, or with stage IV disease significantly increased risk of a poor HR-QoL, with magnitudes of risk from 1.25- to 1.97-fold. Higher education level had a protective effect (MCS: P trend = 2.32 × 10-7; PCS: P trend = 5.62 × 10-14). Hispanics and African-Americans had a 1.35- and 1.57-fold risk of poor PCS, and increase in age had a protective effect for risk of poor MCS (P trend = 1.84 × 10-7). Poor MCS or PCS were associated with poor prognosis and decreased survival at 5 years (HRMCS 1.57, 95 % CI 1.41-1.76 and HRPCS 2.38, 95 % CI 2.08-2.72), and both remained significant when adjusting for age, gender, race, education level, tumor stage, and tumor site. CONCLUSIONS Our findings identify potential mediators for HR-QoL and suggest that baseline HR-QoL assessment may be prognostic for CRC.
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Affiliation(s)
- Monica E Reyes
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yuanqing Ye
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yeling Zhou
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Alexander Liang
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Scott Kopetz
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - M Alma Rodriquez
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
- Office of Cancer Survivorship, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Michelle A T Hildebrandt
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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