scholarly journals Subsite-Specific Dietary Risk Factors for Colorectal Cancer: A Review of Cohort Studies

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Anette Hjartåker ◽  
Bjarte Aagnes ◽  
Trude Eid Robsahm ◽  
Hilde Langseth ◽  
Freddie Bray ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cohort Studies ◽  
Distal Colon ◽  
Proximal Colon ◽  
Risk Estimates ◽  
Specific Risk ◽  
Dietary Components

Objective. A shift in the total incidence from left- to right-sided colon cancer has been reported and raises the question as to whether lifestyle risk factors are responsible for the changing subsite distribution of colon cancer. The present study provides a review of the subsite-specific risk estimates for the dietary components presently regarded as convincing or probable risk factors for colorectal cancer: red meat, processed meat, fiber, garlic, milk, calcium, and alcohol.Methods. Studies were identified by searching PubMed through October 8, 2012 and by reviewing reference lists. Thirty-two prospective cohort studies are included, and the estimates are compared by sex for each risk factor.Results. For alcohol, there seems to be a stronger association with rectal cancer than with colon cancer, and for meat a somewhat stronger association with distal colon and rectal cancer, relative to proximal colon cancer. For fiber, milk, and calcium, there were only minor differences in relative risk across subsites. No statement could be given regarding garlic. Overall, many of the subsite-specific risk estimates were nonsignificant, irrespective of exposure.Conclusion. For some dietary components the associations with risk of cancer of the rectum and distal colon appear stronger than for proximal colon, but not for all.

Limited time Interval between Symptomatic Presentation in Primary Care and Colorectal Cancer Diagnosis

2021 ◽  
Author(s):  
Josephina G. Kuiper ◽  
Myrthe P.P. Herk-Sukel ◽  
Valery E.P.P. Lemmens ◽  
Ernst J. Kuipers ◽  
Ron M.C. Herings
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Diagnosis ◽  
Drug Users ◽  
Index Date ◽  
Distal Colon ◽  
Proximal Colon ◽  
New Drugs ◽  
Time Interval

Abstract Background: Timely recognition of colorectal cancer related symptoms is essential to reduce time to diagnosis. This study aims to investigate the primary healthcare use preceding a colorectal cancer diagnosis.Methods: A population-based case-control study was conducted using data from a cohort of linked data from the Netherlands Cancer Registry (NCR) and the PHARMO General Practitioner (GP) Database (NCR-PHARMO GP cohort). Primary healthcare use among colorectal cancer cases before diagnosis was compared with matched cancer-free controls. Information on primary health care use was derived from the GP Database of the PHARMO Database Network and included all GP consultations and prescribed medication. Mean monthly number of GP consultations and new drugs users was assessed in the year before index date (diagnosis date for cases). Results were stratified by colorectal cancer site: proximal colon cancer, distal colon cancer and rectal cancer.Results: While mean monthly number of GP consultation were stable through the year among cancer-free controls, a statistical significant increase was seen among colorectal cancer cases in the last 4-8 months before diagnosis. Proximal colon cancer cases showed the longest time interval of increased mean monthly number of GP consultations. This increase was largely driven by a consultation for malignant neoplasm colon/rectum. The number of new drug users was stable around 120 per 1,000 persons per month until 8 months before index date for proximal colon cancer cases, 4 months before index date for distal colon cancer cases and 3 months for rectal cancer cases. This increase was mainly driven by the prescription of laxatives drugs.Conclusion: A relatively short time interval of increased GP consultations and new drug users was seen before colorectal cancer diagnosis. The longest period of increased GP consultations and new drugs users was seen among patients diagnosed with proximal colon cancer. This can be explained by the difficultly to diagnose proximal colon cancer given the more subtle signs compared to distal colon cancer and rectal cancer. Therefore, faster diagnosis for this specific tumour subtype is only possible when clear clinical signs and symptoms are present.

scholarly journals Association of dietary insulinemic potential and colorectal cancer risk in men and women

2018 ◽  
Vol 108 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Fred K Tabung ◽  
Weike Wang ◽  
Teresa T Fung ◽  
Stephanie A Smith-Warner ◽  
NaNa Keum ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Risk ◽  
Insulin Response ◽  
Distal Colon ◽  
Proximal Colon ◽  
Cancer Development ◽  
Men And Women

ABSTRACT Background Insulin response may be important in colorectal cancer development. Diet modulates insulin response and may be a modifiable factor in colorectal cancer prevention. Objective We examined associations between hyperinsulinemic diets and colorectal cancer risk with the use of an empirical dietary index for hyperinsulinemia (EDIH), a food-based index that characterizes dietary insulinemic potential on the basis of circulating C-peptide concentrations. Design Diet was assessed every 4 y with food-frequency questionnaires in 46,210 men (Health Professionals Follow-Up Study, 1986–2012) and 74,191 women (Nurses’ Health Study, 1984–2012) to calculate EDIH scores. Multivariable-adjusted Cox regression was used to calculate HRs and 95% CIs for colorectal, proximal/distal colon, and rectal cancer risk. Results During 26 y of follow-up, we documented 2683 incident colorectal cancer cases. Comparing participants in the highest with those in the lowest quintiles, higher EDIH scores were associated with 33% (men: HR: 1.33; 95% CI: 1.11, 1.61; P-trend = 0.0005), 22% (women: HR: 1.22; 95% CI: 1.03, 1.45; P-trend = 0.01), and 26% (men and women: pooled HR: 1.26; 95% CI: 1.12, 1.42; P-trend <0.0001) higher risk of developing colorectal cancer. The positive associations were limited to the distal colon and rectum in men and to the distal and proximal colon in women; however, combined risk estimates were significant for all anatomic locations except for the rectum. For example, comparing participants in extreme EDIH quintiles, there was no significant association for proximal colon cancer in men (HR: 1.15; 95% CI: 0.84, 1.57; P-trend = 0.32), but the risk was elevated for distal colon (HR: 1.63; 95% CI: 1.14, 2.32; P-trend = 0.002) and rectal (HR: 1.63; 95% CI: 1.09, 2.44; P-trend = 0.01) cancer. Among women, the risk was elevated for proximal (HR: 1.28; 95% CI: 1.00, 1.63; P-trend = 0.03) and distal (HR: 1.46; 95% CI: 1.05, 2.03; P-trend = 0.03) colon cancer but not for rectal cancer (HR: 0.88; 95% CI: 0.60, 1.29; P-trend = 0.61). Conclusion The findings suggest that the insulinemic potential of diet may partly underlie the influence of dietary intake on colorectal cancer development. This observational study was registered at www.clinicaltrials.gov as NCT03364582.

scholarly journals A steep increase in healthcare seeking behaviour in the last months before colorectal cancer diagnosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Josephina G. Kuiper ◽  
Myrthe P. P. van Herk-Sukel ◽  
Valery E. P. P. Lemmens ◽  
Ernst J. Kuipers ◽  
Ron M. C. Herings
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Diagnosis ◽  
Primary Healthcare ◽  
Index Date ◽  
Distal Colon ◽  
Proximal Colon ◽  
Healthcare Use ◽  
Healthcare Seeking

Abstract Background Timely recognition of colorectal cancer related symptoms is essential to reduce time to diagnosis. This study aims to investigate the primary healthcare use preceding a colorectal cancer diagnosis. Methods From a cohort of linked cancer and primary care data, patients diagnosed with primary colorectal cancer in the period 2007–2014 were selected and matched to cancer-free controls on gender, birth year, GP practice and follow-up period. Primary healthcare use among colorectal cancer cases before diagnosis was compared with matched cancer-free controls. Mean monthly number of GP consultations and newly prescribed medication was assessed in the year before index date (diagnosis date for cases). Results were stratified by colorectal cancer site: proximal colon cancer, distal colon cancer and rectal cancer. Results A total of 6,087 colorectal cancer cases could be matched to four cancer-free controls (N = 24,348). While mean monthly number of GP consultation were stable through the year among cancer-free controls, a statistical significant increase was seen among colorectal cancer cases in the last 4–8 months before diagnosis. Proximal colon cancer cases showed the longest time interval of increased mean monthly number of GP consultations. This increase was largely driven by a consultation for malignant neoplasm colon/rectum. The number patients receiving a newly prescribed medication was stable around 120 per 1,000 persons per month until 8 months before index date for proximal colon cancer cases, 4 months before index date for distal colon cancer cases and 3 months for rectal cancer cases. This increase was mainly driven by the prescription of laxatives drugs. Conclusion An increase in the healthcare seeking behaviour of colorectal cancer patients prior to diagnosis was seen. The longest period of increased GP consultations and newly prescribed medication was seen among patients diagnosed with proximal colon cancer. This can be explained by the difficultly to diagnose proximal colon cancer given the more subtle signs compared to distal colon cancer and rectal cancer. Therefore, faster diagnosis for this specific tumour subtype may only be possible when clear clinical signs and symptoms are present.

Impact of diabetes on site-specific oncologic outcome in stage I-III colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14114-e14114
Author(s):  
Justin Y Jeon ◽  
Deok Hyun Jeong ◽  
Min Keun Park ◽  
Jennifer A. Ligibel ◽  
Jeffrey A. Meyerhardt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Proximal Colon ◽  
Survival Outcome ◽  
Recurrence Free Survival ◽  
Site Specific ◽  
Free Survival ◽  
All Cause Mortality

e14114 Background: Background: Conflicting results have been reported whether pre diagnosis diabetes mellitus (DM) influence survival of colorectal cancer patients or not. Therefore, we determine the influence of DM on long-term outcomes of stage 1-3 patients with resected colon and rectal cancer. Methods: This prospective study include a total of 4,131 participants who were treated for cancer between 1995 and 2005 in South Korea in a single hospital (Non DM: 3,614 patients, DM: 517 patients) with average follow up period of 12 years. We analyzed differences in all cause mortality, disease free survival (DFS), recurrence free survival (RFS) and colorectal cancer-specific mortality between colorectal patients with DM and those without DM. Results: After adjustment for potential confounders, pre-diagnosis DM significantly associated with increased all cause mortality (HR: 1.46, 95% CI: 1.11-1.92), and recurrence free survival reduced DFS (HR: 1.45, 95%CI: 1.15-1.84) and RFS (HR: 1.32, 95% CI: 0.98-1.76) in colon cancer patients but not in rectal cancer patients. In colon cancer patients, DM negatively affects the survival outcome of proximal colon cancer (HR: 2.08, 95%CI: 1.38-3.13), but not of distal cancer (HR:1.34, 95% CI: 0.92-1.96). Conclusions: To our knowledge, the current study first reported the effects of pre-diagnosis DM on survival outcome of colorectal cancer are site specific (proximal colon, distal colon and rectum). The current study was supported by the National Research Foundation of Korea (KRF) (No. 2011-0004892) and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1120230). [Table: see text]

Dietary fiber intake and risks of proximal and distal colon cancers: A systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15080-e15080 ◽  
Author(s):  
Yu Ma ◽  
Peilin Huang ◽  
Mingyue Hu ◽  
Sunkai Ling ◽  
Yuan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Cohort Studies ◽  
Dietary Fiber ◽  
Meta Analysis ◽  
Distal Colon ◽  
Proximal Colon ◽  
Fiber Intake ◽  
Dietary Fiber Intake ◽  
Colon Cancers

e15080 Background: Epidemiological studies have suggested that intake of dietary fiber is associated with decreased risk of colon cancer, however, these findings are inconsistent in that dietary fiber intake is differentially associated with risks of proximal colon and distal colon cancers. To address this, we conducted a systematic review and meta-analysis. Methods: Pubmed database were searched to identify relevant cohort studies up to December 2016 to examine the association between dietary fiber and risks of proximal colon and distal colon cancers, respectively. A random-effects model was used to compute summary risk estimates. Results: 11 prospective cohort studies were identified and included in the analysis. We observed that the risk of proximal colon cancer was 14% lower among the highest dietary fiber intake compared with the lowest intake (RR = 0.86, 95% confidence interval [CI] = 0.78 to 0.95). A similar result was also found for distal colon cancer (RR = 0.79, 95% CI = 0.71 to 0.87). Conclusions: In current analysis, we show that dietary fiber intake is associated inversely with risks of both proximal and distal colon cancers.

A Tale of Two Colons and Two Cancers

Swiss Surgery ◽  
2003 ◽  
Vol 9 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Gervaz ◽  
Bühler ◽  
Scheiwiller ◽  
Morel
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Splenic Flexure ◽  
Chromosomal Instability ◽  
Proximal Colon ◽  
Colorectal Carcinogenesis ◽  
Physiological Data ◽  
Central Hypothesis ◽  
Group Stratification

The central hypothesis explored in this paper is that colorectal cancer (CRC) is a heterogeneous disease. The initial clue to this heterogeneity was provided by genetic findings; however, embryological and physiological data had previously been gathered, showing that proximal (in relation to the splenic flexure) and distal parts of the colon represent distinct entities. Molecular biologists have identified two distinct pathways, microsatellite instability (MSI) and chromosomal instability (CIN), which are involved in CRC progression. In summary, there may be not one, but two colons and two types of colorectal carcinogenesis, with distinct clinical outcome. The implications for the clinicians are two-folds; 1) tumors originating from the proximal colon have a better prognosis due to a high percentage of MSI-positive lesions; and 2) location of the neoplasm in reference to the splenic flexure should be documented before group stratification in future trials of adjuvant chemotherapy in patients with stage II and III colon cancer.

scholarly journals The Relationship between Inflammation Markers (CRP, IL-6, sCD40L) and Colorectal Cancer Stage, Grade, Size and Location

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1382
Author(s):  
Olga Martyna Koper-Lenkiewicz ◽  
Violetta Dymicka-Piekarska ◽  
Anna Justyna Milewska ◽  
Justyna Zińczuk ◽  
Joanna Kamińska
Keyword(s):  
Colorectal Cancer ◽  
Linear Regression ◽  
Tumor Size ◽  
Distal Colon ◽  
Proximal Colon ◽  
Model Parameters ◽  
Grade Group ◽  
Who Grade ◽  
The Mean ◽  
Mean Concentration

The aim of the study was the evaluation whether in primary colorectal cancer (CRC) patients (n = 55): age, sex, TNM classification results, WHO grade, tumor location (proximal colon, distal colon, rectum), tumor size, platelet count (PLT), mean platelet volume (MPV), mean platelet component (MCP), levels of carcinoembryonic antigen (CEA), cancer antigen (CA 19-9), as well as soluble lectin adhesion molecules (L-, E-, and P-selectins) may influence circulating inflammatory biomarkers: IL-6, CRP, and sCD40L. We found that CRP concentration evaluation in routine clinical practice may have an advantage as a prognostic biomarker in CRC patients, as this protein the most comprehensively reflects clinicopathological features of the tumor. Univariate linear regression analysis revealed that in CRC patients: (1) with an increase in PLT by 10 × 103/μL, the mean concentration of CRP increases by 3.4%; (2) with an increase in CA 19-9 of 1 U/mL, the mean concentration of CRP increases by 0.7%; (3) with the WHO 2 grade, the mean CRP concentration increases 3.631 times relative to the WHO 1 grade group; (4) with the WHO 3 grade, the mean CRP concentration increases by 4.916 times relative to the WHO 1 grade group; (5) with metastases (T1-4N+M+) the mean CRP concentration increases 4.183 times compared to non-metastatic patients (T1-4N0M0); (6) with a tumor located in the proximal colon, the mean concentration of CRP increases 2.175 times compared to a tumor located in the distal colon; (7) in patients with tumor size > 3 cm, the CRP concentration is about 2 times higher than in patients with tumor size ≤ 3 cm. In the multivariate linear regression model, the variables that influence the mean CRP value in CRC patients included: WHO grade and tumor localization. R2 for the created model equals 0.50, which indicates that this model explains 50% of the variance in the dependent variable. In CRC subjects: (1) with the WHO 2 grade, the mean CRP concentration rises 3.924 times relative to the WHO 1 grade; (2) with the WHO 3 grade, the mean CRP concentration increases 4.721 times in relation to the WHO 1 grade; (3) with a tumor located in the rectum, the mean CRP concentration rises 2.139 times compared to a tumor located in the distal colon; (4) with a tumor located in the proximal colon, the mean concentration of CRP increases 1.998 times compared to the tumor located in the distal colon; if other model parameters are fixed.

scholarly journals Site-Specific Risk Factors for Colorectal Cancer in a Korean Population

PLoS ONE ◽  
2011 ◽  
Vol 6 (8) ◽  
pp. e23196 ◽  
Author(s):  
Aesun Shin ◽  
Jungnam Joo ◽  
Jeongin Bak ◽  
Hye-Ryung Yang ◽  
Jeongseon Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Korean Population ◽  
Site Specific ◽  
Specific Risk

scholarly journals Risk factors in the recurrence of the colorectal cancer

2002 ◽  
Vol 49 (2) ◽  
pp. 40-43 ◽  
Author(s):  
J. Ulanska ◽  
A. Dziki ◽  
W. Langner
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Early Stage ◽  
Concomitant Treatment ◽  
Preventive Chemotherapy ◽  
Tnm System ◽  
Definition Of ◽  
Colorectal Cancer Patients

Traditionally, the clinical outcome of colorectal cancer patients may be predicted by pathological staging by either Dukes staging or the UICC-TNM system. However, some of Dukes stage A (approximately 10% of patients) and Dukes B patients (30-40%) will develop local recurrence or distant metastasis years after receiving standard surgical treatments. Therefore it is important to find some other indicators that can predict for recurrence so that we can screen for high-risk early-stage patients who may need preventive chemotherapy or other adjuvant therapy. The aim of this study is determination of risk factor for local recurrence in rectal cancer. In this study there has been used and summarized also research records and publications from different clinical hospitals according to actual international literature. Part of elements connected with patient, tumor and genetic and immunological factors remains independent on curative procedures. However better investigation these factors might affect on therapy, frequency of follow-up examinations, and help to detect recurrence at very early phase. Concomitant treatment factors are able to be moderate by surgeons and therapeutics. Therefore precise definition of risk factors might be helpful in decrease recurrence rate in patients with rectal cancer.

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