330 Increased Risk of Colorectal Cancer in Individuals With Hypothyroidism and Hyperthyroidism: Results From a Population-Based National Study

Abstract Purpose Even though anastomotic leakage after colorectal surgery is a major clinical problem in need of a timely diagnosis, early indicators of leakage have been insufficiently studied. We therefore conducted a population-based observational study to determine whether the patient’s early postoperative pain is an independent marker of anastomotic leakage. Methods By combining the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry, we retrieved prospectively collected data on 3084 patients who underwent anastomotic colorectal surgery for cancer in 2014–2017. Postoperative pain, measured with the numerical rating scale (NRS), was considered exposure, while anastomotic leakage and reoperation due to leakage were outcomes. We performed logistic regression to evaluate associations, estimating odds ratios (ORs) and 95% confidence intervals (CIs), while multiple imputation was used to handle missing data. Results In total, 189 patients suffered from anastomotic leakage, of whom 121 patients also needed a reoperation due to leakage. Moderate or severe postoperative pain (NRS 4–10) was associated with an increased risk of anastomotic leakage (OR 1.69, 95% CI 1.21–2.38), as well as reoperation (OR 2.17, 95% CI 1.41–3.32). Severe pain (NRS 8–10) was more strongly related to leakage (OR 2.38, 95% CI 1.44–3.93). These associations were confirmed in multivariable analyses and when reoperation due to leakage was used as an outcome. Conclusion In this population-based retrospective study on prospectively collected data, increased pain in the post-anaesthesia care unit is an independent marker of anastomotic leakage, possibly indicating a need for further diagnostic measures.

Download Full-text

Colorectal cancer survival among Ministry of National Guard-Health Affairs (MNG-HA) population 2009–2017: retrospective study

BMC Cancer ◽

10.1186/s12885-021-08705-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mesnad Alyabsi ◽

Fouad Sabatin ◽

Majed Ramadan ◽

Abdul Rahman Jazieh

Keyword(s):

Colorectal Cancer ◽

Distant Metastasis ◽

Cancer Survival ◽

National Guard ◽

Population Based ◽

Risk Of Death ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Increased Risk ◽

Cox Proportional Hazard Models

Abstract Background Colorectal cancer (CRC) is the most diagnosed cancer among males and third among females in Saudi Arabia, with up to two-third diagnosed at advanced stage. The objective of our study was to estimate CRC survival and determine prognostic factors. Methods Ministry of National Guard- Health Affairs (MNG-HA) registry data was utilized to identify patients diagnosed with CRC between 2009 and 2017. Cases were followed until December 30th, 2017 to assess their one-, three-, and five-year CRC-specific survivals. Kaplan-Meier method and Cox proportional hazard models were used to assess survival from CRC. Results A total of 1012 CRC patients were diagnosed during 2009–2017. Nearly, one-fourth of the patients presented with rectal tumor, 42.89% with left colon and 33.41% of the cases were diagnosed at distant metastasis stage. The overall one-, three-, and five-year survival were 83, 65 and 52.0%, respectively. The five-year survival was 79.85% for localized stage, 63.25% for regional stage and 20.31% for distant metastasis. Multivariate analyses showed that age, diagnosis period, stage, nationality, basis of diagnosis, morphology and location of tumor were associated with survival. Conclusions Findings reveal poor survival compared to Surveillance, Epidemiology, and End Results (SEER) population. Diagnoses at late stage and no surgical and/or perioperative chemotherapy were associated with increased risk of death. Population-based screening in this population should be considered.

Download Full-text

Tu1804 THE MEAN AGE AT COLORECTAL CANCER DIAGNOSIS IS ASSOCIATED WITH LEVEL OF EDUCATION: A POPULATION-BASED NATIONAL STUDY

Gastroenterology ◽

10.1016/s0016-5085(20)33592-7 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1168

Author(s):

Huaibin M. Ko ◽

Jeannette Tsuei

Keyword(s):

Colorectal Cancer ◽

Cancer Diagnosis ◽

Population Based ◽

National Study ◽

Level Of Education ◽

The Mean

Download Full-text

Insulin enhances and metformin reduces risk of colorectal carcinoma in type-2 diabetes

QJM ◽

10.1093/qjmed/hcz253 ◽

2019 ◽

Author(s):

C-H Chen ◽

C-L Lin ◽

C-Y Hsu ◽

C-H Kao

Keyword(s):

Colorectal Cancer ◽

Type 2 Diabetes ◽

Cohort Study ◽

Dietary Habits ◽

Occult Blood ◽

Population Based ◽

Study Cohort ◽

Urbanization Level ◽

Increased Risk

Abstract Background Identifying colorectal cancer associated risks is important for conducting a program for the survey and prevention of colorectal cancer. Aim To investigate the association between use of insulin or metformin with colorectal cancer (CRC) in type 2 diabetes (T2DM). Design Population-based cohort study. Methods Through analysis of National Health Insurance (NHI) database between 1998 and 2010 in Taiwan, we identified 66 324 T2DM patients aged ≥ 20 years and selected subjects without diabetes by 1: 1 randomly matching with the study cohort based on age, sex and index date. We followed up the participants until 31 December 2011 or when they withdrew from the NHI program. Results Compared with non-diabetic subjects, the T2DM patients exhibited an increased risk of CRC [adjusted HR (aHR) = 1.56, 95% confidence interval (CI) = 1.39–1.75], after adjustment for age, sex, urbanization level, comorbidities and examinations of colonoscopy, sigmoidoscopy, or stool occult blood test. Among the T2DM patients, insulin usage increased the risk of CRC (aHR = 1.86, 95% CI = 1.58–0–2.19) after adjustment for age, sex, urbanization level, comorbidities, metformin usage and examinations; nevertheless, metformin decreased the risk of CRC (aHR = 0.65, 95% CI = 0.54–0.77) after adjustment for age, sex, urbanization level, comorbidities, insulin usage and examinations. Compared with the non-insulin cohort, the risk of CRC tended to increase with the incremental dosage of insulin exposure. Conclusion Our population-based cohort study demonstrated an association between T2DM and CRC. Among the T2DM patients, insulin use was associated with an increased risk of CRC and metformin use was associated with a decreased risk of CRC. Inability to obtain information on several potential confounding factors, such as lifestyle and dietary habits, is the major limitation of the study.

Download Full-text

Renin–angiotensin system blocker use and the risk of acute kidney injury after colorectal cancer surgery: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2019-032964 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032964

Author(s):

Charlotte Slagelse ◽

H Gammelager ◽

Lene Hjerrild Iversen ◽

Kathleen D Liu ◽

Henrik T Toft Sørensen ◽

...

Keyword(s):

Colorectal Cancer ◽

Acute Kidney Injury ◽

Cohort Study ◽

Angiotensin Receptor Blockers ◽

Kidney Injury ◽

Population Based ◽

Adjusted Risk ◽

Increased Risk ◽

The Impact ◽

Postoperative Aki

ObjectivesIt is unknown whether preoperative use of ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) affects the risk of acute kidney injury (AKI) after colorectal cancer (CRC) surgery. We assessed the impact of preoperative ACE-I/ARB use on risk of AKI after CRC surgery.DesignObservational cohort study. Patients were divided into three exposure groups—current, former and non-users—through reimbursed prescriptions within 365 days before the surgery. AKI within 7 days after surgery was defined according to the current Kidney Disease Improving Global Outcome consensus criteria.SettingPopulation-based Danish medical databases.ParticipantsA total of 9932 patients undergoing incident CRC surgery during 2005–2014 in northern Denmark were included through the Danish Colorectal Cancer Group Database.Outcome measureWe computed cumulative incidence proportions (risk) of AKI with 95% CIs for current, former and non-users of ACE-I/ARB, including death as a competing risk. We compared current and former users with non-users by computing adjusted risk ratios (aRRs) using log-binomial regression adjusted for demographics, comorbidities and CRC-related characteristics. We stratified the analyses of ACE-I/ARB users to address any difference in impact within relevant subgroups.ResultsTwenty-one per cent were ACE-I/ARB current users, 6.4% former users and 72.3% non-users. The 7-day postoperative AKI risk for current, former and non-users was 26.4% (95% CI 24.6% to 28.3%), 25.2% (21.9% to 28.6%) and 17.8% (17.0% to 18.7%), respectively. The aRRs of AKI were 1.20 (1.09 to 1.32) and 1.16 (1.01 to 1.34) for current and former users, compared with non-users. The relative risk of AKI in current compared with non-users was consistent in all subgroups, except for higher aRR in patients with a history of hypertension.ConclusionsBeing a current or former user of ACE-I/ARBs is associated with an increased risk of postoperative AKI compared with non-users. Although it may not be a drug effect, users of ACE-I/ARBs should be considered a risk group for postoperative AKI.

Download Full-text

Association between shiftwork and the risk of colorectal cancer in females: a population-based case–control study

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104657 ◽

2018 ◽

Vol 75 (5) ◽

pp. 344-350 ◽

Cited By ~ 11

Author(s):

Wa Mwenga Walasa ◽

Renee N Carey ◽

Si Si ◽

Lin Fritschi ◽

Jane S Heyworth ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Case Control Study ◽

Early Morning ◽

Population Based ◽

Case Control ◽

Colorectal Cancer Risk ◽

Adverse Health Outcomes ◽

Increased Risk ◽

Control Study

ObjectiveResearch indicates that shiftwork may be associated with increased risks of adverse health outcomes, including some cancers. However, the evidence of an association between shiftwork and colorectal cancer risk is limited and inconclusive. Further, while several possible pathways through which shiftwork might result in cancer have been proposed, few studies have taken these factors into account. We investigated the association between two types of shiftwork (graveyard shiftwork and early-morning shiftwork) and six mechanistic shiftwork variables (including light at night and phase shift) and the risk of colorectal cancer among females in an Australian population-based case–control study. Graveyard shiftwork was the primary exposure of interest.MethodsParticipants (350 cases and 410 controls) completed a lifetime occupational history, and exposure to each of the eight shiftwork variables was assigned to participants through a job exposure matrix. We used logistic regression to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for the association between different shiftwork variables and the risk of colorectal cancer, adjusting for potential demographic, lifestyle and medical confounders.ResultsWorking in an occupation involving long-term exposure (>7.5 years) to graveyard shiftwork was not associated with colorectal cancer risk (adjusted OR 0.95, 95% CI 0.57 to 1.58). Similarly, no increased risks of colorectal cancer were seen for any of the other seven shiftwork variables examined.ConclusionsNo evidence of an increased risk of colorectal cancer among females who had worked in occupations involving shiftwork was observed in this study.

Download Full-text