scholarly journals Clinical Implications of Nonbiological Factors With Colorectal Cancer Patients Younger Than 45 Years

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Liu ◽  
Ruoxin Zhang ◽  
Qingguo Li ◽  
Xinxiang Li
Keyword(s):  
Colorectal Cancer ◽  
Marital Status ◽  
Household Income ◽  
Rank Test ◽  
Clinical Implications ◽  
Insurance Status ◽  
County Level ◽  
Median Household Income ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

BackgroundTo evaluate the clinical implications of non-biological factors (NBFs) with colorectal cancer (CRC) patients younger than 45 years.MethodsIn the present study, we have conducted Cox proportional hazard regression analyses to evaluate the prognosis of different prognostic factors, the hazard ratios (HRs) were shown with 95% confidence intervals (CIs). Kaplan–Meier method was utilized to compare the prognostic value of different factors with the log-rank test. NBF score was established according to the result of multivariate Cox analyses.ResultsIn total, 15129 patients before 45 years with known NBFs were identified from the SEER database. Only county-level median household income, marital status and insurance status were NBFs that significantly corelated with the cause specifical survival in CRC patients aged less than 45 years old (P < 0.05). Stage NBF 1 showed 50.5% increased risk of CRC-specific mortality (HR = 1.505, 95% CI = 1.411-1.606, P < 0.001). Stage NBF 0 patients were associated with significantly increased CRC-specific survival (CCSS) when compared with the stage NBF 1 patients in different AJCC TNM stages.ConclusionsNBF stage (defined by county-level median household income, marital status and insurance status) was strongly related to the prognosis of CRC patients. NBFs should arouse enough attention of us in clinical practice of patients younger than 45 years.

Abstract 19514: Race and Willingness to Participate in Cardiovascular Clinical Research

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Xiaotao Zhang ◽  
Lydia A Bazzano ◽  
Stephen G Gavin ◽  
Stephanie Gaudreau ◽  
Joseph Breault
Keyword(s):  
Marital Status ◽  
Household Income ◽  
Odds Ratio ◽  
Consent Form ◽  
Willingness To Participate ◽  
Median Household Income ◽  
Cardiovascular Research ◽  
Large Community ◽  
Academic Center ◽  
Age And Sex

African Americans (AA) are underrepresented in clinical trials in the United States for a variety of reasons. The majority of studies examining this issue were conducted >10 years ago and since then, efforts have been implemented to improve AA enrollment in research. We took advantage of the cardiovascular research data of a large community academic center in New Orleans, Louisiana to examine whether race was associated with participation in cardiovascular research. We used a nested case control design with 80% power to detect a doubling in odds of non-participation. Individuals could be included if they were offered participation in any of the 4 largest studies conducted in 2012, were White or AA and were American citizens (n=974). Median income household income was inferred using postal codes. Cases were defined as individuals who declined to participate and did not sign a consent form. Controls were defined as individuals who agreed to participate and signed a consent form. We identified 100 cases and selected 200 controls matched on age (within 1 year) and sex using a random selection algorithm. Of the 974 eligible for analysis, mean (SD) age was 65 (14) years, median household income in thousands was 51.92 (19.9), and 65.3% were men. Of those who agreed to participate, 32.2% were AA while of those who refused, 31.0% were AA. The unadjusted Mantel-Haenszel odds ratio for non-participation by race was 1.06 (95% CI: 0.60 to 1.94) for AA individuals compared to their White age and sex matched counterparts. Using multivariable conditional logistic regression, the odds ratio for participation in a study was 1.04 (95% CI: 0.56 to 1.92) for AA as compared to their White age and sex matched counterparts, after adjustment for median household income, employment, and marital status. Our findings suggest that, at a large community academic center, race does not significantly affect willingness to participate in cardiovascular research independent of age, gender, socioeconomic and marital status.

scholarly journals Low Socioeconomic Status Is Associated with Worse Outcomes After Curative Surgery for Colorectal Cancer: Results from a Large, Multicenter Study

2019 ◽  
Vol 24 (11) ◽  
pp. 2628-2636 ◽  
Author(s):  
I. van den Berg ◽  
S. Buettner ◽  
R. R. J. Coebergh van den Braak ◽  
K. H. J. Ultee ◽  
H. F. Lingsma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Socioeconomic Status ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Household Income ◽  
Stage I ◽  
Curative Surgery ◽  
Cancer Specific Survival ◽  
Increased Risk ◽  
Percent Increase

Abstract Background Socioeconomic status (SES) has been associated with early mortality in cancer patients. However, the association between SES and outcome in colorectal cancer patients is largely unknown. The aim of this study was to investigate whether SES is associated with short- and long-term outcome in patients undergoing curative surgery for colorectal cancer. Methods Patients who underwent curative surgery in the region of Rotterdam for stage I–III colorectal cancer between January 2007 and July 2014 were included. Gross household income and survival status were obtained from a national registry provided by Statistics Netherlands Centraal Bureau voor de Statistiek. Patients were assigned percentiles according to the national income distribution. Logistic regression and Cox proportional hazard regression were performed to assess the association of SES with 30-day postoperative complications, overall survival and cancer-specific survival, adjusted for known prognosticators. Results For 965 of the 975 eligible patients (99%), gross household income could be retrieved. Patients with a lower SES more often had diabetes, more often underwent an open surgical procedure, and had more comorbidities. In addition, patients with a lower SES were less likely to receive (neo) adjuvant treatment. Lower SES was independently associated with an increased risk of postoperative complications (Odds ratio per percent increase 0.99, 95%CI 0.99–0.998, p = 0.004) and lower cancer-specific mortality (Hazard ratio per percent increase 0.99, 95%CI 0.98–0.99, p = 0.009). Conclusion This study shows that lower SES is associated with increased risk of postoperative complications, and poor cancer-specific survival in patients undergoing surgery for stage I–III colorectal cancer after correcting for known prognosticators.

Surgical density and its effect on esophageal cancer (EC) and gastric (GC) mortality.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 16-16
Author(s):  
M. Y. Ho ◽  
J. S. Albarrak ◽  
W. Y. Cheung
Keyword(s):  
Household Income ◽  
Population Level ◽  
Multimodality Treatment ◽  
General Surgeon ◽  
County Level ◽  
Median Household Income ◽  
Hospital Beds ◽  
Beta Coefficient ◽  
General Surgeons ◽  
The Impact

16 Background: Surgical resection plays an integral role in the multimodality treatment of patients with EC or GC. The distribution of thoracic and general surgeons at the county level varies widely across the US. The impact of the allocation of these surgeons on cancer outcomes is unclear. Our aims were to 1) examine the effect of surgeon density on EC or GC mortality, 2) compare the relative roles of thoracic and general surgeons on EC and GC outcomes and 3) determine other county characteristics associated with cancer mortality. Methods: Using county-level data from the Area Resources File, U.S. Census and National Cancer Institute, we constructed regression models to explore the effect of thoracic and general surgeon density on EC and GC mortality, respectively. Multivariate analyses controlled for incidence rate, county demographics (population aged 65+, proportion eligible for Medicare, education attainment, metropolitan vs. rural), socioeconomic factors (median household income) and healthcare resources (number of general practitioners, number of hospital beds). Results: In total, 332 and 402 counties were identified for EC and GC, respectively: mean EC/GC incidence = 5.29/6.83; mean EC/GC mortality=4.70/3.92; 91% were metropolitan and 9% were rural; mean thoracic and general surgeon densities were 10 and 63 per 100,000 people, respectively. When compared to counties with no thoracic surgeons, those with at least 1 thoracic surgeon had reduced EC mortality (beta coefficient -0.031). For GC, counties with 1 or more general surgeons also had decreased number of deaths (beta coefficient -0.095) when compared with those without any surgeons. While increasing the density of surgeons beyond 10 only yielded minimal improvements in EC mortality, it resulted in significant further reductions in GC mortality. Other county characteristics, such as increased number of hospital beds and higher median household income, were correlated with improved outcomes. Conclusions: Mortality from GC appears to be more susceptible to the benefits of increased surgeon density. For EC, a strategic policy of allocating health resources and distributing the workforce across counties will be best able to optimize outcomes at the population-level. No significant financial relationships to disclose.

scholarly journals Incident Crohn’s Disease as a Risk Factor for Colorectal Cancer in the First 10 Years after Diagnosis: A Nationwide Population-Based Study

2021 ◽  
Vol 10 (20) ◽  
pp. 4663
Author(s):  
Hyunil Kim ◽  
Ji Hoon Kim ◽  
Jung Kuk Lee ◽  
Dae Ryong Kang ◽  
Su Young Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Early Onset ◽  
Late Onset ◽  
Age Groups ◽  
Population Based ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

We investigated the risk of colorectal cancer (CRC) in patients with Crohn’s disease (CD) using the claims data of the Korean National Health Insurance during 2006–2015. The data of 13,739 and 40,495 individuals with and without CD, respectively, were analyzed. Hazard ratios (HRs) were calculated using multivariate Cox proportional hazard regression tests. CRC developed in 25 patients (0.18%) and 42 patients (0.1%) of the CD and non-CD groups, respectively. The HR of CRC in the CD group was 2.07 (95% confidence interval (CI), 1.25–3.41). The HRs of CRC among men and women were 2.02 (95% CI 1.06–3.87) and 2.10 (95% CI, 0.96–4.62), respectively. The HRs of CRC in the age groups 0–19, 20–39, 40–59, and ≥60 years were 0.07, 4.86, 2.32, and 0.66, respectively. The HR of patients with late-onset CD (≥40 years) was significantly higher than that of those with early-onset CD (<40 years). CD patients were highly likely to develop CRC. Early-onset CD patients were significantly associated with an increased risk of CRC than matched individuals without CD. However, among CD patients, late-onset CD was significantly associated with an increased risk of CRC.

scholarly journals County-Level Social Distancing and Policy Impact in the United States: A Dynamical Systems Model

10.2196/23902 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e23902
Author(s):  
Kevin L McKee ◽  
Ian C Crandell ◽  
Alexandra L Hanlon
Keyword(s):  
United States ◽  
Differential Equation ◽  
Population Density ◽  
Household Income ◽  
The United States ◽  
Policy Impact ◽  
County Level ◽  
Median Household Income ◽  
Social Distancing

Background Social distancing and public policy have been crucial for minimizing the spread of SARS-CoV-2 in the United States. Publicly available, county-level time series data on mobility are derived from individual devices with global positioning systems, providing a variety of indices of social distancing behavior per day. Such indices allow a fine-grained approach to modeling public behavior during the pandemic. Previous studies of social distancing and policy have not accounted for the occurrence of pre-policy social distancing and other dynamics reflected in the long-term trajectories of public mobility data. Objective We propose a differential equation state-space model of county-level social distancing that accounts for distancing behavior leading up to the first official policies, equilibrium dynamics reflected in the long-term trajectories of mobility, and the specific impacts of four kinds of policy. The model is fit to each US county individually, producing a nationwide data set of novel estimated mobility indices. Methods A differential equation model was fit to three indicators of mobility for each of 3054 counties, with T=100 occasions per county of the following: distance traveled, visitations to key sites, and the log number of interpersonal encounters. The indicators were highly correlated and assumed to share common underlying latent trajectory, dynamics, and responses to policy. Maximum likelihood estimation with the Kalman-Bucy filter was used to estimate the model parameters. Bivariate distributional plots and descriptive statistics were used to examine the resulting county-level parameter estimates. The association of chronology with policy impact was also considered. Results Mobility dynamics show moderate correlations with two census covariates: population density (Spearman r ranging from 0.11 to 0.31) and median household income (Spearman r ranging from –0.03 to 0.39). Stay-at-home order effects were negatively correlated with both (r=–0.37 and r=–0.38, respectively), while the effects of the ban on all gatherings were positively correlated with both (r=0.51, r=0.39). Chronological ordering of policies was a moderate to strong determinant of their effect per county (Spearman r ranging from –0.12 to –0.56), with earlier policies accounting for most of the change in mobility, and later policies having little or no additional effect. Conclusions Chronological ordering, population density, and median household income were all associated with policy impact. The stay-at-home order and the ban on gatherings had the largest impacts on mobility on average. The model is implemented in a graphical online app for exploring county-level statistics and running counterfactual simulations. Future studies can incorporate the model-derived indices of social distancing and policy impacts as important social determinants of COVID-19 health outcomes.

Evaluation of the role of UGT1A1 genotype testing in colorectal cancer patients administered irinotecan and the occurence of grade 3 and 4 neutropenia.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 412-412 ◽  
Author(s):  
Sushma M. Patel ◽  
Jim Chan ◽  
Rita L. Hui ◽  
Michele M. Spence
Keyword(s):  
Colorectal Cancer ◽  
Cohort Analysis ◽  
Median Number ◽  
Rank Test ◽  
P Value ◽  
Wild Type ◽  
Kaiser Permanente ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Grade 3

412 Background: Irinotecan is metabolized primarily in the liver by the carboxylesterase enzyme to the SN-38 active metabolite and is then inactivated through conjugation by the UGT1A1 enzyme, a polymorphic enzyme. Individuals genotyped with the homozygous allele have an increased risk for grade 3 and 4 neutropenia. Methods: A retrospective cohort analysis was conducted in the Kaiser Permanente California regions. The study period was November 1, 2005 to July 1, 2010 and included patients that were 18 years of age or older, newly initiated on irinotecan for colorectal cancer and had no previous irinotecan therapy within six months of the initiation dose. Patients were excluded if they were enrolled in clinical trials, on granulocyte-colony stimulating factor prophylaxis, and genotype tested for UGT1A1 and subsequently not treated with irinotecan. Patients tested with the UGT1A1 assay were grouped according to their genotype results: wild-type, heterozygous, or homozygous*28. The incidence of grade 3 and 4 neutropenia were compared among patients tested for UGT1A1 variant alleles by their genotype results. Results: A total of 305 (28%) patients were tested with the UGT1A1 assay with a mean age of 62 (+/- 12) years, and 52% of the population female. There were 161 (53%) wild-type, 123 (40%) heterozygous, and 21 (7%) homozygous patients. The median irinotecan dose was 150 mg/m2 (124-180 mg/m2) and median number of irinotecan cycles were 6 (3-12). The wild-type, heterozygous, homozygous*28 population had a 21% (33/161), 24% (29/123), and 48% (10/21) rate of grade 3 and 4 neutropenia. When the homozygous*28 group was compared to the heterozygous and wild-type genotype the adjusted Cox Proportional Hazard was 3.05 (95% CI, 1.55-5.99), p = 0.001. The Kaplan-Meier Log Rank Test yielded a p-value of 0.002. Conclusions: The adjusted risk for homozygous genotyped patients was three times higher compared to the wild-type and heterozygous group for grade 3 and 4 neutropenia. Additional investigational studies examining the benefits of UGT1A1 genotyping as a prognostic test and further effect of dosage adjustments in UGT1A1*28 homozygous initiated on irinotecan therapy are needed.

Clinicopathologic features and clinical outcomes associated with Gleason upgrading from biopsy to radical prostatectomy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5056-5056
Author(s):  
Sun Mi Yoo ◽  
Lillian Werner ◽  
Mari Nakabayashi ◽  
Christopher Sweeney ◽  
Michelle S. Hirsch ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Rank Test ◽  
Clinical Implications ◽  
Low Grade ◽  
Log Rank Test ◽  
Positive Biopsy ◽  
Dana Farber Cancer Institute ◽  
Increased Risk ◽  
Prostate Cancers ◽  
Tissue Specimens

5056 Background: Gleason score stratifies patients into prognostic categories and is critical in guiding treatment. Previous series indicate that ~25% of patients with low-grade (Gleason ≤6) disease on biopsy are upgraded to higher grade disease upon radical prostatectomy (RP). We sought to characterize the clinical and pathologic variables associated with upgrading and investigate its clinical implications. Methods: 1,469 prostate cancer patients underwent prostate biopsy and RP, were seen at Dana-Farber Cancer Institute/Brigham and Women’s Hospital (DFCI/BWH), and had tissue specimens reviewed by DFCI/BWH genitourinary pathologists between 1999-2011. Associations between Gleason upgrading and clinical and pathologic variables were assessed using Wilcoxon’s non-parametric test and Fisher’s exact tests. Log rank test was used to assess association between upgrading and time to biochemical recurrence (BCR). Results: Of 1,469 patients, 958 (65%) had biopsy Gleason 6 and 511 (35%) had biopsy Gleason 7. Among individuals with biopsy Gleason 6, 336 (35%) were upgraded to Gleason ≥7 upon RP (275 3+4 and 49 4+3) while 622 (65%) remained Gleason 6 at RP. Variables associated with increased risk of upgrading: greater PSA at diagnosis (p=1x10-4); age >58 (OR=1.62, p < 1x10-4); >1/3 positive biopsy cores (OR=2.1 for 33-50% compared to ≤33%, p < 1x10-4). In this study the number of cores biopsied was not associated with upgrading. Gleason upgrading was also associated with extraprostatic tissue involvement (OR=1.69, p=0.005). Patients upgraded from biopsy Gleason ≤6 to Gleason 7 on RP had a longer time to BCR than those with Gleason 7 on both biopsy and RP, but a shorter time to BCR than those who remained Gleason 6 on RP (adjusted hazard ratio 0.69, 95% CI 0.49-0.98, p=0.03). Conclusions: Gleason upgrading from low-grade to higher grade disease is associated with a higher PSA at diagnosis, older age at diagnosis, and a greater number of positive biopsy cores. Clinically, prostate cancers upgraded from Gleason ≤6 to Gleason 7 appear to behave differently than those who are not upgraded. These results could have implications in determining ideal candidates for active surveillance.

Abstract P118: County-Level Disparities in the Availability of Farmers Markets in the United States: An Ecological Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Chelsea Singleton ◽  
Olivia Affuso ◽  
Bisakha Sen
Keyword(s):  
At Risk ◽  
Household Income ◽  
Ecological Study ◽  
Negative Association ◽  
Farmers Markets ◽  
Grocery Stores ◽  
County Level ◽  
Median Household Income ◽  
Recreation Centers ◽  
Per Capita

Introduction: Farmers markets (FM) have been hypothesized to be a potential community-level obesity prevention strategy for populations at risk for chronic diseases because they provide a mechanism for communities to purchase healthy locally grown produce. This study aimed to identify county-level factors associated with FM availability in an effort to determine if disparities in availability exist in the US. Hypothesis: Increased FM availability will be associated with higher median household income, lower % minority residents, lower % obese residents and a higher number of grocery stores and recreation centers per 100,000 residents. Methods: An ecological study was conducted using 2009 data from the USDA Food Environment Atlas on 3,135 US counties. Crude and multivariable adjusted logistic regression models where used to determine associations between having at least one FM available and county-level variables such as % African American (AA) residents, % Hispanic residents, median household income, % WIC participants, % adults obese, % adults with diabetes, per capita grocery stores, per capita supercenters and per capita recreation centers. All analyses were stratified by metro county status and adjusted to address data clustering at the state-level. Results: There were 1,088 and 2,047 counties labeled metro and non-metro respectively. Metro Results : Median household income (p = 0.002) and per capita recreation centers (p < 0.0001) were positively associated with FM availability while % WIC residents (p = 0.008), per capita grocery stores (p = 0.02) and % adults with diabetes (p < 0.0001) showed a negative association. Non-Metro Results: Median household income (p < 0.0001), per capita recreation centers (p < 0.0001) and per capita supercenters (p < 0.0001) were positively associated with FM availability while % WIC residents (p = 0.02), per capita grocery stores (p < 0.0001) and % adults with diabetes (p < 0.03) showed a negative association. The % AA residents appeared to be negatively associated with FM availability but did not achieve statistical significance. County obesity prevalence was not associated with FM availability in both metro and non-metro counties. Conclusion: Results showed that counties with more recreation centers and a higher median household income have increased FM availability while counties with more WIC participants and residents with diabetes have less availability. More information on the association between FM access, diet and obesity in at risk populations should be collected at the individual level.

scholarly journals RACE INDEPENDENTLY PREDICTS UNSUCCESSFUL HEALING OF OSTEOCHONDRITIS DISSECANS IN THE PEDIATRIC KNEE

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Jigar S. Gandhi ◽  
Theodore J. Ganley
Keyword(s):  
Osteochondritis Dissecans ◽  
Household Income ◽  
Univariate Analysis ◽  
Sports Participation ◽  
Black Children ◽  
Multivariate Model ◽  
Insurance Status ◽  
Median Household Income ◽  
The Impact

BACKGROUND: Previous studies have reported disparities in medical and surgical care along the lines of race and socioeconomic status. The purpose of this study is to evaluate the impact of these factors on successful or unsuccessful healing of juvenile osteochondritis dissecans (OCD) lesions in the knee. METHODS: We retrospectively reviewed patients younger than 18 years that were treated for a knee OCD lesion at our urban, tertiary children’s hospital between 2006 and 2017. Demographic data included patient-reported race, median household income for the patient’s zip code, and insurance status. We also collected information regarding clinical history, imaging, treatment course, and post-treatment outcomes. The primary outcome of interest was healing of the OCD lesion based on radiographic and clinical examination. Univariate analysis was followed by purposeful entry multivariate regression to control for confounders. RESULTS: A total of 205 children with mean follow-up of 15.8 ± 6.5 months were included in the analysis. The mean age was 12.4 ± 2.8 years and 145 (71%) were male. At their most recent follow-up, 28 subjects (13.7%) did not show radiographic or clinical evidence of healing. In univariate analysis, non-healing lesions were found in 25% of black children compared to 9.4% of white children (p=0.02). There was no difference in insurance status or median household income between patients who successfully and unsuccessfully healed their OCD lesion. After controlling for age, sex, sports participation, lesion size and stability, skeletal maturity, and operative vs. non-operative treatment in a multivariate model, black children had 6.7 times higher odds of unsuccessful healing compared to their white counterparts (95% CI 1.1, 41.7; p=0.04). CONCLUSION: In this study, black children with OCD of the knee were less likely to heal than white patients even when accounting for socioeconomic and other factors in a multivariate model.

scholarly journals Implications of Habitual Alcohol Intake With the Prognostic Significance of Mean Corpuscular Volume in Stage II-III Colorectal Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Liu ◽  
Yufei Yang ◽  
Xinxiang Li ◽  
Sheng Zhang
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Mean Corpuscular Volume ◽  
Alcohol Intake ◽  
Prognostic Significance ◽  
Stage Ii ◽  
Rank Test ◽  
Corpuscular Volume ◽  
Prognostic Role ◽  
Increased Risk

ObjectiveTo elucidate the prognostic significance of mean corpuscular volume (MCV), with implications of habitual alcohol intake in stage II-III colorectal cancer (CRC).BackgroundMCV had the potential to become an ideal prognostic biomarker and be put into clinical application. Few studies, however, have explored whether habitual alcohol intake which greatly increased the value of MCV would affect the prognostic role of MCV.MethodsEligible patients were identified from the CRC database of Fudan University Shanghai Cancer Center (FUSCC) between January 2012 and December 2013. Survival analyses were constructed using the Kaplan–Meier method to evaluate the survival time distribution, and the log-rank test was used to determine the survival differences. Univariate and multivariate Cox proportional hazard models were built to calculate the hazard ratios of different prognostic factors.ResultsA total of 694 patients diagnosed with stage II-III CRC between January 2012 and December 2013 were identified from FUSCC. Low pretreatment MCV was independently associated with 72.0% increased risk of overall mortality compared with normal MCV (HR = 1.720, 95%CI =1.028-2.876, P =0.039, using normal MCV as the reference). In patients with habitual alcohol intake, however, pretreatment MCV positively correlated with the mortality (P = 0.02) and tumor recurrence (P = 0.002) after adjusting for other known prognostic factors.ConclusionsIn CRC patients without habitual alcohol intake, low (&lt;80 fL) level of pretreatment MCV was a predictor of poor prognosis. In patients with habitual alcohol intake, however, pretreatment MCV showed the opposite prognostic role, which would elicit many fundamental studies to elucidate the mechanisms behind.

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