Risk factors for colorectal cancer significantly vary by anatomic site
Objective To conduct an anatomic site-specific case–control study of candidate colorectal cancer (CRC) risk factors.Design Case–control study of US veterans with >1 colonoscopy during 1999–2011. Cases had cancer registry-identified CRC at colonoscopy, while controls were CRC free at colonosco...
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| Language: | English |
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BMJ Publishing Group
2019-08-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/6/1/e000313.full |
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| _version_ | 1850109934484586496 |
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| author | Samir Gupta Lin Liu Joshua Demb Ashley Earles María Elena Martínez Ranier Bustamante Alex K Bryant James D Murphy |
| author_facet | Samir Gupta Lin Liu Joshua Demb Ashley Earles María Elena Martínez Ranier Bustamante Alex K Bryant James D Murphy |
| author_sort | Samir Gupta |
| collection | DOAJ |
| description | Objective To conduct an anatomic site-specific case–control study of candidate colorectal cancer (CRC) risk factors.Design Case–control study of US veterans with >1 colonoscopy during 1999–2011. Cases had cancer registry-identified CRC at colonoscopy, while controls were CRC free at colonoscopy and within 3 years of colonoscopy. Primary outcome was CRC, stratified by anatomic site: proximal, distal, or rectal. Candidate risk factors included age, sex, race/ethnicity, body mass index, height, diabetes, smoking status, and aspirin exposure summarised by adjusted ORs and 95% CIs.Results 21 744 CRC cases (n=7017 rectal; n=7039 distal; n=7688 proximal) and 612 646 controls were included. Males had significantly higher odds relative to females for rectal cancer (OR=2.84, 95% CI 2.25 to 3.58) than distal cancer (OR=1.84, 95% CI 1.50 to 2.24). Relative to whites, blacks had significantly lower rectal cancer odds (OR=0.88, 95% CI 0.82 to 0.95), but increased distal (OR=1.27, 95% CI 1.19 to 1.37) and proximal odds (OR=1.62, 95% CI 1.52 to 1.72). Diabetes prevalence was more strongly associated with proximal (OR=1.29, 95% CI 1.22 to 1.36) than distal (OR=1.15, 95% CI 1.08 to 1.22) or rectal cancer (OR=1.12, 95% CI 1.06 to 1.19). Current smoking was more strongly associated with rectal cancer (OR=1.81, 95% CI 1.68 to 1.95) than proximal cancer (OR=1.53, 95% CI 1.43 to 1.65) or distal cancer (OR=1.46, 95% CI 1.35 to 1.57) compared with never smoking. Aspirin use was significantly more strongly associated with reduced rectal cancer odds (OR=0.71, 95% CI 0.67 to 0.76) than distal (OR=0.85, 95% CI 0.81 to 0.90) or proximal (OR=0.91, 95% CI 0.86 to 0.95).Conclusion Candidate CRC risk factor associations vary significantly by anatomic site. Accounting for site may enable better insights into CRC pathogenesis and cancer control strategies. |
| format | Article |
| id | doaj-art-7194f37b034d4dfa8835c75cbd7e7679 |
| institution | OA Journals |
| issn | 2054-4774 |
| language | English |
| publishDate | 2019-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-7194f37b034d4dfa8835c75cbd7e76792025-08-20T02:37:57ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742019-08-016110.1136/bmjgast-2019-000313Risk factors for colorectal cancer significantly vary by anatomic siteSamir Gupta0Lin Liu1Joshua Demb2Ashley Earles3María Elena Martínez4Ranier Bustamante5Alex K Bryant6James D Murphy7Department of Medicine, University of Toronto, Toronto, Ontario, CanadaDepartment of Respiratory and Critical Care Medicine, 363 Hospital, Chengdu, Sichuan, ChinaMoores Cancer Center, University of California San Diego, La Jolla, California, USADepartment of Research, VA San Diego Healthcare System, San Diego, California, USA65 Moores Cancer Center, University of California San Diego, La Jolla, California, USADepartment of Research, VA San Diego Healthcare System, San Diego, California, USADepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USADepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USAObjective To conduct an anatomic site-specific case–control study of candidate colorectal cancer (CRC) risk factors.Design Case–control study of US veterans with >1 colonoscopy during 1999–2011. Cases had cancer registry-identified CRC at colonoscopy, while controls were CRC free at colonoscopy and within 3 years of colonoscopy. Primary outcome was CRC, stratified by anatomic site: proximal, distal, or rectal. Candidate risk factors included age, sex, race/ethnicity, body mass index, height, diabetes, smoking status, and aspirin exposure summarised by adjusted ORs and 95% CIs.Results 21 744 CRC cases (n=7017 rectal; n=7039 distal; n=7688 proximal) and 612 646 controls were included. Males had significantly higher odds relative to females for rectal cancer (OR=2.84, 95% CI 2.25 to 3.58) than distal cancer (OR=1.84, 95% CI 1.50 to 2.24). Relative to whites, blacks had significantly lower rectal cancer odds (OR=0.88, 95% CI 0.82 to 0.95), but increased distal (OR=1.27, 95% CI 1.19 to 1.37) and proximal odds (OR=1.62, 95% CI 1.52 to 1.72). Diabetes prevalence was more strongly associated with proximal (OR=1.29, 95% CI 1.22 to 1.36) than distal (OR=1.15, 95% CI 1.08 to 1.22) or rectal cancer (OR=1.12, 95% CI 1.06 to 1.19). Current smoking was more strongly associated with rectal cancer (OR=1.81, 95% CI 1.68 to 1.95) than proximal cancer (OR=1.53, 95% CI 1.43 to 1.65) or distal cancer (OR=1.46, 95% CI 1.35 to 1.57) compared with never smoking. Aspirin use was significantly more strongly associated with reduced rectal cancer odds (OR=0.71, 95% CI 0.67 to 0.76) than distal (OR=0.85, 95% CI 0.81 to 0.90) or proximal (OR=0.91, 95% CI 0.86 to 0.95).Conclusion Candidate CRC risk factor associations vary significantly by anatomic site. Accounting for site may enable better insights into CRC pathogenesis and cancer control strategies.https://bmjopengastro.bmj.com/content/6/1/e000313.full |
| spellingShingle | Samir Gupta Lin Liu Joshua Demb Ashley Earles María Elena Martínez Ranier Bustamante Alex K Bryant James D Murphy Risk factors for colorectal cancer significantly vary by anatomic site BMJ Open Gastroenterology |
| title | Risk factors for colorectal cancer significantly vary by anatomic site |
| title_full | Risk factors for colorectal cancer significantly vary by anatomic site |
| title_fullStr | Risk factors for colorectal cancer significantly vary by anatomic site |
| title_full_unstemmed | Risk factors for colorectal cancer significantly vary by anatomic site |
| title_short | Risk factors for colorectal cancer significantly vary by anatomic site |
| title_sort | risk factors for colorectal cancer significantly vary by anatomic site |
| url | https://bmjopengastro.bmj.com/content/6/1/e000313.full |
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