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  • 1
    Keywords: CANCER ; tumor ; carcinoma ; MODEL ; COHORT ; RISK ; POLYMORPHISMS ; WOMEN ; colorectal cancer ; RISK FACTOR ; TOBACCO ; ALCOHOL-CONSUMPTION ; LIFE-STYLE FACTORS ; RECTAL-CANCER ; ASSOCIATIONS ; METAANALYSIS ; INCREASED RISK ; COLON TUMORS ; Tumor Location ; TUMOR MICROSATELLITE INSTABILITY
    Abstract: BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2,741 developed CRC during the follow-up period (mean 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR 1.18, 95%CI 1.06-1.32) and former cigarette smokers (HR 1.21, 95%CI 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR 1.13, 95%CI 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR 1.25, 95%CI 1.04-1.50) and current smokers (HR 1.31, 95%CI 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a non-significant difference between the proximal and distal colon (p=0.45) for former smokers and a significant difference for current smokers (p=0.02). For smokers that had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location.
    Type of Publication: Journal article published
    PubMed ID: 21029790
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  • 2
    Keywords: CANCER ; BLOOD ; Germany ; THERAPY ; RISK ; RISKS ; PROTEIN ; colon ; CYCLE ; ASSOCIATION ; hormone ; HEALTH ; resistance ; AGE ; WOMEN ; MEN ; OBESITY ; smoking ; COLORECTAL-CANCER ; cancer risk ; COLON-CANCER ; cholesterol ; C-REACTIVE PROTEIN ; body mass index ; nutrition ; education ; NESTED CASE-CONTROL ; CROHNS-DISEASE ; inflammation ; insulin ; SERUM ; case-control study ; REGRESSION ; ASSOCIATIONS ; colon cancer ; METAANALYSIS ; PHASE ; INSULIN-RESISTANCE ; metabolic syndrome ; REPLACEMENT THERAPY ; prospective ; CANCER-RISK ; colorectal neoplasms ; C-PEPTIDE ; REPLACEMENT ; WAIST CIRCUMFERENCE ; INFLAMMATORY MARKERS ; nested case-control study ; BODY-MASS ; COLLECTION ; HORMONE-THERAPY ; Abdominal ; Hyperinsulinism ; journals ; nested case control study ; hyperglycemia ; hyperlipidemias
    Abstract: The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of 〉= 3.0 mg/L versus 〈 1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend = 0.01) for colon cancer and 1.02 (95% CI: 0.67, 1.57; P-trend = 0.65) for rectal cancer. Colon cancer risk was significantly increased in men (relative risk = 1.74, 95% CI: 1.11, 2.73; P-trend = 0.01) but not in women (relative risk = 1.06, 95% CI: 0.67, 1.68; P-trend = 0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterol did not attenuate these results. These data provide evidence that elevated CRP concentrations are related to a higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulin resistance, and dyslipidemia
    Type of Publication: Journal article published
    PubMed ID: 20634278
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