Publication:
Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.

dc.contributor.authorMurphy, Neil
dc.contributor.authorWard, Heather A
dc.contributor.authorJenab, Mazda
dc.contributor.authorRothwell, Joseph A
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorCarbonnel, Franck
dc.contributor.authorKvaskoff, Marina
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKühn, Tilman
dc.contributor.authorBoeing, Heiner
dc.contributor.authorAleksandrova, Krasimira
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorSkeie, Guri
dc.contributor.authorBorch, Kristin Benjaminsen
dc.contributor.authorTjønneland, Anne
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorOvervad, Kim
dc.contributor.authorDahm, Christina C
dc.contributor.authorJakszyn, Paula
dc.contributor.authorSánchez, Maria-Jose
dc.contributor.authorGil, Leire
dc.contributor.authorHuerta, José M
dc.contributor.authorBarricarte, Aurelio
dc.contributor.authorQuirós, J Ramón
dc.contributor.authorKhaw, Kay-Tee
dc.contributor.authorWareham, Nick
dc.contributor.authorBradbury, Kathryn E
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorLa Vecchia, Carlo
dc.contributor.authorKarakatsani, Anna
dc.contributor.authorPalli, Domenico
dc.contributor.authorGrioni, Sara
dc.contributor.authorTumino, Rosario
dc.contributor.authorFasanelli, Francesca
dc.contributor.authorPanico, Salvatore
dc.contributor.authorBueno-de-Mesquita, Bas
dc.contributor.authorPeeters, Petra H
dc.contributor.authorGylling, Björn
dc.contributor.authorMyte, Robin
dc.contributor.authorJirström, Karin
dc.contributor.authorBerntsson, Jonna
dc.contributor.authorXue, Xiaonan
dc.contributor.authorRiboli, Elio
dc.contributor.authorCross, Amanda J
dc.contributor.authorGunter, Marc J
dc.date.accessioned2023-01-25T10:21:08Z
dc.date.available2023-01-25T10:21:08Z
dc.date.issued2018-07-26
dc.description.abstractColorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
dc.identifier.doi10.1016/j.cgh.2018.07.030
dc.identifier.essn1542-7714
dc.identifier.pmcPMC6542674
dc.identifier.pmid30056182
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542674/pdf
dc.identifier.unpaywallURLhttp://www.cghjournal.org/article/S1542356518307560/pdf
dc.identifier.urihttp://hdl.handle.net/10668/12770
dc.issue.number7
dc.journal.titleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
dc.journal.titleabbreviationClin Gastroenterol Hepatol
dc.language.isoen
dc.organizationEscuela Andaluza de Salud Pública-EASP
dc.page.number1323-1331.e6
dc.pubmedtypeJournal Article
dc.pubmedtypeMulticenter Study
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.rightsAttribution 4.0 International
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAnatomic Subsite
dc.subjectColorectal Cancer
dc.subjectDistal Colon
dc.subjectHeterogeneity
dc.subjectProximal Colon
dc.subjectRectum
dc.subjectRisk Factors
dc.subject.meshAdult
dc.subject.meshAlcohol Drinking
dc.subject.meshColon
dc.subject.meshColonoscopy
dc.subject.meshColorectal Neoplasms
dc.subject.meshEurope
dc.subject.meshExercise
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshHumans
dc.subject.meshIncidence
dc.subject.meshLife Style
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshProspective Studies
dc.subject.meshRectum
dc.subject.meshRisk Factors
dc.subject.meshSmoking
dc.titleHeterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number17
dspace.entity.typePublication
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