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Title: Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.
Authors: Murphy, Neil
Ward, Heather A
Jenab, Mazda
Rothwell, Joseph A
Boutron-Ruault, Marie-Christine
Carbonnel, Franck
Kvaskoff, Marina
Kaaks, Rudolf
Kühn, Tilman
Boeing, Heiner
Aleksandrova, Krasimira
Weiderpass, Elisabete
Skeie, Guri
Borch, Kristin Benjaminsen
Tjønneland, Anne
Kyrø, Cecilie
Overvad, Kim
Dahm, Christina C
Jakszyn, Paula
Sánchez, Maria-Jose
Gil, Leire
Huerta, José M
Barricarte, Aurelio
Quirós, J Ramón
Khaw, Kay-Tee
Wareham, Nick
Bradbury, Kathryn E
Trichopoulou, Antonia
La Vecchia, Carlo
Karakatsani, Anna
Palli, Domenico
Grioni, Sara
Tumino, Rosario
Fasanelli, Francesca
Panico, Salvatore
Bueno-de-Mesquita, Bas
Peeters, Petra H
Gylling, Björn
Myte, Robin
Jirström, Karin
Berntsson, Jonna
Xue, Xiaonan
Riboli, Elio
Cross, Amanda J
Gunter, Marc J
Keywords: Anatomic Subsite;Colorectal Cancer;Distal Colon;Heterogeneity;Proximal Colon;Rectum;Risk Factors
metadata.dc.subject.mesh: Adult
Alcohol Drinking
Colorectal Neoplasms
Follow-Up Studies
Life Style
Middle Aged
Prospective Studies
Risk Factors
Issue Date: 26-Jul-2018
Abstract: Colorectal 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.
metadata.dc.identifier.doi: 10.1016/j.cgh.2018.07.030
Appears in Collections:Producción 2020

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