RT Journal Article
T1 Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.
A1 Murphy, Neil
A1 Ward, Heather A
A1 Jenab, Mazda
A1 Rothwell, Joseph A
A1 Boutron-Ruault, Marie-Christine
A1 Carbonnel, Franck
A1 Kvaskoff, Marina
A1 Kaaks, Rudolf
A1 Kühn, Tilman
A1 Boeing, Heiner
A1 Aleksandrova, Krasimira
A1 Weiderpass, Elisabete
A1 Skeie, Guri
A1 Borch, Kristin Benjaminsen
A1 Tjønneland, Anne
A1 Kyrø, Cecilie
A1 Overvad, Kim
A1 Dahm, Christina C
A1 Jakszyn, Paula
A1 Sanchez-Perez, Maria-Jose
A1 Gil, Leire
A1 Huerta, José M
A1 Barricarte, Aurelio
A1 Quirós, J Ramón
A1 Khaw, Kay-Tee
A1 Wareham, Nick
A1 Bradbury, Kathryn E
A1 Trichopoulou, Antonia
A1 La Vecchia, Carlo
A1 Karakatsani, Anna
A1 Palli, Domenico
A1 Grioni, Sara
A1 Tumino, Rosario
A1 Fasanelli, Francesca
A1 Panico, Salvatore
A1 Bueno-de-Mesquita, Bas
A1 Peeters, Petra H
A1 Gylling, Björn
A1 Myte, Robin
A1 Jirström, Karin
A1 Berntsson, Jonna
A1 Xue, Xiaonan
A1 Riboli, Elio
A1 Cross, Amanda J
A1 Gunter, Marc J
K1 Anatomic Subsite
K1 Colorectal Cancer
K1 Distal Colon
K1 Heterogeneity
K1 Proximal Colon
K1 Rectum
K1 Risk Factors
AB 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.
YR 2018
FD 2018-07-26
LK http://hdl.handle.net/10668/12770
UL http://hdl.handle.net/10668/12770
LA en
NO Murphy N, Ward HA, Jenab M, Rothwell JA, Boutron-Ruault MC, Carbonnel F, et al. Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study. Clin Gastroenterol Hepatol. 2019 Jun;17(7):1323-1331.e6.
DS RISalud
RD Apr 8, 2025