Prevalence and Incidence of Colorectal Cancer Comorbidities

Abstract

S (ACE) AEP Vol. 20, No. 9 September 2010: 691–724 700 CONCLUSION: The interaction with family history of cancer supports the biological plausibility of our findings, as similar results have been found for breast cancer and radiation. This observational data will increase awareness about potential risks associated with CT scans and the need to minimize the use of unnecessary exams. P26 TOTAL ENERGY, MACRONUTRIENTS AND COLORECTAL CANCER: A CASE-CONTROL STUDY IN ONTARIO AND NEWFOUNDLAND AND LABRADOR Z Sun, J Zhao, P P Wang, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada PURPOSE: The associations of total energy and macronutrients with colorectal cancer risk remain controversial. The objective of this study is to examine such associations through a population based case-control study in Ontario (ON) and Newfoundland and Labrador (NL). METHODS:Data for this case-control study were fromOntario and Newfoundland Familial Colorectal Cancer Registries. Cases were pathologically confirmed new colorectal cancer patients aged 20–74 years during 1999–2003 (NL), 1997–2000 (ON Phase I) and 2003–2006 (ON Phase II). Controls were a sex and age-group matched random sample of the population in each province. Intakes of total energy and macronutrients were derived from a food frequency questionnaire. Multivariate logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence interval (95%CI) after adjusting for total energy and other potential confounding factors. Tests for trend were used to assess dose-response relationships. RESULTS: High intake of total energy was significantly related to an increased risk of CRC (ORZ1.56, 95% CI: 1.21–2.01), whereas inverse associations emerged for intakes of protein (ORZ0.85, 95%CI: 0.69–1.00), carbohydrate (ORZ0.81, 95%CI: 0.63–1.00) and total dietary fibre (ORZ0.84, 95% CI:0.67–0.99). CONCLUSIONS: Findings of this study provides further evidence that diets high in energy may increase the risk, whereas diets high in protein, fibre, and carbohydrate may reduce the risk ofCRC.These results underline the importance of some aspects of total energy and macronutrients and consequently the potential for prevention through dietary changes. P27 PREVALENCE AND INCIDENCE OF COLORECTAL CANCER COMORBIDITIES W Langeberg, M Danese, K Lindquist, M Gleeson, R Griffiths, C O’Malley, Amgen, Outcomes Insights, Thousand Oaks, CA BACKGROUND: The comorbidity profile for colorectal cancer (CRC) patients can change markedly after diagnosis. To assess this, we evaluated the comorbidity burden of CRC cases and matched controls in the year before and after diagnosis. METHODS: Cases included persons 66 years from the SEERMedicare (S-M) database diagnosed 1998 to 2002 with incident, primary CRC (nZ50,168). Persons without cancer (nZ49,929) were randomly selected from the S-M file, matched to cases on gender and county of residence, and assigned a pseudo-diagnosis date from their matched case. The prevalences of 34 comorbid conditions were calculated for the year before diagnosis date. The 3and 12-month incidence rates were calculated per 1,000 person-years among patients initially free of the condition. Rates in the controls were standardized to the age and race distribution of the cases. RESULTS: The prevalence of comorbidities in the year before diagnosis was similar among cases and controls, with little variance due to age, sex, or race. However, the 3and 12-month incidence of comorbidities was notably higher in the cases than the controls. The highest 12-month incidence rates were for: anemia [cases: 476.8 (95% CI: 468.7, 484.8), controls: 31.9 (95% CI: 30.2, 33.7)]; electrolyte disorder [cases: 393.9 (95% CI: 386.9, 401.0), controls: 51.0 (95% CI: 48.7, 53.3)]; infectious disease [cases: 328.9 (95% CI: 322.5, 335.4), controls: 60.3 (95% CI: 57.7, 62.9)]; and hypertension [cases: 189.2 (95% CI: 182.5), controls: 48.0 (95% CI: 45.2, 50.8)]. Incidence rates tended to increase with age and stage. CONCLUSION: Our data suggest marked increases in rates of several comorbidities after CRC diagnosis. This could be a result of the cancer or treatment, or these conditions might be under-diagnosed. The diagnosis of new comorbidities can be anticipated in the treatment of colorectal cancer patients, most likely as a function of the diagnostic process surrounding detection and treatment. P28 ANTIDEPRESSANT USE AMONG BREAST CANCER SURVIVORS AND MORTALITY R Haque, C Avila, J Shi, J Chung, C Cheetham, VP Quinn, Kaiser Permanente Southern California, Research & Evaluation, Pasadena, CA PURPOSE: Despite tamoxifen’s success in reducing the risk of breast cancer (BCa) recurrence, its notable side effects include hot flashes and night sweats. Antidepressants have been used to relieve some of these symptoms. However, few laboratory studies suggest that certain common antidepressants may interfere with tamoxifen’s effectiveness. Our goal was to determine whether concomitant tamoxifen and antidepressant use is associated with all cause mortality. METHODS: We assembled a large cohort of women who were diagnosed with their first BCa in 1996–2006 and treated with tamoxifen and followed through 12/31/07 using