Colon Cancer In Women Research Articles

Allometric versus traditional body-shape indices and risk of colorectal cancer: a Mendelian randomization analysis

BackgroundTraditional body-shape indices such as Waist Circumference (WC), Hip Circumference (HC), and Waist-to-Hip Ratio (WHR) are associated with colorectal cancer (CRC) risk, but are correlated with Body Mass Index (BMI), and adjustment for BMI introduces a strong correlation with height. Thus, new allometric indices have been developed, namely A Body Shape Index (ABSI), Hip Index (HI), and Waist-to-Hip Index (WHI), which are uncorrelated with weight and height; these have also been associated with CRC risk in observational studies, but information from Mendelian randomization (MR) studies is missing.MethodsWe used two-sample MR to examine potential causal cancer site- and sex-specific associations of the genetically-predicted allometric body-shape indices with CRC risk, and compared them with BMI-adjusted traditional body-shape indices, and BMI. Data were obtained from UK Biobank and the GIANT consortium, and from GECCO, CORECT and CCFR consortia.ResultsWHI was positively associated with CRC in men (OR per SD: 1.20, 95% CI: 1.03–1.39) and in women (1.15, 1.06–1.24), and similarly for colon and rectal cancer. ABSI was positively associated with colon and rectal cancer in men (1.27, 1.03–1.57; and 1.40, 1.10–1.77, respectively), and with colon cancer in women (1.20, 1.07–1.35). There was little evidence for association between HI and colon or rectal cancer. The BMI-adjusted WHR and HC showed similar associations to WHI and HI, whereas WC showed similar associations to ABSI only in women.ConclusionsThis large MR study provides strong evidence for a potential causal positive association of the allometric indices ABSI and WHI with CRC in both sexes, thus establishing the association between abdominal fat and CRC without the limitations of the traditional waist size indices and independently of BMI. Among the BMI-adjusted traditional indices, WHR and HC provided equivalent associations with WHI and HI, while differences were observed between WC and ABSI.

Energy balance-related factors in childhood and adolescence and risk of colorectal cancer based on KRAS, PIK3CA, and BRAF mutations and MMR status.

KRAS mutations (KRASmut ), PIK3CAmut , BRAFmut ,and deficient DNA mismatch repair (dMMR) have been associated with the Warburg effect. We previously reported differential associations between early-life energy balance-related factors (height, energy restriction, body mass index[BMI]) and colorectal cancer (CRC) subtypes based on the Warburg effect. We now investigated associations of early-life energy balance-related factors and the risk of CRC subgroups based on mutation and MMR status. Data from the Netherlands Cohort Study was used. KRASmut , PIK3CAmut, BRAFmut, and MMR status were available for 2349 CRC cases, and complete covariate data for 1934 cases and 3911 subcohort members. Multivariable-adjusted Cox regression was used to estimate associations of height, energy restriction proxies (exposure to Dutch Hunger Winter, Second World War, Economic Depression), and early adult BMI (age 20 years) with risk of CRC based on individual molecular features and combinations thereof (all-wild-type+MMR-proficient [pMMR]; any-mutation/dMMR).Height was positively associated with any-mutation/dMMR CRC but not all-wild-type+pMMR CRC, with the exception of rectal cancer in men, and with heterogeneity in associations observed for colon cancer in men (p-heterogeneity = 0.049) and rectal cancer in women (p-heterogeneity = 0.014). Results on early-life energy restriction proxies in relation to the risk of CRC subgroups did not show clear patterns. Early adult BMI was positively, but not significantly, associated with KRASmut colon cancer in men and with BRAFmut and dMMR colon cancer in women. Our results suggest a role of KRASmut , PIK3CAmut , BRAFmut , and dMMR in the etiological pathway between height and CRC risk. KRASmut might potentially play a role in associations of early adult BMI with colon cancer risk in men, and BRAFmut and dMMR in women.

Female Colon Cancer Metastasis Pattern and Prognosis: A SEER-Based Study.

The purpose of this study was to compare the metastatic pattern and prognosis of female colon cancer (FCC) to that of male colon cancer (MCC) to ascertain the independent factors impacting the prognosis of patients with FCC. The data of the present study population were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Descriptive analysis, the Kaplan-Meier method, and the Cox regression were used to evaluated FCC characteristics and factors associated with prognosis. There were 56,442 patients diagnosed with FCC, of whom 8,817 had distant metastases. Compared to patients with nonmetastatic FCC, a greater proportion of metastatic FCC patients was less than 60 years of age, black race, and grade III-IV. The primary sites were mainly located on the left side and have more possibility to receive chemotherapy and radiotherapy. Compared to metastatic MCC, a higher proportion of metastatic FCC patients ranged over 60 years of age, black race, treated without chemotherapy, and insurance, while the primary site was located on the right side. Liver and lung were the two most common sites of solitary metastases in CC, and among patients with solitary metastases in CC, patients who had lung metastases had a better prognosis than those who developed other types of metastasizes. Patients with FCC with metastases of the liver had a worse prognosis than their MCC counterparts. Cox multivariate regression analysis showed that the risk ratio was higher in metastatic FCC patients compared to those without metastases. We report the survival comparison of metastatic FCC with nonmetastatic FCC through the SEER database. Our results suggest that it has unique clinicopathological features and differs from metastatic MCC. Furthermore, patients with liver metastatic FCC have a worse prognosis than those with MCC. Emphasis on screening for colon cancer in women and additional clinical care should be paid for, especially for patients with FCC with metastatic liver cancer.

Energy Balance-Related Factors and Risk of Colorectal Cancer Expressing Different Levels of Proteins Involved in the Warburg Effect.

Energy balance-related factors [body mass index (BMI), waist circumference, physical activity] have been associated with colorectal cancer risk. Warburg effect activation via PI3K/Akt signaling is one of the proposed mechanisms. We investigated whether energy balance-related factors were associated with risk of Warburg subtypes in colorectal cancer. We investigated this using immunohistochemistry for six proteins involved in the Warburg effect (LDHA, GLUT1, MCT4, PKM2, P53, PTEN) on tissue microarrays of 2,399 incident colorectal cancer cases from the prospective Netherlands Cohort Study (ntotal = 120,852; nsubcohort = 5,000; aged 55-69 in 1986; 20.3 years follow-up). Data analyses included 3,911 subcohort members and 1,972 colorectal cancer cases with complete covariate data. Expression levels of all proteins were combined into a pathway-based sum score and categorized into three "Warburg subtypes" (Warburg-low/moderate/high). Multivariable Cox regression analyses were used to estimate associations of BMI, clothing size (waist circumference proxy), and physical activity with Warburg subtypes in colorectal cancer. BMI and clothing size were positively associated with Warburg-moderate and Warburg-high colon cancer risk in men (Pheterogeneity = 0.192). In women, clothing size was positively associated with Warburg-low and Warburg-high colon cancer (Pheterogeneity = 0.005). Nonoccupational physical activity was inversely associated with Warburg-low and Warburg-moderate colon cancer in women (Pheterogeneity = 0.045), but positively associated with Warburg-high rectal cancer in men (Pheterogeneity = 0.089). The Warburg effect might be involved in associations between adiposity and colon cancer risk, though additional mechanisms could be at play in women as well. The inverse association between physical activity and colon cancer might be explained by mechanisms other than the Warburg effect. Further research is needed to reproduce these results and investigate possible additional mechanisms.

Energy balance-related factors in childhood and adolescence and risk of colorectal cancer expressing different levels of proteins involved in the Warburg-effect.

Early‐life (childhood to adolescence) energy balance‐related factors (height, energy restriction, BMI) have been associated with adult colorectal cancer (CRC) risk. Warburg‐effect activation via PI3K/Akt‐signaling might explain this link. We investigated whether early‐life energy balance‐related factors were associated with risk of Warburg‐subtypes in CRC. We used immunohistochemistry for six proteins involved in the Warburg‐effect (LDHA, GLUT1, MCT4, PKM2, P53, and PTEN) on tissue microarrays of 2399 incident CRC cases from the prospective Netherlands Cohort Study (NLCS). Expression levels of all proteins were combined into a pathway‐based sum score and categorized into three Warburg‐subtypes (Warburg‐low/‐moderate/‐high). Multivariable Cox‐regression analyses were used to estimate associations of height, energy restriction proxies (exposure to Dutch Hunger Winter; Second World War [WWII]; Economic Depression) and adolescent BMI with Warburg‐subtypes in CRC. Height was positively associated with colon cancer in men, regardless of Warburg‐subtypes, and with Warburg‐low colon and Warburg‐moderate rectal cancer in women. Energy restriction during the Dutch Hunger Winter was inversely associated with colon cancer in men, regardless of Warburg‐subtypes. In women, energy restriction during the Hunger Winter and WWII was inversely associated with Warburg‐low colon cancer, whereas energy restriction during the Economic Depression was positively associated with Warburg‐high colon cancer. Adolescent BMI was positively associated with Warburg‐high colon cancer in men, and Warburg‐moderate rectal cancer in women. In conclusion, the Warburg‐effect seems to be involved in associations of adolescent BMI with colon cancer in men, and of energy restriction during the Economic Depression with colon cancer in women. Further research is needed to validate these results.

Impact of Tumor Location on Survival in Patients With Colorectal Cancer: A Retrospective Cohort Study Based on Taiwan's Cancer Registry Database.

Background:Colorectal cancer is one of the leading cancers worldwide. This study aimed to investigate the mortality differences between 2 primary tumor locations, the proximal/distal colon and rectosigmoid junction (RSJ)/rectum, after adjusting for comorbidities.Methods:The Taiwan Cancer Registry linked with Taiwan’s National Health Insurance Research Database was used to estimate the 5-year mortality rate among patients with colorectal cancer. A total of 73 769 individuals were enrolled in the study, which included 44 234 patients with proximal and distal colon cancers and 29 535 patients with RSJ and rectal cancers. Potential mortality risk was calculated using Cox regression analysis.Results:The mortality rates due to the location of the cancer in the proximal/distal colon and RSJ/rectum were 45.27% and 42.20%, respectively. After adjustment for age, sex, comorbidities, and clinical stages, the proximal/distal colon had a 1.03-fold higher 5-year overall mortality rate than RSJ/rectal cancer (95% confidence interval = 1.00–1.05). Proximal and distal colon cancers had a worse prognosis and survival than RSJ and rectal colon cancers in women and older patients (⩾70 years). Comorbidities had different effects on mortality in the proximal/distal colon and RSJ/rectum.Conclusions:Tumor location is associated with the prognosis of patients with colorectal cancer. It is important to treat patients beyond their cancer treatment, and to manage their comorbidities.

Cancer screening rates and characteristics of low-participating groups in Sapporo city

Objectives The purpose of this study was to assess the situation of regional cancer screening of individuals in Sapporo city through an independent survey and to identify groups with low cancer screening rates.Methods We conducted a self-administered questionnaire survey on 3,000 men aged 40 to 69 years and 4,000 women aged 20 to 69 years living in Sapporo (response rate = 32.4%). The contents of the survey were quoted from the health slips of the Comprehensive Survey of Living Conditions related to cancer screening, as well as basic and cancer-related attributes. We analyzed the relationship between cancer screening participation rate, basic attributes, and cancer-related attributes using the χ2 test or logistic regression analysis.Results The screening rates recorded in this study for gastric, colon, and lung cancers were 67.4%, 59.2%, and 66.1%, respectively in men, and 48.7%, 47.7%, and 53.4%, respectively in women. The screening rates were 52.7% and 56.1% for uterine and breast cancers, respectively. The participation rate of non-working individuals and those who had National Health Insurance was significantly lower for all cancer types among both men and women. Regarding attributes and cancer screening, the odds ratio of working to non-working individuals was 3.00 to 3.09 in men and 1.41 to 2.46 in women. The odds ratio of non-National Health Insurance individuals was 3.47 to 4.26 in men and 1.47 to 2.52 in women. In addition, there was a significant association between awareness and rates of Sapporo city cancer screening in both men and women, with the exception of stomach cancer screening in women. Furthermore, the odds ratio of awareness was 1.41 to 1.74 in men and 1.24 to 1.48 in women.Conclusion The cancer types with screening rate below 50% were gastric and colon cancers in women. In men, the screening rate for gastric, colon, and lung cancers exceeded 50%. The cancer-screening rate was found to be low among both non-working men and women, those with national health insurance, or those who do not recognize the Sapporo city cancer screening (regional screening). The characteristics of the group with low participation status in Sapporo city, which was the only parameter not reported in the Comprehensive Survey of Living Conditions, has been clarified.

Incidence of colorectal cancers in India

A number of studies on population-based cancer registries (PBCRs) data have been reported from India about various cancers. However, updated status of colorectal cancer is not available in literature. The objective is to provide an overview of age-specific and age-adjusted colorectal cancer incidence reported in 27 PBCRs in India. Secondary data on age-specific and age-adjusted rates of incidence rate, the lifetime risk of the disease was computed using cumulative risk and a number of cases for all ages (0–75 years), were collected from the report of the National Cancer Registry Program 2012-2014 in 27 population-based control registries. The annual incidence rates (AARs) for colon cancer and rectal cancer in men are 5.36 and 5.17/100,000, respectively. The AAR for colon cancer in women is 4.3/100,000. Males were comparably at higher risk than females. The maximum lifetime risk of developing colon cancer ranged from 167 to 500 females and lifetime risk of developing rectum cancer ranged from 100 to 353 in males. The risk of colorectal cancers was high amongst the Northeast population followed by South regions of India. The management of colon and rectal cancer cases and screening could serve to control the disease.

Sugary Drink Consumption and Subsequent Colorectal Cancer Risk: The Japan Public Health Center-Based Prospective Cohort Study.

Most studies examining the associations of sugary drink consumption on colorectal cancer risk have been conducted in Western populations. This study consisted of 74,070 participants in the Japan Public Health Center-based Prospective Study who completed a food frequency questionnaire (1995-1999). The participants were followed until December 2013 to investigate the associations between sugary drink consumption and colorectal cancer risk using Cox proportional hazards regression models. Among the 74,070 participants, mean age was 56.5 years at baseline, with a mean body mass index (BMI) of 23.5 and a mean daily consumption of 286 mL/day for men and 145 mL/day for women. During a follow-up of 15 years, 1,648 colorectal cancer cases were identified. No overall greater risk of colorectal cancer was observed among men [multivariable HR = 0.84; 95% confidence of interval (CI), 0.70-1.02; ≥254 mL/day vs. nonconsumers] and women (HR = 1.20; 95% CI, 0.96-1.50, ≥134 mL/day vs. nonconsumers). Sugary drink consumption was associated with colon cancer among women (HR = 1.36; 95% CI, 1.03-1.78, ≥134 mL/day vs. nonconsumers). HRs for proximal colon cancer among women who consumed sugary drinks, as compared with nonconsumers, were 1.47 (95% CI, 1.03-2.10) for sugary drink consumption less than 134 mL/day, and 1.45 (95% CI, 1.01-2.09) for at least 134 mL/day. In this large prospective cohort of Japanese with a moderate sugary drink consumption level and low prevalence of obesity, we observed a 36% increased risk of colon cancer in women. Our findings highlight the importance of subsite- and sex-specific investigation.

Gender comparison of clinical, histopathological, therapeutic and outcome factors in 185,967 colon cancer patients

IntroductionColorectal carcinomas represent the third most common cause of cancer-related deaths in Germany. Although the incidence is significantly higher in men compared with women and gender is a well-established crucial factor for outcome in other diseases, detailed gender comparisons for colon cancer are lacking.MethodsThis retrospective population-based cohort study included all patients diagnosed with colon cancer in Germany between 2000 and 2016 who were included in the common dataset of colorectal cancer patients from the quality conference of the German Cancer Society. We compared clinical, histopathological, and therapeutic characteristics as well as overall and recurrence-free survival.ResultsA total of 185,967 patients were included in the study, of which 85,685 were female (46.1%) and 100,282 were male (53.9%). The proportion of women diagnosed with colon cancer decreased from 2000 to 2016 (f: 26.6 to 40.1%; m: 24.9 to 41.9%; p < 0.001), and the proportion of very old patients was especially high in women (f: 27.3%; m: 15.6%; p < 0.001). The localization in women was more right-sided (f: 45.0%, m: 36.7%; p < 0.001), and women had a higher tumor grading and a higher UICC stage (especially stage III nodal-positive) at diagnosis of primary colon cancer (UICC III: f: 22.7%, m: 21.0%; p < 0.001). We could detect a significantly better overall (hazard ratio: 0.853, lower 95%: 0.841, upper 95%: 0.864; p < 0.001) and recurrence-free survival (hazard ratio: 0.857, lower 95%: 0.845, upper 95%: 0.868; p < 0.001) in women compared with men, even though women received chemotherapy less frequently compared with men (f: 26.1%, m: 28.1%; p < 0.001).ConclusionWe could detect several variables that differed significantly between men and women regarding clinical, histopathological, therapeutic, and outcome factors. We believe that it is crucial to consider gender as a key factor in the diagnosis and treatment of colon cancer. Sex-specific diagnostic tools could lead to an earlier diagnosis of colon cancer in women, and ways to increase the rate of chemotherapy in women should be evaluated. Furthermore, we recommend stratifying randomized trials by gender.

Meat subtypes and colorectal cancer risk: A pooled analysis of 6 cohort studies in Japan.

Red meat and processed meat have been suggested to increase risk of colorectal cancer (CRC), especially colon cancer. However, it remains unclear whether these associations differ according to meat subtypes or colon subsites. The present study addressed this issue by undertaking a pooled analysis of large population‐based cohort studies in Japan: 5 studies comprising 232 403 participants (5694 CRC cases) for analysis based on frequency of meat intake, and 2 studies comprising 123 635 participants (3550 CRC cases) for analysis based on intake quantity. Study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model and then pooled using the random effect model. Comparing the highest vs lowest quartile, beef intake was associated with an increased risk of colon cancer in women (pooled HR 1.20; 95% CI, 1.01‐1.44) and distal colon cancer (DCC) risk in men (pooled HR 1.30; 95% CI, 1.05‐1.61). Frequent intake of pork was associated with an increased risk of distal colon cancer in women (pooled HR 1.44; 95% CI, 1.10‐1.87) for “3 times/wk or more” vs “less than 1 time/wk”. Frequent intake of processed red meat was associated with an increased risk of colon cancer in women (pooled HR 1.39; 95% CI, 0.97‐2.00; P trend = .04) for “almost every day” vs “less than 1 time/wk”. No association was observed for chicken consumption. The present findings support that intake of beef, pork (women only), and processed red meat (women only) might be associated with a higher risk of colon (distal colon) cancer in Japanese.

Opportunities for reducing emergency diagnoses of colon cancer in women and men: A data-linkage study on pre-diagnostic symptomatic presentations and benign diagnoses.

ObjectivesTo identify opportunities for reducing emergency colon cancer diagnoses, we evaluated symptoms and benign diagnoses recorded before emergency presentations (EP).MethodsCohort of 5,745 colon cancers diagnosed in England 2005–2010, with individually linked cancer registry and primary care data for the 5‐year pre‐diagnostic period.ResultsColon cancer was diagnosed following EP in 34% of women and 30% of men. Among emergency presenters, 20% of women and 15% of men (p = 0.002) had alarm symptoms (anaemia/rectal bleeding/change in bowel habit) 2–12 months pre‐diagnosis. Women with abdominal symptoms (change in bowel habit/constipation/diarrhoea) received a benign diagnosis (irritable bowel syndrome (IBS)/diverticular disease) more frequently than men in the year before EP: 12% vs. 6% among women and men (p = 0.002). EP was more likely in women (OR = 1.20; 95% CI 1.1–1.4), independently of socio‐demographic factors and symptoms. Benign diagnoses in the pre‐diagnostic year (OR = 2.01; 95% CI 1.2–3.3) and anaemia 2–5 years pre‐diagnosis (OR = 1.91; 95% CI 1.2–3.0) increased the risk of EP in women but not men. The risk was particularly high for women aged 40–59 with a recent benign diagnosis vs. none (OR = 4.41; 95% CI 1.3–14.9).ConclusionsWomen have an increased risk of EP, in part due to less specific symptoms and their more frequent attribution to benign diagnoses. For women aged 40–59 years with new‐onset IBS/diverticular disease innovative diagnostic strategies are needed, which might include use of quantitative faecal haemoglobin testing (FIT) or other colorectal cancer investigations. One‐fifth of women had alarm symptoms before EP, offering opportunities for earlier diagnosis.

Abstract 5264: A prospective study of dietary inflammatory index scores and colorectal cancer risk: The Singapore Chinese Health Study

Abstract Background. Colorectal cancer (CRC) has increased dramatically in Singapore during the past three decades and becomes the most common cancer when both sexes combined. Extensive evidence shown the specific component of diet may modulate inflammation and thus influence to disease endpoints, including CRC. We determine the association between diet inflammatory index (DII)TM, a literature-derived, population-based score, developed to assess the inflammatory potential of an individual's diet, and CRC risk in Singaporean Chinese, using data from the Singaporean Chinese Health Study (SCHS). Methods. A total of 61,321 SCHS study participants was included in the current analysis. The DII scores were calculated using validated food frequency questionnaires (FFQs). Cox proportional hazards model was performed to assess the association between DII scores and CRC risk. Results. There was a positive association between DII score and CRC risk in females (HRs and respective 95% CIs: 1.30 (1.02-1.64), 1.32 (1.03-1.67), and 1.20 (0.93-1.55) for Q2, Q3, Q4 vs. Q1). DII score was associated with increased risk of colon cancer (HRQ4vsQ1=1.35, 95% CI: 1.08-1.68; Ptrend=0.04) and this association appeared stronger in females. Among never-smokers, the highest quartile of DII was associated with statically significant 43% increased risk of developing CRC in women compared to those in the lowest quartile (HRQ4vsQ1=1.43, 95% CI: 1.01-2.02; Ptrend=0.03). There was also a dose-response association between DII scores with colon cancer in women among those with BMI less than 25 (HRQ4vsQ1=1.66, 95% CI: 1.03-2.68; Ptrend=0.04). Conclusions. Consumption of anti-inflammatory foods will reduce the risk of colorectal cancer, particularly among females and non-smokers. This will have substantial public health impact as prevention program should focus on promoting healthy and anti-inflammatory foods to reduce the risk of colorectal cancer. Citation Format: Hung N. Luu, Renwei Wang, Nittin Shivappa, James R. Hébert, Woon-Puay Koh, Jian-Min Yuan. A prospective study of dietary inflammatory index scores and colorectal cancer risk: The Singapore Chinese Health Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5264.

Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants

ObjectiveTo investigate the association of grip strength with disease specific incidence and mortality and whether grip strength enhances the prediction ability of an established office based risk score.DesignProspective population based...

Diabetes mellitus and the risk of gastrointestinal cancer in women compared with men: a meta-analysis of cohort studies

BackgroundThe increasing epidemic proportions of diabetes mellitus (DM) are a major cause of premature illness and death. However, whether DM confers the same excess risk of gastrointestinal cancer for women as it does for men remains controversial. The purpose of this study was to estimate the relation between DM and gastrointestinal cancer in women compared with men after accounting for other major risk factors based on cohort studies.MethodsWe performed a meta-analysis of cohort studies published through May 2017 from PubMed, Embase, and the Cochrane Library. Studies with cohort designs were stratified by sex and reported the relation between DM and esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), colon cancer (CC), rectal cancer (RC), hepatocellular carcinoma (HCC), or pancreatic cancer (PC) risk. The ratio of relative risk (RRR) between men and women was employed to measure the sex differences in the relation between DM and gastrointestinal cancer with a random effects model with inverse variance weighting.ResultsWe included 38 cohort studies reporting data on 18,060,698 individuals. The pooled RRR indicated DM women was associated with an increased risk of GC (RRR: 1.14; 95%CI: 1.06–1.22; p < 0.001), while the risk of HCC was lower (RRR: 0.88; 95%CI: 0.79–0.99; p = 0.031) as compared with DM men. Further, there was no evidence of sex differences in the RRR between participants who had DM compared with those without DM for EC (p = 0.068), CRC (p = 0.618), and PC (p = 0.976). In addition, the pooled RRR showed a statistically significant association between DM and the risk of CC in women compared with men (RRR: 0.93; 95%CI: 0.86–1.00; p = 0.050), and there was no evidence of sex differences for RC among participants with DM compared to those without DM (p = 0.648). Finally, the sex differences of the comparison between DM and non-DM for gastrointestinal cancer risk at different sites were variable after stratification for different effect estimates.ConclusionsThe findings of this study suggested female-to-male RRR of DM was increased for GC, while reduced for HCC and CC. However, there were no sex differences for the relation between DM and the risk of EC, CRC, PC, and RC.

Is dietary fibre truly protective against colon cancer? A systematic review and meta-analysis

Colorectal cancer is the third most common cancer worldwide. Growing evidence shows that about 47% of cases of colorectal cancer can be prevented by a healthy lifestyle. We performed a systematic review and meta-analysis aimed to evaluate the association between dietary fibre intake and the risk of colon cancer. We performed a structured computer search on PubMed, including epidemiological studies reporting results of dietary fibre intake and risk of colon cancer in women or men. We compared subjects exposed to the highest versus the lowest consumption. The search strategy identified 376 papers. After screening, 25 datasets were included in our meta-analysis. Results suggest a protective role of dietary fibre intake on colon cancer risk ES = 0.74 (95% CI = 0.67–0.82), p value = .000, but, moderate statistical heterogeneity (χ2 = 42.73, p value = .011) was found. Due to the high mortality of colorectal cancer, it is important to identify effective preventive measures, especially those of a healthy lifestyle, such as a healthy diet.

Expression and Polymorphism of Toll-Like Receptor 4 and Effect on NF-κB Mediated Inflammation in Colon Cancer Patients.

Our aim was to evaluate the association between the expression and the polymorphism of TLR4/NF-κB pathways and colon cancer. TLR4 (rs4986790, rs10759932, rs10759931 and rs2770150) were genotyped in blood samples from Colorectal patients and healthy controls. TLR4 and cytokines inflammatory expression were evaluated by real time PCR on 40 matching normal and colon tissues and the protein level by Immunohistochemistry. The high level of TLR4 expression in colon cancer tissues is mainly due to infections by bacteria in the human colon and leads to induction of an acute secretion of inflammatory cytokines mediated by NF-κB. Also, we report here a clear evidence for an association between TLR4 rs10759931 polymorphism (OR = 0.086, CI: 0.04–0.18, P = <0.00001). This polymorphism affects the entire population without being specific to either gender or to any age group. In contrast, the rs2770150 is associated with colon cancer in women aged over 50 years and is closely linked with the decreased levels of female sex hormones during the post-menopausal period (OR = 0.188, CI: 0.074–0.48, P = <0.00084). rs10759932 and rs4986790 appear to have any association with colon cancer. Our data suggest that TLR4 SNPs could possibly serve as biomarkers for decision making in colon cancer treatment.

P53: Long-term monitoring of the digestive cancer in Novosibirsk

This study used data from population-based cancer registries and total mortality over the past quarter of a century in NIITPM, Novosibirsk. The follow-up period was from 1985 to 2014. Both registers operated in the two regions, the most typical for the city. The results can be extrapolated to the entire population of Novosibirsk. For long-term analysis we used data from two registers concerning gastric cancer, colorectal cancer and liver cancer. Morbidity and mortality from stomach cancer over the past 25 years have declined, however, the proportion of GC 3–4 (end-stage) remains constant with a tendency to increase. In general, the incidence of colorectal cancer in the Novosibirsk region remains at a consistently high level, but the detection rates of colon cancer in women have increased. Men were exposed to colorectal cancer more frequently than women, especially in the older age groups. Meanwhile the share of detection of colorectal cancer clinical stage 3–4 decreased by one third. With regard to liver cancer, decline was observed over 25 years that is 2.1 times lower that coincide with national trends. At the same time, death rates from liver cancer in Novosibirsk are lower than in Russia as a whole. However, the index of malignancy (the ratio of mortality to incidence) of liver cancer was 0.94 in Novosibirsk. In summary, while there are a variety of long -term monitoring of trends in the incidence of cancer, this requires new research, especially the identification of genetic markers for the prevention and possible introduction in oncologic patients.

Estrogen receptor beta (ERβ) gene polymorphisms as a predictor of overall survival in patients with gastric cancer (GC) from Japan and Los Angeles County (LAC).

4036 Background: Use of menopausal hormones has correlated with a lower risk of colon cancer in women. Prostate cancer patients (pts) treated with estrogen have a reduced risk of developing GC as a...

The Prevalence of Coronary Heart Disease, Stroke and Selected Co-Morbidities in Patients with Newly Diagnosed Type 2 Diabetes Population - Based on Cohort Study of Outpatients

Abstract The prospective study analyses prevalence of coronary heart disease, stroke, elevated serum levels of ALT and GGT and prevalence of cancer diseases in patients with newly diagnosed type 2 diabetes mellitus, and usage of this epidemiological data in everyday clinical practice. Outpatients with newly diagnosed type 2 diabetes mellitus were monitoring during the period of August 2007 - August 2011. The patients with previously treated type 2 diabetes mellitus were eliminated from the monitoring. The population consists of 117 males and 83 females aged 30 to 92 years sent by GPs and various specialists. The relatively low prevalence of known coronary artery disease was recorded in men (34%) and in women (19%). Prevalence of stroke history was confirmed in 12% of men and 7% of women. The elevated serum ALT levels &gt; 0.55 μkat/l was recorded in 45% of men and 45% of women and elevated serum GGT levels &gt; 0.45 μkat/l was recorded in 81% of men and 68% of women. Prevalence of cancer diseases was recorded 5% in women and 5.26% of men. In the studied group of patients there was recorded the occurrence of colon cancer in men over 64 years old and the occurrence of breast cancer, endometrial cancer and colon cancer in women over 62 years old.