Incidence Of Large Bowel Cancer Research Articles

Hereditary factors are unlikely behind unusual pattern of early - Onset colorectal cancer in Egyptians: A study of family history and pathology features in Egyptians with large bowel cancer (cross-sectional study)

BackgroundColorectal cancer in Egypt has a higher incidence in young patients compared to western countries, where the disease is more prevalent in the old age group. This difference has been attributed to higher incidence of hereditary cancers in young Egyptian patients. The aim of this study is to compare the family history criteria and pathology features of tumors in young (≤40 years) and old (>40 years) Egyptian patients with adenocarcinoma of the colon and rectum. Materials and methodsThis is the analysis of our prospectively collected data on the pathology features of tumors in 313 consecutive patients (133 young, 180 old) with colorectal cancer presenting to the Department of Surgery within an eight-year period. A detailed family history was obtained from 258 patients (112 young, 146 old). Results41 young and 48 old patients reported family history of cancer, the difference was not statistically significant. Ten young patients (9%) reported a family history of colorectal cancer in a first degree relative (3 fitting into Amsterdam criteria, 7 fitting into less strict criteria) which was not significantly different from the old age group. The pathologic features of tumors in both groups resembled sporadic rather than hereditary cancer and there was no significant difference between groups in tumor location, degree of differentiation, mucin production, synchronous and metachronous colorectal tumors or polyps and grossly stricturing or ulcerating tumors. Extracolonic tumors developed in one young and two old patients. ConclusionThe characteristics of large bowel cancer in young Egyptian patients do not differ significantly from those in older patients. Despite the high incidence of large bowel cancer in young Egyptian patients, family history and pathologic features of tumors do not support a hereditary origin of colorectal cancer in this age group in Egypt.

Incidence of Small Bowel Cancer in the United States and Worldwide: Geographic, Temporal, and Racial Differences

To examine the demographic and geographic patterns of small bowel cancer incidence in the United States and worldwide. Incidence data from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 to 2000 were used to analyze the four histologic types of small bowel cancer, adenocarcinomas, carcinoid tumors, lymphomas, and sarcomas. International comparisons were made using data from Cancer Incidence in Five Continents (CIVIII). Geographic correlations between small bowel and both large bowel and stomach cancer incidence, were performed. Men had higher rates than women for all types of small bowel cancer. Blacks had almost double the incidence of carcinomas and carcinoid tumors compared to whites (10.6 vs. 5.6 per million people; 9.2 vs. 5.4 per million people, respectively). Small bowel cancer incidence has risen, with the greatest increase for carcinoid tumors (21%) and black men (120%). A geographic correlation between small and large bowel cancer incidence, but not small bowel and stomach cancer, were observed. Small bowel cancer incidence in the U.S. is higher in blacks compared to whites, particularly for carcinomas and carcinoid tumors. Small bowel cancer incidence is rising, particularly in black men. The geographic correlation between large and small bowel cancer suggests shared etiologies.

Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study

Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect. We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable. Follow-up consisted of 1939011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated. In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.

Effect of age, period of diagnosis and birth cohort on large bowel cancer incidence in a well-defined French population, 1976-1995.

The objective of this study was to present trends in colorectal cancer incidence by sex and subsite in a well-defined French population. All of the 4486 large bowel cancer cases registered between 1976 and 1995 in the Burgundy registry of digestive tract cancers was included in this study. Time trends in colorectal cancer incidence were analysed over the 1976-95 period. The effects of age, period and cohort were evaluated using a log-linear Poisson model. The incidence rates for right colon cancer increased over time: + 21.6% (95% CI: + 13.5; + 29.7) per 5-year period in males and +10.4% (95% CI: + 3.4; + 17.3) in females. Left colon cancer rates increased in males (+ 10.6% 95% CI: + 4.6; + 16.6). Left colon cancer in females and rectal cancer incidence rates did not significantly change. Between the 1901 cohort to the 1941 cohort, estimated cumulative risks for right colon cancer increased sharply. The increase was less marked for left colon and the cumulative risk for rectal cancer remained almost stable. Temporal trends were different by subsites and sexes. In conclusion, our results confirm the existence of different trends in colorectal cancer incidence between subsites and sexes. These differences probably reflect aetiological distinctions.

Is polyp removal primarlly responsible for the reduced incidence of large bowel cancer in younger people in the UK?

Is polyp removal primarlly responsible for the reduced incidence of large bowel cancer in younger people in the UK?

Is polyp removal primarlly responsible for the reduced incidence of large bowel cancer in younger people in the UK?

Is polyp removal primarlly responsible for the reduced incidence of large bowel cancer in younger people in the UK?

Tamoxifen and risk of large bowel cancer in women with breast cancer.

The increasingly consistent association between estrogen replacement therapy and colorectal cancer suggests that the anti-estrogen tamoxifen may also be associated with large bowel cancer incidence. Women with new diagnoses of breast cancer were identified from the Surveillance Epidemiology and End Results (SEER) Program, a set of geographically defined, population based cancer registries representing approximately ten percent of the U.S. population. Of 85,411 women with local or regional breast cancer diagnosed from 1983-90, 14,984 women were reported to have received hormonal therapy and 70,427 were not known to have received hormonal therapy. Subsequent cancer diagnoses were identified in this cohort beginning 6 months after initial breast cancer diagnosis until death, or December 31, 1994. Multivariate Cox proportional hazards models were used to estimate the risk of developing colorectal cancer and other second cancers according to hormonal therapy use. Over the follow-up period 793 colorectal, 2,648 contralateral breast, 506 endometrial, 250 ovarian, 98 gastric, and 1,765 other cancers were identified in the study cohort. While overall there was no association between hormonal therapy use and colorectal cancer (relative risk (RR) 1.09, 95% confidence interval (CI) 0.88-1.35), in the period five or more years after diagnosis, risk was increased significantly by about 50% (95% CI 1.00-2.15). As expected, based upon clinical trials data, cancers of the contralateral breast were significantly decreased, and cancers of the uterine endometrium were significantly increased. No other meaningful associations were observed. When women were excluded for whom hormonal therapy might represent therapy other than tamoxifen (premenopausal women and those who received chemotherapy), this did not meaningfully alter these estimates. The results of this large population based cohort study suggest that tamoxifen therapy may modestly increase risk of large bowel cancer in women, but only after 5 years following initiation of breast cancer therapy.

Aspirin and Breast Cancer: No Surprises Yet

In this issue of the Journal, a report by Egan et al. (/) from the Nurses' Health Study suggests that the use of aspirin does not reduce the incidence of breast cancer. Was there any reason to think that it would? In 1991, my colleagues and I reported in this Journal on the relation of nonsteroidal anti-inflammatory drug (NSAID) use to the risk of large-bowel cancer (2). Our analysis was stimulated by the results of experiments in rodents, in which a variety of NSAIDs reduced the incidence of chemically induced colon cancer, possibly through reducing prostaglandin synthesis (5-9). It had also been reported that sulindac, a nonaspirin NSAID, caused regression of adenomatous colon polyps in humans (10). Our hospital-based, case-control study of large-bowel cancer yielded a statistically significant relative risk estimate of 0.5 for continuing regular NSAID use, mostly aspirin, and we proposed that NSAID use might reduce colon cancer incidence in humans. Subsequent results from case-control and follow-up studies and from a randomized trial of aspirin as a prophylaxis against myocardial infarction have, for the most part, supported a reduction in the incidence of large-bowel cancer in NSAID users, with most of the information referring to aspirin (11-18). The

Starch intake and colorectal cancer risk: an international comparison

Intakes of starch, non-starch polysaccharides (NSPs), protein and fat have been compared with colorectal cancer incidence in 12 populations worldwide. There were strong inverse associations between starch consumption and large bowel cancer incidence (large bowel r = -0.70, colon r = -0.76). There was no significant relation with NSPs, although the association with large bowel cancer incidence was still significant when NSP was combined with resistant starch (RS) to give an estimate of fermentable carbohydrate (large bowel r = -0.52, colon r = -0.60). The relationships between starch, RS and NSPs and cancer incidence remained statistically significant after adjusting for fat and protein intakes. The strong inverse associations found here suggest a potentially important role for starch in protection against colorectal cancer and correspond with the hypothesis that fermentation in the colon is the mechanism for preventing colorectal cancer. Measures of both starch and NSPs need to be included in future epidemiological studies of diet and bowel cancer.

The effect of family history of cancer, religion, parity and migrant status on survival in colorectal cancer: Data from the Melbourne Colorectal Cancer Study

The association between 5-year survival and several risk factors was investigated in 705 histologically confirmed, new cases of colorectal adenocarcinoma as one aspect of a comprehensive population-based study of large bowel cancer incidence, aetiology and survival—the Melbourne Colorectal Cancer Study. 5-year survival was not influenced by the previously determined risk of a family history of colorectal cancer in near-relatives. Similarly, other previously determined risk factors of religion, number of children, age at birth of first child and migrant status did not influence survival.

Aspirin Use and Incidence of Large-Bowel Cancer in a California Retirement Community

Aspirin Use and Incidence of Large-Bowel Cancer in a California Retirement Community

Aspirin Use and Incidence of Large-Bowel Cancer in a California Retirement Community

Aspirin Use and Incidence of Large-Bowel Cancer in a California Retirement Community

NSAIDs reduce the incidence of large bowel cancer

NSAIDs reduce the incidence of large bowel cancer

Metabolism pattern of fecal bile acids in patients with large bowel cancer

The feca! bile acids were extracted from 21 patients with large bowel (colonic and rectal) cancer and 21 controls, and the bile acid composition and concentration were measured by gas chromatography. The total bile acid concentration and concentration of individual bile acids were not statistically different between colonic and rectal cancer. But the concentration and the percentage composition of secondary bile acids (deoxycholic and lithocholic acids) were significantly higher than that in controls. However the percentage composition of primary bile acids (cholic and chenocholic acids) were significantly lower than that in controls. The results suggest that incidence of large bowel cancer is closely related to the metabolism of fecal bile acids, and the etiology of colonic and rectal cancers may be the same.

The risks of cancers of the colon and rectum in relation to coffee consumption.

To assess whether recent coffee consumption is related to the incidence of large bowel cancer, the authors analyzed data from a multipurpose hospital-based case-control study of several cancers, conducted from 1978 to 1986 in Boston, Massachusetts, New York, New York, Philadelphia, Pennsylvania, and Baltimore, Maryland: 717 cases of colon cancer and 538 cases of rectal cancer were compared with 3,883 controls admitted for nonmalignant and malignant illnesses unrelated to coffee use. Relative risks were estimated by multiple logistic regression with allowance for age, sex, cigarette smoking, alcohol consumption, and several other potential confounding factors. Overall, relative to the consumption of one cup of coffee per day, the estimated relative risk of colon cancer for consumption of up to four cups per day in the period before admission was close to 1.0; for consumption of five or more cups per day, it was 0.6 (95% confidence interval 0.4-0.8). The results were consistent in men and women, and similar results were obtained whether the measure of consumption was use in the year before admission or use three years before admission. For rectal cancer, some relative risk estimates were elevated, particularly in men, but there was no consistent pattern of association, nor was there a trend of increasing risk with increasing consumption. The data suggest that recent coffee consumption is not related to an increased risks of large bowel cancer and that heavy coffee consumption may reduce the risk of colon cancer. A biologic rationale for such a reduction has not been established.

Meat, starch, and nonstarch polysaccharides and large bowel cancer

Starch and nonstarch polysaccharides enter the large gut where they are available for fermentation by the bacterial flora. The effect of fermentation on nitrogen metabolism, the supply of nutrients to the mucosa, and the carcinogen production is discussed in relation to epidemiological associations between dietary intake and large bowel cancer incidence.

Serum cholesterol and large bowel cancer. A case-control study.

A case-control study of the relationship of serum cholesterol to large bowel cancer incidence was performed for 245 members of the Kaiser Permanente Medical Care Program in northern California. Five controls were obtained for each case, matched for age, sex, race, and time of examination. The mean serum cholesterol levels of cases were not significantly different from those of controls for all colorectal cancers, right-sided colon cancers, and left-sided colon cancers. Analysis by quartiles of serum cholesterol level suggested neither a direct nor an inverse relationship between serum cholesterol and large bowel cancer, and there was no evidence of a threshold value below which the risk of cancer increased. The study did not support the findings from other studies of an inverse relationship between serum cholesterol and large bowel cancer.

Screening for asymptomatic bowel cancer in general practice.

General practitioners screened 4284 asymptomatic people aged over 40 to compare the incidence of large bowel cancer and polyps with a control general practice (4288 patients). Compliance was best in young women (60%), and overall it was 42%. Twenty six patients who had a positive Haemoccult test result (1.5% of those screened) were examined by colonoscopy and 10 had polyps. The incidence of cancers in the two groups was similar but in the control (unscreened patients) practice no polyps were found.

Risks of intestinal cancer in Crohn's disease.

This review describes the principal features of the three studies that have established clearly that patients in the U.S.A. or the U.K. who have long-standing (greater than 7 years) Crohn's colitis are at increased risk (up to 20-fold) of developing large bowel cancer. In addition, it emphasizes that there are no data on the extent of this risk in patients in other countries, and also that the magnitude of the risk of cancer of the small intestine in Crohn's disease is unknown. Despite the increased incidence of large bowel cancer in long-standing Crohn's colitis in the U.S.A. or the U.K., the total number of such patients is small, as is the number in which the colonic carcinoma will occur. However, careful supervision is advised for the small group at risk, despite the limitations of current methods for the early detection of cancer of the large intestine.

Fecal steroids and urinary volatile phenols in four Scandinavian populations.

Population samples from 4 study areas showing a 3-fold variation in large bowel cancer incidence were investigated for fecal bile acid loss and concentration, fecal neutral steroid loss and concentration, and urinary loss of volatile phenols. Each sample consisted of 30 randomly selected men, aged 50-59 years. Daily loss of bile acids was found to be identical in the 4 areas, but due to differences in fecal bulk, the fecal bile acid concentration varied, showing a positive correlation with large bowel cancer incidence. No significant difference between the 4 populations emerged with regard to fecal neutral steroids or urinary volatile phenols.