Colorectal Cancer In Men Research Articles

Light Alcohol Drinking and Risk of Cancer: A Meta-Analysis of Cohort Studies.

PurposeThe purpose of this study was to determine whether light alcohol drinking increases the risk of cancer by using a meta-analysis of cohort studies because the newly revised 2015 European Code against Cancer fourth edition on alcohol and cancer was based on critical flaws in the interpretation and citation of the previous meta-analyses.Materials and MethodsPubMed and EMBASE were searched in April, 2016. Two authors independently reviewed and selected cohort studies on the association between very light (≤ 0.5 drink/day), light (≤ 1 drink/day), or moderate drinking (1-2 drinks/day) and the risk of cancer incidence and mortality. A pooled relative riskwith its 95% confidence intervalwas calculated by a random-effects meta-analysis. Main outcome measures were cancer incidence and mortality.ResultsA total of 60 cohort studies from 135 articles were included in the final analysis. Very light drinking or light drinking was not associated with the incidence of most cancers except for female breast cancer in women and male colorectal cancer. Conversely, light drinking was associated with a decreased incidence of both female and male lung cancer significantly and both female and male thyroid cancer marginally significantly. Moderate drinking significantly increased the incidence of male colorectal cancer and female breast cancer,whereas it decreased the incidence of both female and male hematologic malignancy.ConclusionWe found that very light or light alcohol drinking was not associated with the risk of most of the common cancers except for the mild increase in the incidence of breast cancer in women and colorectal cancer in men.

Highlights of This Issue

The prevalence of metabolically unhealthy phenotype in normal-weight adults is 30%, but few studies have explored the association between metabolic phenotype and colorectal cancer incidence in normal-weight individuals. Liang and colleagues used data from the Women's Health Initiative to study this association. Women with one or none of the four components (elevated triglycerides, low HDL-C, elevated blood pressure, and elevated fasting glucose) were classified as metabolically healthy. Among normal-weight women, those who were metabolically unhealthy had higher risks of colorectal cancer compared with those who were metabolically healthy.Evidence suggests that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer (CRC). Park and colleagues tested whether the inverse associations between NSAID use and CRC is similarly observed across sexes and five racial/ethnic groups. Use of aspirin and other NSAIDs was associated with a lower incidence of CRC in men but not in women. Further, the findings suggest that the benefit of NSAIDs for CRC may be strongest for white men and generalizes to African American, Japanese, and Latino but not to Native Hawaiian men.Percent breast density (PBD) is a strong risk factor for breast cancer that is influenced by several other factors. Alcohol consumption is associated with an increased risk of breast cancer with an uncertain association with PBD. Ziembicki and colleagues present a systematic review and meta-analysis to examine the association of alcohol consumption with PBD. Meta-analysis of 11 studies found a statistically significant difference in PBD when comparing the highest with the lowest alcohol consumption level, suggesting a positive association between alcohol intake and PBD.Farris and colleagues examined the associations between postdiagnosis physical activity and change from prediagnosis physical activity with quality of life (QoL) in prostate cancer survivors. In this study, prostate cancer survivors were followed over seven years with interviews/questionnaires to capture QoL outcomes. Both total and recreational physical activities were positively associated with physical QoL. Men who met physical activity guidelines had significantly higher physical and mental QoL scores compared with those who did not meet guidelines. Further, those who adopted and met guidelines had increased QoL, while those who relapsed experienced decreased QoL.

Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

Evidence has accumulated that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer. We tested whether the inverse associations between NSAIDs and colorectal cancer is similarly observed across sexes and five racial/ethnic groups (Japanese, Latino, African American, Native Hawaiian, and white) in the Multiethnic Cohort (MEC) Study. During a mean follow-up of 16.1 years, we identified 4,882 invasive incident colorectal cancer cases among 183,199 eligible participants. Cox proportional hazards models were used to calculate HRs and 95% confidence intervals (CI). Use of aspirin and other NSAIDs was associated with a lower incidence of colorectal cancer in men (HR = 0.77; 95% CI, 0.69-0.86 for current vs. never users of aspirin) but not in women (Pinteraction = 0.005). Among male current users, a reduced risk was observed with ≥6 years of aspirin or total NSAID use. The inverse association with current NSAID use in men was observed in all racial/ethnic groups, except for Native Hawaiians, and was stronger in whites. Our findings suggest that the benefit of NSAIDs for colorectal cancer may be strongest for white men and generalizes to African American, Japanese, and Latino, but not to Native Hawaiian men. The lack of inverse association observed in women and Native Hawaiian men in the MEC should be interpreted with caution. As only very few ethnic/racial groups are likely to be represented in trials of NSAIDs and colorectal cancer, it is important to conduct prospective observational studies in various populations to test the generalizability of their results. Cancer Epidemiol Biomarkers Prev; 26(2); 162-9. ©2016 AACR.

Abstract IA12: Food and nutrition and colorectal cancer: Patterns for prevention

Abstract Diet is a complex environmental exposure. Evidence from epidemiologic studies and experimental studies in animal models has indicated that diet and components of diet have an important role in modulating risk of colorectal cancer (CRC). The WCRF/AICR Continuous Update Project Report routinely evaluates epidemiologic studies of diet and cancer risk. In the 2011 report on diet and CRC, the reviewers determined that the evidence was convincing that consumption of foods containing dietary fiber protect against CRC and intake of red meat, processed meat, ethanol from alcoholic beverages are causes of CRC. The evidence that physical activity protects against colon cancer and that body fatness and abdominal fatness (consequences of diet and inactivity) contribute to CRC was also labeled as convincing. Consumption of garlic, milk, and calcium was reported as probably protective, while the evidence was limited that non-starchy vegetables, fruits and foods containing vitamin D protect against CRC, or that foods containing iron, and also cheese, foods containing animal fats, and foods containing sugars are causes of CRC. Experimental studies in animals and randomized controlled trials in humans have helped to expand our understanding of the wide array of mechanisms by which dietary constituents may cause or prevent CRC, including through modulation of inflammation and immune function, carcinogen metabolism, hormone and growth-factor regulation, DNA repair capacity, cell-cycle control, and proliferation and apoptosis. Increasingly, the importance of diet-gut microbe interactions are being recognized; diet can influence the amount and types of microbes present in the gut, and gut microbial metabolism of dietary constituents produces compounds that may have positive or adverse effects on CRC risk. In the past decade, there has been a growing emphasis on identifying dietary patterns associated with lower cancer risk, with the recognition that, although many dietary constituents have been suggested to have preventive effects, they are not consumed in isolation and the role of diet in cancer prevention might be maximized when dietary patterns are considered versus any one single component. Diet quality has been studied using statistical clustering or factor analysis within a data set, an agnostic approach that can potentially identify new patterns important to CRC risk. Another approach is to use diet quality scoring systems defined a priori. These are derived based on emerging evidence of diet and disease risk, have algorithms that can be applied across multiple data sets, and provide the potential for more direct translation to public health messages. A variety of diet quality indices have been developed, including Healthy Eating Index (HEI-2005; HEI-2010), Alternative Healthy Eating Index 2010 (AHEI), the Dietary Approaches to Stop Hypertension (DASH) index, and indices based on the Mediterranean diet. A role for diet quality in CRC risk has been reported in the context of several prospective cohort studies. Reedy et al. (Am. J. Epidemiol., 2008), testing associations between scores on 4 diet quality indices and CRC risk in the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study, reported that higher scores on all 4 indices were associated with a lower risk of CRC in men, but that, in women, only the HEI-2005 score showed an association. In the same NIH-AARP population, 4 different methods of indexing adherence to the DASH diet were associated with lower risk of CRC in men, but only 2 of the DASH indexing methods were associated with a significantly lower CRC risk in women (Miller et al, Am. J. Clin Nutr., 2013). Recently, in the Women's Health Initiative Observational Study, a cohort of postmenopausal US women, higher HEI-2010 diet quality index scores were associated with lower risk of CRC and, similarly, higher DASH diet quality index scores were associated with a 22%–28% lower risk of CRC (Vargas et al, Am. J. Epidemiol., 2016). In these studies, indices of Mediterranean-diet adherence have been less consistently associated with CRC risk. Future use of experimental diets in animal studies that capture the complexity of the human diets may help to further characterize the effectiveness of these diet patterns and the components of them. Understanding the impact of the totality of complex diet patterns is needed further inform approaches for CRC prevention. Citation Format: Johanna W. Lampe. Food and nutrition and colorectal cancer: Patterns for prevention. [abstract]. In: Proceedings of the AACR Special Conference on Colorectal Cancer: From Initiation to Outcomes; 2016 Sep 17-20; Tampa, FL. Philadelphia (PA): AACR; Cancer Res 2017;77(3 Suppl):Abstract nr IA12.

Changing socioeconomic inequalities in cancer incidence and mortality: Cohort study with 54 million person-years follow-up 1981-2011.

Cancer is increasingly responsible for the mortality gap between high and low socioeconomic position groups in high-income countries. This study investigates which cancers are contributing more to socioeconomic gaps in mortality and how this changes over time.New Zealand census data from 1981, 1986, 1991, 1996, 2001 and 2006, were linked to three to five years of subsequent mortality and cancer registrations, resulting in 54 and 42 million years of follow-up cancer incidence and mortality, respectively. Age- and ethnicity-standardised cancer mortality rates and the slope index of inequality (SII) by income were calculated.The contribution of cancer to absolute inequalities (SII) in mortality increased from 16 to 27% for men and from 12 to 31% for women from 1981-84 to 2006-11, peaking in 1991-94 for men and in 1996-99 for women and then levelling off, parallel to peaks in lung cancer inequalities. Lung cancer was the largest driver of cancer inequality trends (49% of the cancer mortality gap in 1981-84 to 33% in 2006-11 for men and 32 to 33% for women) followed by colorectal cancer in men (2 to 11%) and breast cancer in women (declining from 44 to 13%). Women in the lowest income quintile experienced no decline in cancer mortality.The contribution of cancer to income inequalities in all-cause mortality has expanded in this high-income country. Action to address socioeconomic inequalities should prioritise equitable tobacco control, obesity control and improved access to cancer screening, early diagnosis and high quality treatment for those with the lowest incomes.

Intake of different types of red meat, poultry, and fish and incident colorectal cancer in women and men: results from the Malmö Diet and Cancer Study

ABSTRACTBackground: Colorectal cancer (CRC) is considered one of the most common forms of cancer in the Western world. High intake of red and processed meat is considered to increase CRC development.Objective: This study examined associations between intake of red meats, poultry, and fish and incident CRC, and if weight status modifies the associations.Design: In the Malmö Diet and Cancer Study, dietary data was collected through a modified diet history method. Via the Swedish Cancer Registry, 728 cases of CRC were identified during 428 924 person-years of follow-up of 16 944 women and 10 987 men.Results: Beef intake was inversely associated with colon cancer. However, in men high intake of beef was associated with increased risk of rectal cancer. High intake of pork was associated with increased incidence of CRC, and colon cancer. Processed meat was associated with increased risk of CRC in men. Fish intake was inversely associated with risk of rectal cancer. No significant interactions were found between different types of meat and weight status.Conclusions: Findings suggest that associations between meat intake and CRC differ depending on meat type, sex, and tumor location in the bowel. Weight status did not modify observed associations.

Serum CA125 concentration as a predictor of peritoneal dissemination of colorectal cancer in men and women

Peritoneal dissemination (PD) of cancer is difficult to diagnose. Previous reports have shown that carbohydrate antigen 125 (CA125) is a sensitive marker of PD of gastric cancer. However, CA125 has not been evaluated as a marker of colorectal cancer (CRC), and its accuracy in men is controversial. The aim of this study was to compare the ability of CA125 and carcinoembryonic antigen (CEA) to predict PD of CRC in men and women.Preoperative CA125 and CEA concentrations were measured in 853 people (510 men, 343 women) over 10 years. PD was confirmed intraoperatively in 57 patients. The predictive ability was compared between CA125 and CEA.Compared with CEA, CA125 concentration had a lower sensitivity, higher specificity, and diagnostic accuracy, and significantly greater area under the curve. Further analysis of CA125's sensitivity and specificity among CEA-negative group (n = 514) showed acceptable sensitivity (57.1%) and good specificity (92.0%). In men and women, CA125 concentration did not increase with stage from I to IV unless PD was present (P < 0.001). CEA concentration was increased in women with metastasis with PD (P < 0.001) or without PD (P < 0.001), but was increased only in men with metastasis without PD (P < 0.01). CA125 concentration correlated with PD grade for men and women, but CEA concentration correlated with grade only in women.When analyzed according to the primary tumor site, CA125 concentration in men did not differ between patients with the primary site in the right or left colon, or the rectum, regardless of PD status. By contrast, CA125 concentration differed between PD-positive and PD-negative patients with cancer in the right (P < 0.001) or left (P < 0.001) colon but not in the rectum. CEA concentration in men did not differ according to the primary site or PD status. In women, CA125 and CEA concentrations differed significantly between the PD-positive and PD-negative groups in patients with the primary tumor in the right (P < 0.001) or left (P < 0.001) colon; tumor sites did not differ between the PD-positive and PD-negative groups.These findings suggest that CA125 is a better tumor marker than CEA for predicting PD of CRC in both men and women.

Risk factors for cancer development in type 2 diabetes: A retrospective case-control study.

BackgroundThe risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancer – difficult within regular outpatient diabetes care - is of utmost importance for patients’ survival. The aim of this multicenter, retrospective (years 1998–2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting.MethodsIn the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified. The control group consisted of 203 strictly age- and gender matched subjects with type 2 diabetes without cancer. Factors associated with diabetes: disease duration, antidiabetic medications use and metabolic control of diabetes were analyzed. Also other variables: BMI (body mass index), smoking habits, place of residence and comorbidities were included into analysis.ResultsThe most prevalent malignancies in men and women together were breast cancer (20.7 %) and colorectal cancer (16.3 %). HbA1c (hemoglobin A1c) level ≥8.5 %, obesity and insulin treatment in dose-dependent and time-varying manner demonstrated significant association with increased risk of malignancy, while metformin use was associated with a lower risk of cancer. Diabetes duration, comorbidities, smoking habits, place of residence and aspirin use did not show significant association with risk of malignancy.ConclusionsIn the outpatient setting the obese patients with poorly controlled insulin treated type 2 diabetes mellitus should be rigorously assessed towards malignancies, particularly breast cancer in women and colorectal cancer in men.

Cancer mortality gap between black and white individuals narrows, but disparities remain

Although substantial progress has occurred in reducing the mortality gap between African American and white patients who have been diagnosed with certain cancers, gaps have widened or remained the same for both breast cancer in women and colorectal cancer in men, according to a new report published by the ACS. The report appears in both CA: A Cancer Journal for Clinicians and its consumer version, Cancer Facts & Figures for African Americans: 2016–2018, providing the most recent data regarding cancer incidence, mortality, survival, screening, and risk factors for African American individuals.1, 2 A continuous reduction in cancer death rates for African Americans has occurred since the early 1990s, resulting in more than 300,000 cancer deaths averted over the past 20 years. In addition, death rates for this group have dropped faster during the most recent time period compared with whites for all cancers combined, including death rates for colorectal cancer in women and lung and prostate cancers. Meanwhile, the racial gap in death rates has widened for breast cancer in women and remained constant for colorectal cancer in men. The authors of the report state that the gap is likely the result of inequalities in access to health care, which includes both screening and treatment.

Changing Epidemiology of Common Cancers in Southern Iran, 2007-2010: A Cross Sectional Study.

We have evaluated the ever changing epidemiology of cancers in Fars province, Iran since the re-establishment of Fars cancer registry. Based on the collected data from all related sources in Fars province from 2007–2010 we calculated the cancer age-standardized rates per 100,000 person-years (ASRs). The results are presented as incidence rates of cases by site according to the International Classification of Diseases for Oncology (ICD-O), sex, age, crude rate, and ASRs. In women the total ASR was 41.70 per 100,000 from 1985–1989 which had increased to 55.50 and 95.46 during 1998–2002 and 2007–2010. The incidence of breast cancer in women during 2007–2010 was about two and four times higher than 1998–2002 and 1985–1989. The incidence of colorectal cancer in women during 2007–2010 was about three and five times higher than 1998–2002 and 1985–1989. In men the total ASR was 62.9 per 100,000 in 1985–1989 that increased to 64.50 and 101.48 during 1998–2002 and 2007–2010. Although stomach cancer was the most common cancer among men during 1985–1989 and 1998–2002, but in recent study bladder cancer was the most common cancer among men in Fars province. The incidence of colorectal cancer in men during 2007–2010 was about three times higher than 1998–2002 and 1985–1989. This study shows growing incidence of cancer in southern Iran. The colorectal cancer in both genders had increased and its pattern is similar to western countries. In men, bladder and prostate cancers had a growing rate and the incidences of these cancers in the present study were greater than stomach cancer.

Secondary malignancies in chronic myeloid leukemia patients after imatinib-based treatment: long-term observation in CML Study IV.

Treatment of chronic myeloid leukemia (CML) has been profoundly improved by the introduction of tyrosine kinase inhibitors (TKIs). Long-term survival with imatinib is excellent with a 8-year survival rate of ∼88%. Long-term toxicity of TKI treatment, especially carcinogenicity, has become a concern. We analyzed data of the CML study IV for the development of secondary malignancies. In total, 67 secondary malignancies were found in 64 of 1525 CML patients in chronic phase treated with TKI (n=61) and interferon-α only (n=3). The most common malignancies (n⩾4) were prostate, colorectal and lung cancer, non-Hodgkin's lymphoma (NHL), malignant melanoma, non-melanoma skin tumors and breast cancer. The standardized incidence ratio (SIR) for all malignancies excluding non-melanoma skin tumors was 0.88 (95% confidence interval (0.63–1.20)) for men and 1.06 (95% CI 0.69–1.55) for women. SIRs were between 0.49 (95% CI 0.13–1.34) for colorectal cancer in men and 4.29 (95% CI 1.09–11.66) for NHL in women. The SIR for NHL was significantly increased for men and women. An increase in the incidence of secondary malignancies could not be ascertained. The increased SIR for NHL has to be considered and long-term follow-up of CML patients is warranted, as the rate of secondary malignancies may increase over time.

Does Ovarian Stimulation for In Vitro Fertilization Affect Colorectal Cancer Risk

The greater age-adjusted risk for colorectal cancer in men than in women is often attributed to estrogen's protective effect in premenopausal women. In addition, postmenopausal hormone use has been associated with reduced colorectal cancer risk. This effect of reproductive hormones has raised the question of whether ovarian stimulation for in vitro fertilization (IVF) can affect colorectal cancer risk. In a nationwide Dutch cohort …

Seasonal mortality variations of cardiovascular, respiratory and malignant diseases in the City of Belgrade

The main purpose of this paper is to examine seasonal variations in mortality resulting from cardiovascular diseases, respiratory diseases and cancer, as well as to provide a review of environmental factors underlying such phenomenon. The herein presented study was conducted on the territory of Belgrade based on the data on daily mortality rates obtained from the Institute of Public Health in Belgrade for the period 2009-2014, as well as the data on annual mortality rates provided by the Statistical Office of the Republic of Serbia for the period 2000-2014. The analysis of mortality variations was performed by the use of Theil-Sen method, smooth trend method and cubic spline interpolation, whereas desriptive tools, such as winter/summer ratio and dissimilarity index, were used to examine the seasonal pattern. According to the Institute of Public Health, over 113430 deaths were registered in Belgrade area for the period 2009-2014, out of which 53.25% is attributed to cardiovascular diseases, 4.01% to respiratory diseases and 27.50% to cancer. The annual mortality rates caused by cardiovascular diseases and cancer on the territory of Belgrade are among the highest ranking in Europe. The leading causes of death in the observed period included: cardiomyopathy, heart attack and stroke with accompanying complications, breast cancer in women, prostate and colorectal cancer in men, lung and bronchus cancer for both genders, and chronic obstructive pulmonary disease. Cardiovascular and respiratory mortality rates are significantly higher among people aged 65 and over, whereas more than one third of deaths caused by cancer is observed among younger people aged between 45 and 64 years. Research results show that seasonal variations were most pronounced in mortality resulting from cardiovascular and respiratory diseases, with highest mortality rates recorded in February and March and lowest during the summer season. Also, the number of deaths due to cardiovascular diseases increased twice, namely at the end of June and October, which is assumed to be the result of sudden temperature changes. Nonetheless, no such seasonal variations were observed in mortality caused by cancer. Seasonal variations in mortality resulting from cardiovascular diseases also indicate gender differences, which is why sudden temperature changes in interim periods affect more women than men. As regards deseasonalized trend, mortality caused by cardiovascular diseases stagnates, while mortality caused by cancer and mortality caused by respiratory diseases records moderate to severe increase. This is a uniform trend in almost all municipalities in Belgrade, with average mortality rates being higher in central zones than in suburbs over the last 15 years, particularly mortality caused by cancer. A slight increase in the overall mortality can also be attributed to aging of the population, which cannot be verified due to lack of available accurate data on the average age structure of Belgrade population for the observed period. A better understanding of seasonal variations in mortality caused by chronic non-communicable diseases can contribute to improving the population health care and rising awareness of the population concerning greater health care in changeable weather conditions due to global warming and climate change. These findings can also enhance preventive action on environmental risk factors that are not limited exclusively to weather conditions, such as air pollution.

Risk factors for colorectal cancer in man induce aberrant crypt foci in rats: Preliminary findings

ABSTRACTEpidemiological studies have demonstrated clear associations between specific dietary and environmental risk factors and incidence of colorectal cancer, but the mechanisms responsible for these associations are not known. An animal model could facilitate such an understanding. Both genotoxic and nongenotoxic carcinogens induce aberrant crypt foci (ACF) in the colons of F344 rats. F344 rats were provided with diets that contained putative risk factors for CRC: low calcium and low vitamin D, high iron, high fructose, and decreased light (UV) exposure or a control diet for 14 wk. The rats were then assessed with biochemical measures and by topological examination for evidence of colon abnormalities. Circulating ionized calcium was decreased from 2.85 to 1.69 mmol/L, and ACF were increased from 0.7 to 13.6 lesions/colon (both P < 0.001). Rats exposed to the multiple environmental conditions associated with colon cancer, developed ACF similar to the heterogeneous or ill-defined ACF in the human colon. Heterogeneous ACF are the most frequently seen in humans and are also seen in rats shortly after exposure to the non-genotoxic colon carcinogen, dextransulfate sodium. The rodent model could be used to assess the pathways from diet and environment to colon cancer and to provide guidance for clinical studies.

Isoflavone and Soyfood Intake and Colorectal Cancer Risk: A Case-Control Study in Korea.

We aimed to assess the relationship between dietary soyfood and isoflavone intake and colorectal cancer risk in a case-control study. A total of 901 colorectal cancer cases and 2669 controls were recruited at the National Cancer Center, Korea. A semi-quantitative food frequency questionnaire was used to assess the usual dietary habits, and the isoflavone intake level was estimated from five soyfood items. A high intake of total soy products, legumes, and sprouts was associated with a reduced risk for colorectal cancer in men and women, although the middle quartiles of intake of total soy products were associated with an elevated risk. In contrast, a high intake of fermented soy paste was associated with an elevated risk for colorectal cancer in men. The groups with the highest intake quartiles of isoflavones showed a decreased risk for colorectal cancer compared to their counterparts with the lowest intake quartiles in men (odds ratio (OR): 0.67, 95% confidence interval (CI): 0.51–0.89) and women (OR: 0.65, 95% CI: 0.43–0.99). The reduced risk for the highest intake groups persisted for distal colon cancer in men and rectal cancer in women. The association between soyfood intake and colorectal cancer risk was more prominent among post-menopausal women than pre-menopausal women. In conclusion, a high intake of total soy products or dietary isoflavones was associated with a reduced risk for overall colorectal cancer, and the association may be more relevant to distal colon or rectal cancers.

Trends in major cancer mortality in Korea, 1983–2012, with a joinpoint analysis

BackgroundCancer is the leading cause of death in Korea. This study aims to examine changes in temporal trends in major cancer mortality. Materials and methodsMortality data for 1993–2012 were obtained from the Korean Statistics Information Service(KOSIS) database and age-standardized to the 2000 Korean population. Joinpoint analysis was used to identify significant changes in trends over time. The annual percentage rate change (APC) was computed for each segment of the trends. ResultsThe age-standardized mortality rates (ASR) for all cancer sites combined decreased by 9.1% and 1.1% in men and women, respectively, from 1983 to 2012. ASRs from cancers of esophagus, stomach, and liver decreased substantially, whereas ASRs from cancer for all other sites increased markedly. ASRs for all cancer sites combined increased until 1994 and thereafter decreased significantly in both genders except for the period of 1998–2002 (APC: −5.5% for men [p<0.05] and 0.07% for women). ASRs for esophagus and liver cancers increased until the early 1990s and thereafter declined, leading to significant decreases [p<0.05] for esophagus cancer (APC: −1.85% for men and −3.82% for women) and liver cancer (APC: −1.55% for men and −0.56% for women) in 1983–2012. ASRs for stomach cancer declined (APC: −4.06% for men and −4.07% for women) except for 1990–1994. ASRs for uterine cancer peaked in 2003 and then declined (APC: 2.85%). ASRs increased significantly until 2002 for colorectal cancer in men (APC: 7.52%) and lung cancer in both genders. The most consistently upward trend was observed for non-Hodgkin’s lymphoma (APC: 3.55% for men and 5.29% for women; number of joinpoints=0). The greatest ASR increase was seen for prostate cancer for which mortality increased until 2002 at an APC of 12.56%. ConclusionWhile mortality decreased significantly for esophagus, stomach and liver cancers in recent decades in Korea, challenges still remain for many other cancers, especially pancreatic, breast, and prostate cancers and non-Hodgkin’s lymphoma. Surveillance of cancer mortality trends can lend valuable insights as to the prevention and control of cancer. Public health promotion efforts to control cancer such as lowering smoking rate and obesity could reduce the burden of cancer in many sites.

Digestive cancers and occupational asbestos exposure: incidence study in a cohort of asbestos plant workers

ObjectiveThe aim of our study was to estimate the incidence of digestive cancers within a cohort of asbestos-exposed workers.MethodsOur study was based on a cohort of 2024 participants occupationally exposed...

Alcohol Drinking, Cigarette Smoking and Risk of Colorectal Cancer in the Korean Multi-center Cancer Cohort.

Background:The present study aimed to examine the association between cigarette smoking, alcohol consumption and colorectal cancer risk among Korean adults.Methods:Data from the Korean Multi-center Cancer Cohort between 1993 and 2005 were analyzed. The study population comprised 18,707 subjects aged older than 20 years old. The subjects were followed until December 31, 2011 (median follow-up of 11.2 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence intervals of cigarette smoking and alcohol consumption for colorectal cancer risk.Results:In men, longer duration and higher average amount of alcohol consumption were associated with elevated risk of colorectal cancer (HR 1.93 [1.17–3.18] for ≥ 30 years of consumption compared to non-drinkers; HR 2.24 [1.31–3.84] for ≥ 30 g/d). Former smokers showed a non-significantly elevated risk of colorectal cancer in men. There was no apparent association between alcohol consumption or cigarette smoking and colorectal cancer risk among women.Conclusions:Alcohol consumption was associated with increased colorectal cancer risk among Korean men, and both a longer duration and a higher amount of consumption were associated with elevated risk.

Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts.

Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer.

Incident cancers attributable to alcohol consumption in Germany, 2010.

Germany lacks an up-to-date assessment of the cancer burden attributable to alcohol. Therefore, cancer incidence attributable to this exposure was estimated for colorectal, liver, breast, and upper aerodigestive tract (UADT) cancer. Additionally, the impact of alcohol on UADT cancer was analyzed by smoking status, to account for synergistic interactions between these two risk factors. Alcohol consumption and smoking prevalence from a nationwide survey in Germany 2008-2011 were combined with relative risks of incident cancer from meta-analyses to obtain population attributable risks (PARs), indicating the proportion of cancers that could be avoided by eliminating a risk factor. Each PAR was multiplied with the respective cancer incidence for 2010 to calculate the absolute number of attributable cases. In Germany, for the year 2010, approximately 13,000 incident cancer cases could be attributed to alcohol consumption (3% of total cases). PAR was highest for esophageal cancer (men: 47.6% and women: 35.8%) and lowest for colorectal cancer in men (9.7%) and breast cancer in women (6.6%). Among women, moderate consumption levels account for the greatest PAR overall, whereas heavy drinking contributes considerably to overall PAR among men. Additionally, moderate-to-heavy drinking among smokers substantially contributes to the overall PAR of UADT cancers compared to drinking among non-smokers. In Germany, a substantial proportion of cases of common cancers can be attributed to alcohol consumption, even when consumed at moderate levels. Alcohol consumption with concurrent tobacco smoking is especially important for cancers of the UADT. These findings strengthen the rationale for prevention measures that address exposure at all levels.