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Heterogeneity of colorectal cancer risk by tumour characteristics: Large prospective study of UK women.

Abstract

Associations between behavioural and other personal factors and colorectal cancer risk have been reported to vary by tumour characteristics, but evidence is inconsistent. In a large UK-based prospective study we examined associations of 14 postulated risk factors with colorectal cancer risk overall, and across three anatomical sites and four morphological subtypes. Among 1.3 million women, 18,518 incident colorectal cancers were identified during 13.8 (SD 3.4) years follow-up via record linkage to national cancer registry data. Cox regression yielded adjusted relative risks. Statistical significance was assessed using correction for multiple testing. Overall, colorectal cancer risk was significantly associated with height, body mass index (BMI), smoking, alcohol intake, physical activity, parity and menopausal hormone therapy use. For smoking there was substantial heterogeneity across morphological types; relative risks around two or greater were seen in current smokers both for signet ring cell and for neuroendocrine tumours. Obese women were also at higher risk for signet ring cell tumours. For adenocarcinomas, the large majority of colorectal cancers in the cohort, all risk factor associations were weak. There was little or no heterogeneity in risk between tumours of the right colon, left colon and rectum for any of the 14 factors examined. These epidemiological findings complement an emerging picture from molecular studies of possible different developmental pathways for different tumour types.

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  • Authors+Show Affiliations

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    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom. Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. REDISSEC, Health Services Research on Chronic Patients Network, Madrid, Spain.

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    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

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    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    ,

    Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, United Kingdom.

    Source

    International journal of cancer 140:5 2017 Mar 01 pg 1082-1090

    MeSH

    Adenocarcinoma
    Alcohol Drinking
    Carcinoma
    Colorectal Neoplasms
    Contraceptives, Oral, Hormonal
    Exercise
    Female
    Follow-Up Studies
    Hormone Replacement Therapy
    Humans
    Menopause
    Middle Aged
    Neuroendocrine Tumors
    Obesity
    Organ Specificity
    Proportional Hazards Models
    Prospective Studies
    Reproductive History
    Risk
    Smoking
    Surveys and Questionnaires
    United Kingdom

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    27859268

    Citation

    Burón Pust, Andrea, et al. "Heterogeneity of Colorectal Cancer Risk By Tumour Characteristics: Large Prospective Study of UK Women." International Journal of Cancer, vol. 140, no. 5, 2017, pp. 1082-1090.
    Burón Pust A, Alison R, Blanks R, et al. Heterogeneity of colorectal cancer risk by tumour characteristics: Large prospective study of UK women. Int J Cancer. 2017;140(5):1082-1090.
    Burón Pust, A., Alison, R., Blanks, R., Pirie, K., Gaitskell, K., Barnes, I., ... Green, J. (2017). Heterogeneity of colorectal cancer risk by tumour characteristics: Large prospective study of UK women. International Journal of Cancer, 140(5), pp. 1082-1090. doi:10.1002/ijc.30527.
    Burón Pust A, et al. Heterogeneity of Colorectal Cancer Risk By Tumour Characteristics: Large Prospective Study of UK Women. Int J Cancer. 2017 Mar 1;140(5):1082-1090. PubMed PMID: 27859268.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Heterogeneity of colorectal cancer risk by tumour characteristics: Large prospective study of UK women. AU - Burón Pust,Andrea, AU - Alison,Rupert, AU - Blanks,Roger, AU - Pirie,Kirstin, AU - Gaitskell,Kezia, AU - Barnes,Isobel, AU - Gathani,Toral, AU - Reeves,Gillian, AU - Beral,Valerie, AU - Green,Jane, AU - ,, PY - 2016/09/16/received PY - 2016/11/01/revised PY - 2016/11/08/accepted PY - 2016/11/20/pubmed PY - 2017/5/16/medline PY - 2016/11/19/entrez KW - colorectal cancer KW - risk factors KW - smoking KW - subtype SP - 1082 EP - 1090 JF - International journal of cancer JO - Int. J. Cancer VL - 140 IS - 5 N2 - Associations between behavioural and other personal factors and colorectal cancer risk have been reported to vary by tumour characteristics, but evidence is inconsistent. In a large UK-based prospective study we examined associations of 14 postulated risk factors with colorectal cancer risk overall, and across three anatomical sites and four morphological subtypes. Among 1.3 million women, 18,518 incident colorectal cancers were identified during 13.8 (SD 3.4) years follow-up via record linkage to national cancer registry data. Cox regression yielded adjusted relative risks. Statistical significance was assessed using correction for multiple testing. Overall, colorectal cancer risk was significantly associated with height, body mass index (BMI), smoking, alcohol intake, physical activity, parity and menopausal hormone therapy use. For smoking there was substantial heterogeneity across morphological types; relative risks around two or greater were seen in current smokers both for signet ring cell and for neuroendocrine tumours. Obese women were also at higher risk for signet ring cell tumours. For adenocarcinomas, the large majority of colorectal cancers in the cohort, all risk factor associations were weak. There was little or no heterogeneity in risk between tumours of the right colon, left colon and rectum for any of the 14 factors examined. These epidemiological findings complement an emerging picture from molecular studies of possible different developmental pathways for different tumour types. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/27859268/Heterogeneity_of_colorectal_cancer_risk_by_tumour_characteristics:_Large_prospective_study_of_UK_women_ L2 - https://doi.org/10.1002/ijc.30527 DB - PRIME DP - Unbound Medicine ER -