Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study (original) (raw)

Abstract

The aetiology of colorectal cancer was studied in a cohort of 11,888 residents of a retirement community. After four and one-half years of follow-up, 58 male and 68 female incident colorectal cancers were identified. Daily alcohol drinkers experienced nearly a two-fold increase in risk (2 sided P = 0.002). Colorectal cancer was also positively associated with Quetelet's index and inversely associated with avocational physical activity. The results were consistent for both sexes but were statistically significant only for males. With the exception of dietary vitamin C, none of the nutrients under study (i.e., vitamins A and E, dietary fibre, calcium, and beta carotene) showed a significant association with colorectal cancer. An inverse relationship between colorectal cancer and dietary vitamin C was observed in females, but there was no association with either vitamin C from supplements or with total vitamin C intake. Males and females who had 3 or more children showed a significantly reduced risk of colorectal cancer (RR = 0.45, 95% CI = 0.2, 0.9), but those with no children did not show the highest risk.

687

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ames B. N. Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative diseases. Science. 1983 Sep 23;221(4617):1256–1264. doi: 10.1126/science.6351251. [DOI] [PubMed] [Google Scholar]
  2. Bebb H. T., Houser H. B., Witschi J. C., Littell A. S., Fuller R. K. Calorie and nutrient contribution of alcoholic beverages to the usual diets of 155 adults. Am J Clin Nutr. 1971 Sep;24(9):1042–1052. doi: 10.1093/ajcn/24.9.1042. [DOI] [PubMed] [Google Scholar]
  3. Bingham S. A., Williams D. R., Cummings J. H. Dietary fibre consumption in Britain: new estimates and their relation to large bowel cancer mortality. Br J Cancer. 1985 Sep;52(3):399–402. doi: 10.1038/bjc.1985.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bingham S., Williams D. R., Cole T. J., James W. P. Dietary fibre and regional large-bowel cancer mortality in Britain. Br J Cancer. 1979 Sep;40(3):456–463. doi: 10.1038/bjc.1979.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Block G., Dresser C. M., Hartman A. M., Carroll M. D. Nutrient sources in the American diet: quantitative data from the NHANES II survey. I. Vitamins and minerals. Am J Epidemiol. 1985 Jul;122(1):13–26. doi: 10.1093/oxfordjournals.aje.a114072. [DOI] [PubMed] [Google Scholar]
  6. Breslow N. E., Enstrom J. E. Geographic correlations between cancer mortality rates and alcohol-tobacco consumption in the United States. J Natl Cancer Inst. 1974 Sep;53(3):631–639. doi: 10.1093/jnci/53.3.631. [DOI] [PubMed] [Google Scholar]
  7. Burkitt D. P. Epidemiology of cancer of the colon and rectum. Cancer. 1971 Jul;28(1):3–13. doi: 10.1002/1097-0142(197107)28:1<3::aid-cncr2820280104>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  8. Byers T., Graham S., Swanson M. Parity and colorectal cancer risk in women. J Natl Cancer Inst. 1982 Nov;69(5):1059–1062. [PubMed] [Google Scholar]
  9. Byers T., Marshall J., Fiedler R., Zielezny M., Graham S. Assessing nutrient intake with an abbreviated dietary interview. Am J Epidemiol. 1985 Jul;122(1):41–50. doi: 10.1093/oxfordjournals.aje.a114085. [DOI] [PubMed] [Google Scholar]
  10. Dales L. G., Friedman G. D., Ury H. K., Grossman S., Williams S. R. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol. 1979 Feb;109(2):132–144. doi: 10.1093/oxfordjournals.aje.a112668. [DOI] [PubMed] [Google Scholar]
  11. Drasar B. S., Irving D. Environmental factors and cancer of the colon and breast. Br J Cancer. 1973 Feb;27(2):167–172. doi: 10.1038/bjc.1973.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Garabrant D. H., Peters J. M., Mack T. M., Bernstein L. Job activity and colon cancer risk. Am J Epidemiol. 1984 Jun;119(6):1005–1014. doi: 10.1093/oxfordjournals.aje.a113805. [DOI] [PubMed] [Google Scholar]
  13. Garland C., Shekelle R. B., Barrett-Connor E., Criqui M. H., Rossof A. H., Paul O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet. 1985 Feb 9;1(8424):307–309. doi: 10.1016/s0140-6736(85)91082-7. [DOI] [PubMed] [Google Scholar]
  14. Gerhardsson M., Norell S. E., Kiviranta H., Pedersen N. L., Ahlbom A. Sedentary jobs and colon cancer. Am J Epidemiol. 1986 May;123(5):775–780. doi: 10.1093/oxfordjournals.aje.a114306. [DOI] [PubMed] [Google Scholar]
  15. Graham S., Dayal H., Swanson M., Mittelman A., Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst. 1978 Sep;61(3):709–714. [PubMed] [Google Scholar]
  16. Gray G. E., Paganini-Hill A., Ross R. K., Henderson B. E. Assessment of three brief methods of estimation of vitamin A and C intakes for a prospective study of cancer: comparison with dietary history. Am J Epidemiol. 1984 Apr;119(4):581–590. doi: 10.1093/oxfordjournals.aje.a113775. [DOI] [PubMed] [Google Scholar]
  17. Haenszel W., Kurihara M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst. 1968 Jan;40(1):43–68. [PubMed] [Google Scholar]
  18. Haenszel W., Locke F. B., Segi M. A case-control study of large bowel cancer in Japan. J Natl Cancer Inst. 1980 Jan;64(1):17–22. [PubMed] [Google Scholar]
  19. Hill M. J. The effect of some factors on the faecal concentration of acid steroids, neutral steroids and urobilins. J Pathol. 1971 Aug;104(4):239–245. doi: 10.1002/path.1711040405. [DOI] [PubMed] [Google Scholar]
  20. Holdstock D. J., Misiewicz J. J., Smith T., Rowlands E. N. Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity. Gut. 1970 Feb;11(2):91–99. doi: 10.1136/gut.11.2.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Howe G. R., Craib K. J., Miller A. B. Age at first pregnancy and risk of colorectal cancer: a case-control study. J Natl Cancer Inst. 1985 Jun;74(6):1155–1159. [PubMed] [Google Scholar]
  22. Jain M., Cook G. M., Davis F. G., Grace M. G., Howe G. R., Miller A. B. A case-control study of diet and colo-rectal cancer. Int J Cancer. 1980 Dec 15;26(6):757–768. doi: 10.1002/ijc.2910260609. [DOI] [PubMed] [Google Scholar]
  23. Jones B. R., Barrett-Connor E., Criqui M. H., Holdbrook M. J. A community study of calorie and nutrient intake in drinkers and nondrinkers of alcohol. Am J Clin Nutr. 1982 Jan;35(1):135–139. doi: 10.1093/ajcn/35.1.135. [DOI] [PubMed] [Google Scholar]
  24. Lew E. A., Garfinkel L. Variations in mortality by weight among 750,000 men and women. J Chronic Dis. 1979;32(8):563–576. doi: 10.1016/0021-9681(79)90119-x. [DOI] [PubMed] [Google Scholar]
  25. Liu K., Stamler J., Moss D., Garside D., Persky V., Soltero I. Dietary cholesterol, fat, and fibre, and colon-cancer mortality. An analysis of international data. Lancet. 1979 Oct 13;2(8146):782–785. doi: 10.1016/s0140-6736(79)92126-3. [DOI] [PubMed] [Google Scholar]
  26. Manousos O., Day N. E., Trichopoulos D., Gerovassilis F., Tzonou A., Polychronopoulou A. Diet and colorectal cancer: a case-control study in Greece. Int J Cancer. 1983 Jul 15;32(1):1–5. doi: 10.1002/ijc.2910320102. [DOI] [PubMed] [Google Scholar]
  27. McMichael A. J., Potter J. D., Hetzel B. S. Time trends in colo-rectal cancer mortality in relation to food and alcohol consumption: United States, United Kingdom, Australia and New Zealand. Int J Epidemiol. 1979 Dec;8(4):295–303. doi: 10.1093/ije/8.4.295. [DOI] [PubMed] [Google Scholar]
  28. McMichael A. J., Potter J. D. Parity and death from colon cancer in women: a case-control study. Community Health Stud. 1984;8(1):19–25. doi: 10.1111/j.1753-6405.1984.tb00420.x. [DOI] [PubMed] [Google Scholar]
  29. McMichael A. J., Potter J. D. Reproduction, endogenous and exogenous sex hormones, and colon cancer: a review and hypothesis. J Natl Cancer Inst. 1980 Dec;65(6):1201–1207. [PubMed] [Google Scholar]
  30. Miller A. B., Howe G. R., Jain M., Craib K. J., Harrison L. Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer. Int J Cancer. 1983 Aug 15;32(2):155–161. doi: 10.1002/ijc.2910320204. [DOI] [PubMed] [Google Scholar]
  31. Modan B., Barell V., Lubin F., Modan M., Greenberg R. A., Graham S. Low-fiber intake as an etiologic factor in cancer of the colon. J Natl Cancer Inst. 1975 Jul;55(1):15–18. doi: 10.1093/jnci/55.1.15. [DOI] [PubMed] [Google Scholar]
  32. Nomura A. M., Stemmermann G. N., Heilbrun L. K., Salkeld R. M., Vuilleumier J. P. Serum vitamin levels and the risk of cancer of specific sites in men of Japanese ancestry in Hawaii. Cancer Res. 1985 May;45(5):2369–2372. [PubMed] [Google Scholar]
  33. Nomura A., Heilbrun L. K., Stemmermann G. N. Body mass index as a predictor of cancer in men. J Natl Cancer Inst. 1985 Feb;74(2):319–323. [PubMed] [Google Scholar]
  34. Papadimitriou C., Day N., Tzonou A., Gerovassilis F., Manousos O., Trichopoulos D. Biosocial correlates of colorectal cancer in Greece. Int J Epidemiol. 1984 Jun;13(2):155–159. doi: 10.1093/ije/13.2.155. [DOI] [PubMed] [Google Scholar]
  35. Phillips R. L. Role of life-style and dietary habits in risk of cancer among seventh-day adventists. Cancer Res. 1975 Nov;35(11 Pt 2):3513–3522. [PubMed] [Google Scholar]
  36. Phillips R. L., Snowdon D. A. Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists. J Natl Cancer Inst. 1985 Feb;74(2):307–317. [PubMed] [Google Scholar]
  37. Pollack E. S., Nomura A. M., Heilbrun L. K., Stemmermann G. N., Green S. B. Prospective study of alcohol consumption and cancer. N Engl J Med. 1984 Mar 8;310(10):617–621. doi: 10.1056/NEJM198403083101003. [DOI] [PubMed] [Google Scholar]
  38. Potter J. D., McMichael A. J. Diet and cancer of the colon and rectum: a case-control study. J Natl Cancer Inst. 1986 Apr;76(4):557–569. doi: 10.1093/jnci/76.4.557. [DOI] [PubMed] [Google Scholar]
  39. Potter J. D., McMichael A. J. Large bowel cancer in women in relation to reproductive and hormonal factors: a case-control study. J Natl Cancer Inst. 1983 Oct;71(4):703–709. [PubMed] [Google Scholar]
  40. Reddy B. S., Weisburger J. H., Wynder E. L. Fecal bacterial beta-glucuronidase: control by diet. Science. 1974 Feb 1;183(4123):416–417. doi: 10.1126/science.183.4123.416. [DOI] [PubMed] [Google Scholar]
  41. Stemmermann G., Nomura A. M., Heilbrun L. K., Mower H., Hayashi T. Colorectal cancer in Hawaiian Japanese men: a progress report. Natl Cancer Inst Monogr. 1985 Dec;69:125–131. [PubMed] [Google Scholar]
  42. Stähelin H. B., Rösel F., Buess E., Brubacher G. Cancer, vitamins, and plasma lipids: prospective Basel study. J Natl Cancer Inst. 1984 Dec;73(6):1463–1468. [PubMed] [Google Scholar]
  43. Thornton J., Symes C., Heaton K. Moderate alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol. Lancet. 1983 Oct 8;2(8354):819–822. doi: 10.1016/s0140-6736(83)90738-9. [DOI] [PubMed] [Google Scholar]
  44. Weiss N. S., Daling J. R., Chow W. H. Incidence of cancer of the large bowel in women in relation to reproductive and hormonal factors. J Natl Cancer Inst. 1981 Jul;67(1):57–60. [PubMed] [Google Scholar]
  45. Wynder E. L., Kajitani T., Ishikawa S., Dodo H., Takano A. Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data. Cancer. 1969 May;23(5):1210–1220. doi: 10.1002/1097-0142(196905)23:5<1210::aid-cncr2820230530>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  46. Wynder E. L., Shigematsu T. Environmental factors of cancer of the colon and rectum. Cancer. 1967 Sep;20(9):1520–1561. doi: 10.1002/1097-0142(196709)20:9<1520::aid-cncr2820200920>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]