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Cancer Causes & Control
Published in: Cancer Causes & Control 9/2013

01-09-2013 | Original paper

A large prospective study of risk factors for adenocarcinomas and malignant carcinoid tumors of the small intestine

Authors: Amanda J. Cross, Albert R. Hollenbeck, Yikyung Park

Published in: Cancer Causes & Control | Issue 9/2013

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Abstract

Purpose

Small intestinal cancer is increasing in the U.S.A, yet little is known about its etiology. Our aim was to prospectively evaluate risk factors for this malignancy by the two main histologic subtypes (adenocarcinomas and carcinoids).

Methods

Hazard ratios and 95 % confidence intervals (CI) were estimated for all incident small intestinal cancers (n = 237), adenocarcinomas (n = 84), and malignant carcinoids (n = 124), by demographic and lifestyle factors among 498,376 men and women.

Results

Age was the only risk factor for adenocarcinomas (HR for ≥65 vs. 50–55 years = 3.12, 95 % CI 1.33, 7.31). Age (HR for ≥65 vs. 50–55 years = 3.31, 95 % CI 1.51, 7.28), male sex (HR = 1.44, 95 % CI 1.01, 2.05), body mass index (BMI, HR for ≥35 vs. 18.5–<25 kg/m2 = 1.95, 95 % CI 1.06, 3.58), and current menopausal hormone therapy use (HR = 1.94, 95 % CI 1.07, 3.50) were positively associated with malignant carcinoids. A family history of any cancer or colorectal cancer (HR = 1.42, 95 % CI 0.99, 2.03; 1.61, 0.97, 2.65, respectively), or a personal history of colorectal polyps (HR = 1.51, 95 % CI 0.92, 2.46) produced elevated, but not statistically significant, risks for malignant carcinoids. Race, education, diabetes, smoking, physical activity, and alcohol intake were not associated with either histologic subtype.

Conclusions

Risk factors differed according to cancer subtype; only age was associated with adenocarcinomas, whereas age, male sex, BMI, and menopausal hormone therapy use were positively associated with malignant carcinoids.
Literature
1.
Parkin DM, Whelan SL, Ferlay J, Teppo DB (2002) Cancer Incidence in Five Continents Vol. VIII. Lyon, France: IARC Scientific Publications
2.
3.
Howlader N NA, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975–2010, National Cancer Institute. Bethesda, MD, http://​seer.​cancer.​gov/​csr/​1975_​2010/​, based on November 2012 SEER data submission, posted to the SEER web site, 2013
4.
Scelo G, Boffetta P, Hemminki K, Pukkala E, Olsen JH, Andersen A, Tracey E, Brewster DH, McBride ML, Kliewer EV, Tonita JM, Pompe-Kirn V, Chia KS, Jonasson JG, Martos C, Colin D, Brennan P (2006) Associations between small intestine cancer and other primary cancers: an international population-based study. Int J Cancer 118:189–196PubMedCrossRef
5.
Schottenfeld D, Fraumeni JF (2006) Cancer epidemiology and prevention. Oxford University Press, New YorkCrossRef
6.
Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS (2009) Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 249:63–71PubMedCrossRef
7.
Haselkorn T, Whittemore AS, Lilienfeld DE (2005) Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control 16:781–787PubMedCrossRef
8.
Schottenfeld D, Beebe-Dimmer JL, Vigneau FD (2009) The epidemiology and pathogenesis of neoplasia in the small intestine. Ann Epidemiol 19:58–69PubMedCrossRef
9.
Ries LA, Young JL, Keel GE, Eisner MP, Lin YD, Horner MJ (2007) SEER survival monograph: cancer survival among adults: U.S. SEER Program, 1988–2001, patient and tumor characteristics. Bethesda, MD: National Cancer Institute
10.
Modlin IM, Champaneria MC, Chan AK, Kidd M (2007) A three-decade analysis of 3,911 small intestinal neuroendocrine tumors: the rapid pace of no progress. Am J Gastroenterol 102:1464–1473PubMedCrossRef
11.
Schatzkin A, Subar AF, Thompson FE, Harlan LC, Tangrea J, Hollenbeck AR, Hurwitz PE, Coyle L, Schussler N, Michaud DS, Freedman LS, Brown CC, Midthune D, Kipnis V (2001) Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol 154:1119–1125PubMedCrossRef
12.
Michaud DS, Midthune D, Hermansen S, Leitzmann MF, Harlan LC, Kipnis V et al (2005) Comparison of cancer registry case ascertainment with SEER estimates and self-reporting in a subset of the NIH-AARP diet and health study. J Registry Manag 32:70–77
13.
International classification of diseases for oncology: Third edition (2000). Geneva: World Health Organization
14.
Shack LG, Wood HE, Kang JY, Brewster DH, Quinn MJ, Maxwell JD, Majeed A (2006) Small intestinal cancer in England & Wales and Scotland: time trends in incidence, mortality and survival. Aliment Pharmacol Ther 23:1297–1306PubMedCrossRef
15.
Boffetta P, Hazelton WD, Chen Y, Sinha R, Inoue M, Gao YT, Koh WP, Shu XO, Grant EJ, Tsuji I, Nishino Y, You SL, Yoo KY, Yuan JM, Kim J, Tsugane S, Yang G, Wang R, Xiang YB, Ozasa K, Nagai M, Kakizaki M, Chen CJ, Park SK, Shin A, Ahsan H, Qu CX, Lee JE, Thornquist M, Rolland B, Feng Z, Zheng W, Potter JD (2012) Body mass, tobacco smoking, alcohol drinking and risk of cancer of the small intestine–a pooled analysis of over 500,000 subjects in the Asia Cohort Consortium. Ann Oncol 23:1894–1898PubMedCrossRef
16.
Cross AJ, Leitzmann MF, Subar AF, Thompson FE, Hollenbeck AR, Schatzkin A (2008) A prospective study of meat and fat intake in relation to small intestinal cancer. Cancer Res 68:9274–9279PubMedCrossRef
17.
Schatzkin A, Park Y, Leitzmann MF, Hollenbeck AR, Cross AJ (2008) Prospective study of dietary fiber, whole grain foods, and small intestinal cancer. Gastroenterology 135:1163–1167PubMedCrossRef
18.
Chen CC, Neugut AI, Rotterdam H (1994) Risk factors for adenocarcinomas and malignant carcinoids of the small intestine: preliminary findings. Cancer Epidemiol Biomarkers Prev 3:205–207PubMed
19.
Kaerlev L, Teglbjaerg PS, Sabroe S, Kolstad HA, Ahrens W, Eriksson M, Guenel P, Hardell L, Launoy G, Merler E, Merletti F, Stang A, Olsen J (2000) Is there an association between alcohol intake or smoking and small bowel adenocarcinoma? Results from a European multi-center case-control study. Cancer Causes Control 11:791–797PubMedCrossRef
20.
Negri E, Bosetti C, La Vecchia C, Fioretti F, Conti E, Franceschi S (1999) Risk factors for adenocarcinoma of the small intestine. Int J Cancer 82:171–174PubMedCrossRef
21.
Wu AH, Yu MC, Mack TM (1997) Smoking, alcohol use, dietary factors and risk of small intestinal adenocarcinoma. Int J Cancer 70:512–517PubMedCrossRef
22.
Hassan MM, Phan A, Li D, Dagohoy CG, Leary C, Yao JC (2008) Risk factors associated with neuroendocrine tumors: a U.S.-based case-control study. Int J Cancer 123:867–873PubMedCrossRef
23.
Chow WH, Linet MS, McLaughlin JK, Hsing AW, Chien HT, Blot WJ (1993) Risk factors for small intestine cancer. Cancer Causes Control 4:163–169PubMedCrossRef
24.
Qubaiah O, Devesa SS, Platz CE, Huycke MM, Dores GM (2010) Small intestinal cancer: a population-based study of incidence and survival patterns in the United States, 1992 to 2006. Cancer Epidemiol Biomarkers Prev 19:1908–1918PubMedCrossRef
25.
Chlebowski RT, Wactawski-Wende J, Ritenbaugh C, Hubbell FA, Ascensao J, Rodabough RJ, Rosenberg CA, Taylor VM, Harris R, Chen C, Adams-Campbell LL, White E (2004) Estrogen plus progestin and colorectal cancer in postmenopausal women. N Engl J Med 350:991–1004PubMedCrossRef
26.
Green J, Czanner G, Reeves G, Watson J, Wise L, Roddam A, Beral V (2012) Menopausal hormone therapy and risk of gastrointestinal cancer: nested case-control study within a prospective cohort, and meta-analysis. Int J Cancer 130:2387–2396
27.
Grodstein F, Newcomb PA, Stampfer MJ (1999) Postmenopausal hormone therapy and the risk of colorectal cancer: a review and meta-analysis. Am J Med 106:574–582PubMedCrossRef
28.
WCRF/AICR (2011) World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project. Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer. Washington, DC
29.
Hassan MM, Phan A, Li D, Dagohoy CG, Leary C, Yao JC (2008) Family history of cancer and associated risk of developing neuroendocrine tumors: a case-control study. Cancer Epidemiol Biomarkers Prev 17:959–965PubMedCrossRef
30.
Sellner F (1990) Investigations on the significance of the adenoma-carcinoma sequence in the small bowel. Cancer 66:702–715PubMedCrossRef
31.
Kahi CJ, Rex DK, Imperiale TF (2008) Screening, surveillance, and primary prevention for colorectal cancer: a review of the recent literature. Gastroenterology 135:380–399PubMedCrossRef
32.
Neugut AI, Jacobson JS, Suh S, Mukherjee R, Arber N (1998) The epidemiology of cancer of the small bowel. Cancer Epidemiol Biomarkers Prev 7:243–251PubMed
33.
Babovic-Vuksanovic D, Constantinou CL, Rubin J, Rowland CM, Schaid DJ, Karnes PS (1999) Familial occurrence of carcinoid tumors and association with other malignant neoplasms. Cancer Epidemiol Biomarkers Prev 8:715–719PubMed
Metadata
Title
A large prospective study of risk factors for adenocarcinomas and malignant carcinoid tumors of the small intestine
Authors
Amanda J. Cross
Albert R. Hollenbeck
Yikyung Park
Publication date
01-09-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 9/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0251-8

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