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Published in: Cancer Causes & Control 8/2009

01-10-2009 | Original paper

Lifestyle factors, obesity and the risk of colorectal adenomas in EPIC-Heidelberg

Authors: Silke Hermann, Sabine Rohrmann, Jakob Linseisen

Published in: Cancer Causes & Control | Issue 8/2009

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Abstract

Objective

We investigated the association of lifestyle and obesity with colorectal adenoma risk in a prospective setting.

Methods

At recruitment (1994–1998), information on diet, anthropometry, lifestyle, and medication was assessed in 25,540 participants of the EPIC-Heidelberg cohort. Until June 2007, 536 verified incident colorectal adenomas were identified. Furthermore, participants with negative colonoscopy (n = 3966) were included in the analytic cohort.

Results

In multivariate logistic regression analyses, participants with highest alcohol intake had an increased adenoma risk (odds ratio [OR] = 1.63; 95% CI 1.21–2.22) compared with lowest intake group. Folate consumption modified the ethanol effect (p-interaction = 0.03). Current smokers had a significantly increased adenoma risk compared with never smokers (OR = 1.40; 95% CI 1.16–1.84). Regular NSAID intake was associated with lower risk in subjects who reported their use at least twice compared with nonusers (OR = 0.70; 95% CI 0.53–0.93). Physical activity, body mass index, and waist-to-hip ratio were not consistently associated with adenoma risk.

Conclusions

The results of this prospective cohort study showed that alcohol intake and smoking are important risk factors for colorectal adenoma, and regular NSAID use decreases the risk. The relationship between alcohol consumption and adenoma risk was modified by folate intake. However, we could not confirm an effect of obesity or physical activity on adenoma risk.
Literature
1.
go back to reference Neugut AI, Garbowski GC, Lee WC et al (1993) Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case–control study. Ann Intern Med 118:91–95PubMed Neugut AI, Garbowski GC, Lee WC et al (1993) Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case–control study. Ann Intern Med 118:91–95PubMed
2.
go back to reference Ferlay J, Bray F, Pisani P, Parkin D (2002) GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. IARC Press, Lyon Ferlay J, Bray F, Pisani P, Parkin D (2002) GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. IARC Press, Lyon
5.
6.
9.
go back to reference Morimoto LM, Newcomb PA, Ulrich CM, Bostick RM, Lais CJ, Potter JD (2002) Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential? Cancer Epidemiol Biomarkers Prev 11:1012–1018PubMed Morimoto LM, Newcomb PA, Ulrich CM, Bostick RM, Lais CJ, Potter JD (2002) Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential? Cancer Epidemiol Biomarkers Prev 11:1012–1018PubMed
16.
go back to reference Erhardt JG, Kreichgauer HP, Meisner C, Bode JC, Bode C (2002) Alcohol, cigarette smoking, dietary factors and the risk of colorectal adenomas and hyperplastic polyps—a case control study. Eur J Nutr 41:35–43. doi:10.1007/s003940200004 PubMedCrossRef Erhardt JG, Kreichgauer HP, Meisner C, Bode JC, Bode C (2002) Alcohol, cigarette smoking, dietary factors and the risk of colorectal adenomas and hyperplastic polyps—a case control study. Eur J Nutr 41:35–43. doi:10.​1007/​s003940200004 PubMedCrossRef
18.
go back to reference Shrubsole MJ, Wu H, Ness RM, Shyr Y, Smalley WE, Zheng W (2008) Alcohol drinking, cigarette smoking, and risk of colorectal adenomatous and hyperplastic polyps. Am J Epidemiol 167:1050–1058. doi:10.1093/aje/kwm400 PubMedCrossRef Shrubsole MJ, Wu H, Ness RM, Shyr Y, Smalley WE, Zheng W (2008) Alcohol drinking, cigarette smoking, and risk of colorectal adenomatous and hyperplastic polyps. Am J Epidemiol 167:1050–1058. doi:10.​1093/​aje/​kwm400 PubMedCrossRef
19.
go back to reference Riboli E, Cornee J, Macquart-Moulin G, Kaaks R, Casagrande C, Guyader M (1991) Cancer and polyps of the colorectum and lifetime consumption of beer and other alcoholic beverages. Am J Epidemiol 134:157–166PubMed Riboli E, Cornee J, Macquart-Moulin G, Kaaks R, Casagrande C, Guyader M (1991) Cancer and polyps of the colorectum and lifetime consumption of beer and other alcoholic beverages. Am J Epidemiol 134:157–166PubMed
20.
go back to reference Hoshiyama Y, Kono S, Sasaba T, Shigematsu T, Kawaguchi T (2000) Relation of cigarette smoking, alcohol use, and dietary habits to colon adenomas: a case–control study in Saitama, Japan. Asian Pac J Cancer Prev 1:139–146PubMed Hoshiyama Y, Kono S, Sasaba T, Shigematsu T, Kawaguchi T (2000) Relation of cigarette smoking, alcohol use, and dietary habits to colon adenomas: a case–control study in Saitama, Japan. Asian Pac J Cancer Prev 1:139–146PubMed
21.
go back to reference Stemmermann GN, Heilbrun LK, Nomura AM (1988) Association of diet and other factors with adenomatous polyps of the large bowel: a prospective autopsy study. Am J Clin Nutr 47:312–317PubMed Stemmermann GN, Heilbrun LK, Nomura AM (1988) Association of diet and other factors with adenomatous polyps of the large bowel: a prospective autopsy study. Am J Clin Nutr 47:312–317PubMed
22.
go back to reference Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC (1995) Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 122:327–334PubMed Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC (1995) Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 122:327–334PubMed
24.
go back to reference Giovannucci E, Colditz GA, Stampfer MJ, Willett WC (1996) Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control 7:253–263. doi:10.1007/BF00051301 PubMedCrossRef Giovannucci E, Colditz GA, Stampfer MJ, Willett WC (1996) Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control 7:253–263. doi:10.​1007/​BF00051301 PubMedCrossRef
27.
go back to reference Bohlscheid-Thomas S, Hoting I, Boeing H, Wahrendorf J (1997) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26 (Suppl 1):S59-70. doi:10.1093/ije/26.suppl_1.S59 Bohlscheid-Thomas S, Hoting I, Boeing H, Wahrendorf J (1997) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26 (Suppl 1):S59-70. doi:10.​1093/​ije/​26.​suppl_​1.​S59
28.
go back to reference Wareham NJ, Jakes RW, Rennie KL et al (2003) Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 6:407–413. doi:10.1079/PHN2002439 PubMedCrossRef Wareham NJ, Jakes RW, Rennie KL et al (2003) Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 6:407–413. doi:10.​1079/​PHN2002439 PubMedCrossRef
29.
go back to reference Boutron MC, Faivre J, Dop MC, Quipourt V, Senesse P (1995) Tobacco, alcohol, and colorectal tumors: a multistep process. Am J Epidemiol 141:1038–1046PubMed Boutron MC, Faivre J, Dop MC, Quipourt V, Senesse P (1995) Tobacco, alcohol, and colorectal tumors: a multistep process. Am J Epidemiol 141:1038–1046PubMed
30.
go back to reference International Agency for Research on Cancer (IARC) (1999) Lyon: World Health Organization. IARC Monographs on the Evaluation of the carcinogenic risk of chemicals to humans: re-evaluation of some organic chemicals, hydrazine and hydrogen peroxide (part two) International Agency for Research on Cancer (IARC) (1999) Lyon: World Health Organization. IARC Monographs on the Evaluation of the carcinogenic risk of chemicals to humans: re-evaluation of some organic chemicals, hydrazine and hydrogen peroxide (part two)
33.
go back to reference Bergheim I, Parlesak A, Dierks C, Bode JC, Bode C (2003) Nutritional deficiencies in German middle-class male alcohol consumers: relation to dietary intake and severity of liver disease. Eur J Clin Nutr 57:431–438. doi:10.1038/sj.ejcn.1601557 PubMedCrossRef Bergheim I, Parlesak A, Dierks C, Bode JC, Bode C (2003) Nutritional deficiencies in German middle-class male alcohol consumers: relation to dietary intake and severity of liver disease. Eur J Clin Nutr 57:431–438. doi:10.​1038/​sj.​ejcn.​1601557 PubMedCrossRef
34.
go back to reference Giovannucci E (2002) Epidemiologic studies of folate and colorectal neoplasia: a review. J Nutr 132:2350S–2355SPubMed Giovannucci E (2002) Epidemiologic studies of folate and colorectal neoplasia: a review. J Nutr 132:2350S–2355SPubMed
39.
go back to reference Giovannucci E, Chen J, Smith-Warner SA et al (2003) Methylenetetrahydrofolate reductase, alcohol dehydrogenase, diet, and risk of colorectal adenomas. Cancer Epidemiol Biomarkers Prev 12:970–979PubMed Giovannucci E, Chen J, Smith-Warner SA et al (2003) Methylenetetrahydrofolate reductase, alcohol dehydrogenase, diet, and risk of colorectal adenomas. Cancer Epidemiol Biomarkers Prev 12:970–979PubMed
40.
go back to reference Wolf LA, Terry PD, Potter JD, Bostick RM (2007) Do factors related to endogenous and exogenous estrogens modify the relationship between obesity and risk of colorectal adenomas in women? Cancer Epidemiol Biomarkers Prev 16:676–683. doi:10.1158/1055-9965.EPI-06-0883 PubMedCrossRef Wolf LA, Terry PD, Potter JD, Bostick RM (2007) Do factors related to endogenous and exogenous estrogens modify the relationship between obesity and risk of colorectal adenomas in women? Cancer Epidemiol Biomarkers Prev 16:676–683. doi:10.​1158/​1055-9965.​EPI-06-0883 PubMedCrossRef
41.
go back to reference Pischon T, Lahmann PH, Boeing H et al (2006) Body size and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 98:920–931PubMedCrossRef Pischon T, Lahmann PH, Boeing H et al (2006) Body size and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 98:920–931PubMedCrossRef
42.
go back to reference Lubin F, Rozen P, Arieli B et al (1997) Nutritional and lifestyle habits and water-fiber interaction in colorectal adenoma etiology. Cancer Epidemiol Biomarkers Prev 6:79–85PubMed Lubin F, Rozen P, Arieli B et al (1997) Nutritional and lifestyle habits and water-fiber interaction in colorectal adenoma etiology. Cancer Epidemiol Biomarkers Prev 6:79–85PubMed
43.
44.
go back to reference Hauret KG, Bostick RM, Matthews CE et al (2004) Physical activity and reduced risk of incident sporadic colorectal adenomas: observational support for mechanisms involving energy balance and inflammation modulation. Am J Epidemiol 159:983–992. doi:10.1093/aje/kwh130 PubMedCrossRef Hauret KG, Bostick RM, Matthews CE et al (2004) Physical activity and reduced risk of incident sporadic colorectal adenomas: observational support for mechanisms involving energy balance and inflammation modulation. Am J Epidemiol 159:983–992. doi:10.​1093/​aje/​kwh130 PubMedCrossRef
45.
go back to reference Terry MB, Neugut AI, Bostick RM et al (2002) Risk factors for advanced colorectal adenomas: a pooled analysis. Cancer Epidemiol Biomarkers Prev 11:622–629PubMed Terry MB, Neugut AI, Bostick RM et al (2002) Risk factors for advanced colorectal adenomas: a pooled analysis. Cancer Epidemiol Biomarkers Prev 11:622–629PubMed
48.
go back to reference Bartram HP, Wynder EL (1989) Physical activity and colon cancer risk? Physiological considerations. Am J Gastroenterol 84:109–112PubMed Bartram HP, Wynder EL (1989) Physical activity and colon cancer risk? Physiological considerations. Am J Gastroenterol 84:109–112PubMed
49.
go back to reference Garcia Rodriguez LA, Huerta-Alvarez C (2000) Reduced incidence of colorectal adenoma among long-term users of nonsteroidal antiinflammatory drugs: a pooled analysis of published studies and a new population-based study. Epidemiology 11:376–381. doi:10.1097/00001648-200007000-00003 PubMedCrossRef Garcia Rodriguez LA, Huerta-Alvarez C (2000) Reduced incidence of colorectal adenoma among long-term users of nonsteroidal antiinflammatory drugs: a pooled analysis of published studies and a new population-based study. Epidemiology 11:376–381. doi:10.​1097/​00001648-200007000-00003 PubMedCrossRef
50.
go back to reference Tangrea JA, Albert PS, Lanza E et al (2003) Non-steroidal anti-inflammatory drug use is associated with reduction in recurrence of advanced and non-advanced colorectal adenomas (United States). Cancer Causes Control 14:403–411. doi:10.1023/A:1024990617158 PubMedCrossRef Tangrea JA, Albert PS, Lanza E et al (2003) Non-steroidal anti-inflammatory drug use is associated with reduction in recurrence of advanced and non-advanced colorectal adenomas (United States). Cancer Causes Control 14:403–411. doi:10.​1023/​A:​1024990617158 PubMedCrossRef
53.
go back to reference Thun MJ, Henley SJ, Patrono C (2002) Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst 94:252–266PubMed Thun MJ, Henley SJ, Patrono C (2002) Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst 94:252–266PubMed
55.
go back to reference Sansbury LB, Bergen AW, Wanke KL et al (2006) Inflammatory cytokine gene polymorphisms, nonsteroidal anti-inflammatory drug use, and risk of adenoma polyp recurrence in the polyp prevention trial. Cancer Epidemiol Biomarkers Prev 15:494–501. doi:10.1158/1055-9965.EPI-05-0763 PubMedCrossRef Sansbury LB, Bergen AW, Wanke KL et al (2006) Inflammatory cytokine gene polymorphisms, nonsteroidal anti-inflammatory drug use, and risk of adenoma polyp recurrence in the polyp prevention trial. Cancer Epidemiol Biomarkers Prev 15:494–501. doi:10.​1158/​1055-9965.​EPI-05-0763 PubMedCrossRef
56.
go back to reference Martinez ME, O’Brien TG, Fultz KE et al (2003) Pronounced reduction in adenoma recurrence associated with aspirin use and a polymorphism in the ornithine decarboxylase gene. Proc Natl Acad Sci USA 100:7859–7864. doi:10.1073/pnas.1332465100 PubMedCrossRef Martinez ME, O’Brien TG, Fultz KE et al (2003) Pronounced reduction in adenoma recurrence associated with aspirin use and a polymorphism in the ornithine decarboxylase gene. Proc Natl Acad Sci USA 100:7859–7864. doi:10.​1073/​pnas.​1332465100 PubMedCrossRef
Metadata
Title
Lifestyle factors, obesity and the risk of colorectal adenomas in EPIC-Heidelberg
Authors
Silke Hermann
Sabine Rohrmann
Jakob Linseisen
Publication date
01-10-2009
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 8/2009
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-009-9366-3

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