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  • 1
    ISSN: 1573-7225
    Keywords: Colon cancer ; hormone replacement therapy ; reproductive history ; risk factors ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hormonal factors have been inconsistently associated with coloncancer risk in women. The associations between reproductive events, menstrualfactors, exogenous hormones, and colon cancer were evaluated in a largecase-control study (894 female cases and 1,120 female age-matchedpopulation-based controls) in the United States, stratifying by age atdiagnosis, tumor site, family history and other potential risk factors.Overall, higher parity was associated with a marginally decreased risk ofcolon cancer (five or more births compared with nulliparous: odds ratio [OR]= 0.75, 95 percent confidence interval [CI] = 0.53-1.06) after adjusting forage at diagnosis, family history of colorectal cancer, vigorous lifetimephysical activity, body mass index (BMI) (wt/ht 1.5 ), total energy intake,and aspirin use. No important associations were observed for otherreproductive or menstrual events. An inverse association between recent useof hormone replacement therapy (HRT) and colon cancer was observed (OR = 0.71, CI = 0.56-0.89). Although interaction termswere not significant, this inverse association appeared to be more pronouncedfor those with an older age at diagnosis; for those without a first-degreerelative with colorectal cancer; and for those with a relatively low BMI. Thereduced risk associated with HRT use did not appear to be explained by otherbehaviors related to HRT use.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7225
    Keywords: colon cancer ; disease stage ; hormone replacement therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Hormone replacement therapy (HRT) has been inversely associated with colon cancer incidence in several epidemiologic studies. In this study we used data from a population-based incident case–control study of colon cancer to evaluate the role of HRT use in survival after diagnosis with colon cancer. Methods: Data from 815 postmenopausal women living in Utah, California, and Minnesota diagnosed between 1 September 1991 and 30 September 1994 were used to examine associations between HRT and survival. Results: After adjusting for age at time of diagnosis, stage of disease at time of diagnosis, study center, and body mass index (BMI), we observed that women who had ever used HRT had a 30% lesser probability of dying of any cause and a 40% lower probability of dying from colon cancer specifically during the follow-up period. Further evaluation by years of HRT use showed that those who had used HRT for 4 or more years had the lowest risk of dying of colon cancer (hazard rate ratio 0.5, 95% confidence interval 0.3–0.9). Evaluation of other lifestyle variables with HRT use did not show significant confounding or effect modification. Conclusions: These findings suggest that HRT use may improve short-term survival after diagnosis with colon cancer; there is no suggestion that HRT use is detrimental to survival.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7225
    Keywords: Case-control studies ; colorectal neoplasms ; dietary fat ; energy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to examine the effects of the intakeof dietary fat upon colorectal cancer risk in a combined analysis of datafrom 13 case-control studies previously conducted in populations withdiffering colorectal cancer rates and dietary practices. Original datarecords for 5,287 cases of colorectal cancer and 10,470 controls werecombined. Logistic regression analysis was used to estimate odds ratios (OR)for intakes of total energy, total fat and its components, and cholesterol.Positive associations with energy intake were observed for 11 of the 13studies. However, there was little, if any, evidence of anyenergy-independent effect of either total fat with ORs of 1.00, 0.95, 1.01,1.02, and 0.92 for quintiles of residuals of total fat intake (P trend =0.67) or for saturated fat with ORs of 1.00, 1.08, 1.06, 1.21, and 1.06 (Ptrend = 0.39). The analysis suggests that, among these case-control studies,there is no energy-independent association between dietary fat intake andrisk of colorectal cancer. It also suggests that simple substitution of fatby other sources of calories is unlikely to reduce meaningfully the risk ofcolorectal cancer.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 8 (1997), S. 872-882 
    ISSN: 1573-7225
    Keywords: Body size ; colon cancer ; diet ; diet diversity ; physical activity ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study, we evaluate diet diversity, diet composition, and risk of colon cancer in an incident population-based study of 1,993 cases and2,410 controls in the Kaiser Permanente Medical Care Program of Northern California, eight counties in Utah, and the Twin Cities area of Minnesota(United States). Ninety-one and one-half percent of the population were non-Hispanic White. Dietary intake was obtained using an adaptation of the CARDIA diet-history questionnaire. Diet diversity was defined as the number of unique food items reported; diversity also was explored within six major food groups. Composition of the diet was described by estimating the proportion of total number of food items contributed by major food groups. Younger individuals, higher educated individuals, and those who lived in larger households reported eating the most diverse diet. Total diet diversity was not associated with colon cancer. However, eating a diet with greater diversity of meats, poultry, fish, and eggs, was associated with a50 percent increase in risk among all men (95 percent confidence interval[CI] = 1.1-2.0; P trend = 0.01), with slightly stronger associations for younger men and men with distal tumors. A diet with a greater number of refined grain products also was associated with increased risk among men(odds ratio [OR] = 1.7, CI = 1.3-2.3). Women who ate a diet with a more diverse pattern of vegetables were at approximately a 20 percent lower risk than women who had the least diverse diet in vegetables. Assessment of diet composition showed that men who consumed a large proportion of their food items from meat, fish, poultry, and eggs were at an increased risk, with the most marked association being for distal tumors (OR = 1.7, CI = 1.2-2.5).Women who consumed the largest percentage of their food items in the form of plant foods (fruits, vegetables, or whole grains) were at a reduced risk of developing colon cancer (OR = 0.7, CI = 0.5-1.0).
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7225
    Keywords: Colon cancer ; family history ; females ; reproductive hormones ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: The Utah (United States) Population Database was used to evaluate the associations between reproductive factors and colon cancer risk and the impact that family history, age at diagnosis, and tumor site have on these associations. From the cohort of (White) women in the database, all first-primary cases of colon cancer (n=819) and controls who had complete fertility information (n=3, 202) were examined. The majority of tumors (68.6 percent) among women diagnosed at age 64 years or less were in the distal segment of the colon, while among women 65 or older, the majority of tumors (55.7 percent) were proximal. Women diagnosed before age 65 had a lower risk of colon cancer with increasing numbers of liveborn children (odds ratio [OR]=0.6, 95 percent confidence interval [CI]=0.3–0.9 for women with five or more children compared with women with one or two children). A long interval between first and second births (first birth-interval) was associated with increased risk of tumors in the distal segment of the colon (OR=1.4, CI=1.0–2.0) and among women diagnosed before age 65 (OR=1.6, CI=1.0–2.5); a longer, average birth-interval was associated with increased risk of proximal tumors (OR=1.5, CI=1.1–2.1). A longer, first birth-interval increased the risk associated with a family history of colon cancer, as did a longer average birth-interval and an older age at first or last birth. From these data, it appears that reproductive factors have heterogeneous effects on the risk of colon cancer that vary with age at diagnosis, tumor site, and family history of disease.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-7225
    Keywords: beta-carotene ; colon cancer ; dietary fiber ; folate ; fruits ; thiamin ; United States ; vegetables ; vitamin C ; vitamin B6 ; whole grains
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plant foods have been associated inversely with colon cancer. Since amajor focus of this study was to identify components of plant foods whichmay account for their association with colon cancer, nutrients which arecommonly found in plant foods also were evaluated. A population-basedcase-control study was conducted in Northern California, Utah, and the ‘TwinCities’ area of Minnesota (United States). Complete data were available frominterviewer-administered questionnaires on 1,993 cases and 2,410 controls.Higher intakes of vegetables (for highest relative to lowest quintile ofintake) were associated inversely with colon cancer risk: the odds ratio(OR) was 0.7 for both men (95 percent [CI] confidence interval = 0.5-0.9)and women (CI = 0.5-1.0). Associations were stronger among those withproximal tumors. Total fruit intake was not associated with colon cancerrisk although, among men, higher levels of whole grain intake wereassociated with a decreased risk (OR = 0.6, CI = 0.4-0.9 for older men);high intakes of refined grains were associated with an increased risk (OR =1.5, CI = 1.1-2.1). Dietary fiber intake was associated with a decreasedrisk of colon cancer: OR = 0.5 (CI = 0.3-0.9) for older men; OR = 0.7 (CI =0.4-1.2) for older women; OR = 0.6 (CI = 0.4-1.0) for men with proximaltumors; OR = 0.5 (CI = 0.3-0.9) for women with proximal tumors. Othernutrients, for which plant foods were the major contributor - such asvitamin B6, thiamin, and niacin (women only) - also were associatedinversely with colon cancer. Neither beta-carotene nor vitamin C wasprotective for colon cancer. Adjustment of plant foods for nutrients foundin plant foods or for supplement use did not appreciably alter the observedassociations between plant foods and colon cancer.
    Type of Medium: Electronic Resource
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