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  • 1
    ISSN: 1573-7225
    Keywords: cancer ; cigarette smoking ; family history ; genes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective:Family history of cancer has been a useful tool to identify highly penetrant genes. However, the association between family history and low-penetrance genes that are prevalent in the population is less well understood. While epidemiologists have studied low-penetrance genes in association studies at the population level, geneticists have often favored family studies to identify low-penetrance genes in the same manner that these families have been used to identify high-penetrance genes. In this study, we evaluated the association between family history of cancer and molecular variants of three genes: N-acetyltransferases (NAT2), glutathione-S-transferases (GSTM-1), and methylenetetrahydrofolate reductase (MTHFR). These genes were examined because of their plausible functional significance and their association with cancer risk in some studies. Methods:In a large multi-centered study of colon cancer, reported family history of cancer in first-degree relatives was used to classify cases and controls separately as having a family history of colorectal cancer, hormone-related cancers, smoking-related cancers, prostate cancer, and any cancer. Results:With three weak exceptions, we did not observe significant associations between any of these genes and family history of cancer. The ability of family history to positively predict the presence of variants of low-penetrance genes that may carry an elevated risk ranged from 41% to 60%; low-penetrance variants accurately predicted a family history of cancer 9 to 17% of the time. Assessment of the likelihood of having a family history of cancer given the combination of genetic and environmental factors, showed that those who smoked 20 or more cigarettes per day were more likely to have a family history of a smoking-related cancer irrespective of genotype. Conclusions:People with a family history of cancer are not more likely to have a variant of low-penetrance genes than those without a family history of cancer. Family studies may not be efficient methods to study low-penetrance genes.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7225
    Keywords: Age ; Australia ; colon neoplasia ; diet ; parity ; physical activity ; reproduction ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Data from two population-based case-control studies were used to investigate the effect of age on colon cancer risk. Dietary intake data were assessed from a study conducted in Utah (United States) between 1979 and 1983; reproductive data were assessed from a study conducted in Adelaide (Australia) between 1979 and 1980. Data from both studies were assessed for their impact on those less than 65 years of age and those 65 or more years of age. Intake of energy, fat, and protein had a greater impact on risk among older men than among younger men. Risk estimates for the upper quartile of intake relative to the lowest quartile of intake were 8.5 (95 percent confidence interval [CI]=1.7–43.0) for energy, 8.2 (CI=1.6–41.3) for protein, and 7.2 (CI=1.6–31.4) for total fat for older men, while comparable risk estimates were 2.4 (CI=0.6–9.1) for energy, 3.0 (CI=0.7–13.6) for protein, and 1.9 (CI=0.5–7.1) for total fat among younger men. Similar trends were seen for older women for energy and protein. β-carotene decreased colon cancer risk among younger men (odds ratio [OR]=0.4, CI=0.1–1.2) and women (OR=0.1, CI=0.1–0.5), although not among older men (OR=1.2, CI=0.3–4.9) and women (OR=1.9, CI=0.6–64). Calcium decreased risk of colon cancer among older men (OR=0.1, CI=〈0.1–0.8) and younger women (OR=0.2, CI=〈0.1–0.7). Women who were diagnosed at age 65 or older and were nulliparous had a tenfold increase in colon cancer risk (CI=2.4–47.9) relative to women who had an early age at first birth. Women diagnosed with colon cancer before age 65 did not experience an increase of colon cancer risk associated with being nulliparous. These data suggest that age at diagnosis may interact with other factors to alter risk of colon cancer.
    Type of Medium: Electronic Resource
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  • 3
    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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  • 4
    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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  • 5
    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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  • 6
    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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  • 7
    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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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 11 (2000), S. 555-563 
    ISSN: 1573-7225
    Keywords: colon cancer ; colonoscopy ; diet ; FOB test ; family history of cancer ; sigmoidoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Sigmoidoscopy screening and fecal occult blood (FOB) tests have been demonstrated as effective ways to reduce mortality from colorectal cancer. However, most studies of colorectal cancer screening and cancer mortality have not taken into consideration lifestyle factors that could account for the observed associations. The purpose of this study was to determine the association between screening and incidence of colon cancer, taking into consideration important lifestyle factors. Methods: We estimated the association between screening and colon cancer after taking into consideration health and lifestyle factors using data obtained as part of population-based case–control study of incident colon cancers. Results: Sigmoidoscopy screening, especially as part of a checkup, was protective against incident colon cancer in both men (OR 0.56, 95% CI 0.44–0.77) and women (OR 0.53, 95% CI 0.33–0.77) after adjusting for other risk factors for colon cancer. For men, associations were stronger for distal tumors (OR 0.48, 95% CI 0.31–0.71) than for proximal tumors (OR 0.67, 95% CI 0.45–1.11). We did not observe significant associations between FOB test and colon cancer. Differences in characteristics between those who were screened and not screened were also observed. Men were more likely to report having a sigmoidoscopy as part of a checkup than were women, as were people with higher levels of education. People who reported having a sigmoidoscopy as part of a checkup also reported eating diets lower in fat and higher in fiber, folate, and vegetables. Men were more likely to report higher levels of physical activity, and women were more likely to report taking hormone replacement therapy (HRT) if they also reported a sigmoidoscopy. Both men and women who reported a sigmoidoscopy for screening purposes were more likely to have a family history of colorectal cancer. Conclusions: These data provide additional support for the benefits of having a screening sigmoidoscopy. The associations between screening sigmoidoscopy and colon cancer do not appear to be the result of lifestyle factors.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 4 (1993), S. 559-563 
    ISSN: 1573-7225
    Keywords: Alcohol ; caffeine ; coffee ; males ; prostate cancer ; smoking ; theobromine ; tea ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Data from a population-based study of newly diagnosed cases of prostate cancer (n=362) and age-matched controls (n=685) conducted in Utah (United States) between 1983 and 1986 were used to determine if cigarette smoking, alcohol, coffee, tea, caffeine, and theobromine were associated with prostate cancer risk. These factors were examined since their use differs in the Utah population, which is comprised predominantly of members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormon), from most other populations. Pack-years of cigarettes smoked, alcohol intake, and consumption of alcohol, coffee, tea, and caffeine were not associated with prostate cancer risk. Compared with men with very low levels of theobromine intake, older men consuming 11 to 20 and over 20 mg of theobromine per day were at increased risk of prostate cancer (odds ratio [OR] for all tumors = 2.06, 95 percent confidence interval [CI]=1.33–3.20, and OR=1.47, CI=0.99–2.19, respectively; OR for aggressive tumors = 1.90, CI=0.90–3.97, and OR=1.74, CI=0.91–3.32, respectively). We present biological mechanisms for a possible association between prostate cancer and theobromine. This finding needs further exploration in studies with a wider range of theobromine exposures and more men with aggressive tumors.
    Type of Medium: Electronic Resource
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  • 10
    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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