Meta-analyses of colorectal cancer risk factors
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Demographic, behavioral, and environmental factors have been associated with increased risk of colorectal cancer (CRC). We reviewed the published evidence and explored associations between risk factors and CRC incidence.
We identified 12 established non-screening CRC risk factors and performed a comprehensive review and meta-analyses to quantify each factor’s impact on CRC risk. We used random-effects models of the logarithms of risks across studies: inverse-variance weighted averages for dichotomous factors and generalized least squares for dose–response for multi-level factors.
Significant risk factors include inflammatory bowel disease (RR = 2.93, 95 % CI 1.79–4.81); CRC history in first-degree relative (RR = 1.80, 95 % CI 1.61–2.02); body mass index (BMI) to overall population (RR = 1.10 per 8 kg/m2 increase, 95 % CI 1.08–1.12); physical activity (RR = 0.88, 95 % CI 0.86–0.91 for 2 standard deviations increased physical activity score); cigarette smoking (RR = 1.06, 95 % CI 1.03–1.08 for 5 pack-years); and consumption of red meat (RR = 1.13, 95 % CI 1.09–1.16 for 5 servings/week), fruit (RR = 0.85, 95 % CI 0.75–0.96 for 3 servings/day), and vegetables (RR = 0.86, 95 % CI 0.78–0.94 for 5 servings/day).
We developed a comprehensive risk modeling strategy that incorporates multiple effects to predict an individual’s risk of developing CRC. Inflammatory bowel disease and history of CRC in first-degree relatives are associated with much higher risk of CRC. Increased BMI, red meat intake, cigarette smoking, low physical activity, low vegetable consumption, and low fruit consumption were associated with moderately increased risk of CRC.
- Meta-analyses of colorectal cancer risk factors
Cancer Causes & Control
Volume 24, Issue 6 , pp 1207-1222
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
- Additional Links
- Colorectal cancer
- Colon neoplasms
- Colonic neoplasms
- Colorectal neoplasms
- Colorectal risk factors
- Colorectal cancer prevention
- Industry Sectors
- Author Affiliations
- 1. School of Nursing and Community and Family Medicine, Duke University, 307 Trent Drive, Durham, NC, 27710, USA
- 2. Division of Quantitative Sciences, Department of Biostatistics, Unit 1409, The University of Texas MD Anderson Cancer Center, P. O. Box 301402, Houston, TX, 77230-1402, USA
- 3. Research, Outcomes, Surveillance, Evaluations, National Center for Telehealth and Technology, Joint Base Lewis-McChord, Tacoma, WA, 98431, USA
- 4. Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03766, USA
- 5. Professor Emeritus, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Houston, TX, 77230, USA