Abstract
To investigate the subsite-specific risk factors for colorectal cancer, we conducted a case-control study, using a common questionnaire which inquired about general lifestyles over the past five years (1988–92), at the Aichi Cancer Center Hospital, Nagoya, Japan. This study compared 432 patients with histopathologically diagnosed colorectal cancer (94 proximal colon [cecum, ascending colon, transverse colon]; 137 distal colon [descending colon, sigmoid colon]; 201 rectum [rectosigmoid, rectum]); and 31,782 first-visit outpatient controls who were free from cancer. In both genders, habitual smoking selectively increased the risk for rectum cancer. Soft or loose feces increased the risk for all subsites of colorectal cancer, particularly in female cancer (odds ratio [OR]=4.5). Among female dietary habits, Japanese-style foods decreased the risk factors for distal colon cancer, but increased the risk for proximal colon cancer. These results suggested that the risk factors for colorectal cancer differ by subsite among such a low-risk population as the Japanese. It is suggested also that ‘irritable bowel’ (soft or loose feces) might be associated with distal subsites of colorectal cancer, independently or combined with habitual smoking. Cancer Causes and Control 1995, 6, 14–22.
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References
Waterhouse J, Muir CS, Shanmugaratnam J, Powell J, eds. Cancer Incidence in Five Continents, Vol. IV, Lyon, France: International Agency for Research on Cancer, 1982; IARC Sci. Pub. No. 42: 710–3.
Muir CS, Waterhouse J, Mack T, Powell J, Whelan SL, eds. Cancer Incidence in Five Continents, Vol. V. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 88: 852–5.
Parkin DM, Muir CS, Whelan SL, Gao YT, Feray J, Powell J, eds. Cancer Incidence in Five Continents, Vol. VI. Lyon, France: International Agency for Research on Cancer, 1992; IARC Sci. Pub. No. 120: 924–9.
Tajima K, Hirose K, Nakagawa N, Kuroishi T, Tominaga S, Urban-rural difference in the trend of colo-rectal cancer mortality with special reference to the subsites of colon cancer in Japan. Jpn J Cancer Res 1985; 76: 717–28.
Shimizu H, Mack TM, Ross RK, Henderson BE, Cancer of the gastrointestinal tract among Japanese and white immigrants in Los Angeles County. JNCI 1987; 78: 223–8.
Vernick LJ, Kuller LH. A case-control study of cholecystectomy and right-side colon cancer. Am J Epidemiol 1982; 116: 86–101.
McMichael AJ, Potter JD. Host factors in carcinogenesis: certain bile-acid metabolism profiles that selectively increase the risk of proximal colon cancer. JNCI 1985; 75: 185–91.
Tajima K, Tominaga S. Dietary habits and gastro-intenstinal cancers: a comparative case-control study of stomach and large intestinal cancers in Nagoya, Japan. Jpn J Cancer Res 1985; 76: 705–16.
Young TB, Wolf DA. Case-control study of proximal and distal colon cancer and diet in Wisconsin. Int J Cancer, 1988; 42: 167–75.
Peters RK, Garabrant DH, Yu MC, Mack TM. A case-control control study of occupational and dietary factors in colorectal cancer in young men by subsite. Cancer Res 1989; 49: 5459–68.
Steinmetz KA, Potter JD. Food-group consumption and colon cancer in Adelaide case-control study. I. Vegetables and fruit. Int J Cancer 1993; 53: 711–9.
Steinmetz KA, Potter JD. Food-group consumption and colon cancer in Adelaide case-control study. II. Meat, poultry, seafood, dairy foods and eggs. Int J Cancer 1993; 53: 720–7.
Yoo KY, Tajima K, Kuroishi T, et al. Independent protective effect of lactation against breast cancer a case-control study in Japan. Am J Epidemiol 1992; 135: 726–33.
Inoue M, Tajima K, Hirose K, Kuroishi T, Gao CM, Kito T. Life-style and subsite of gastric cancer—joint effect of smoking and drinking habit. Int J Cancer 1994; 56: 494–9.
Japanese Research Society for Cancer of Colon and Rectum. The General Rules for Clinical and Pathological Studies on Cancer of Colon, Rectum and Anus, 4th Edition. Kanehara-Shuppan, Japan: Japanese Research Society for Cancer of Colon and Rectum, 1985.
SAS Institute Inc. SAS/STAT User's Guide, Version 6. Cary, NC (USA): SAS Institute Inc., 1990.
Patients and Medical Institutions in Japan-Graphical Review of Health Statistics-1992. Tokyo, Japan: Health and Welfare Statistics Association, 1992.
The Report of Nationwide Survey on Health Promotion in 1990. Tokyo, Japan: Japan Health Promotion and Fitness Foundation, 1990.
Hamajima N, Hirose K, Inoue M, Takezaki T, Kuroishi T, Tajima K. Case-control studies: matched controls or all available controls? J Clin Epidemiol 1994: 47: 971–5.
West DW, Slattery ML, Robinson LM, et al. Dietary intake and colon cancer: sex-and anatomic site-specific associations. Am J Epidemiol 1989; 130: 883–94.
Haenszel W, Locke FB, Segi M. A case-control study of large bowel cancer in Japan. JNCI 1980; 64: 17–22.
Choi SY, Kahyo H. Effect of cigarette smoking and alcohol consumption in the etiology of cancers of the digestive tract. Int J Cancer 1991; 49: 381–6.
Baron JA. Smoking and estrogen-related disease. Am J Epidemiol 1984; 119: 9–22.
O'Connell DL, Hulka BS, Chambless LE, Wilkinson WE, Deubner DC. Cigarette smoking, alcohol consumption, and breast cancer risk. JNCI 1987; 78: 229–34.
Sandler RS, Sandler DP, Comstock GW, Helsing KJ, Shore DL. Cigarette smoking and the risk of colorectal cancer in women. JNCI 1988; 80: 1329–33.
Giovannucci E, Rimm EB, Stampfer MJ, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. men. JNCI 1994; 86: 183–91.
Giovannucci E, Colditz GA, Stampfer MJ, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. women. JNCI 1994; 86: 192–9.
Kusaka Y, Kondou H, Morimoto K. Healthy lifestyles are associated with higher natural killer cell activity. Prev Med 1992; 21: 602–15.
Nakachi K, Imai K. Environmental and physiological influences on human natural killer cell activity in relation to good health practices. Jpn J Cancer Res 1992; 83: 798–805.
Trinchieri G. Biology of natural killer cells. In: Dixon FJ, ed. Advances in Immunology. San Diego, CA (USA) Academic Press, 1989: 187–376.
Kato I, Tominaga S, Matsuura A, Yoshii Y, Shirai M, Kobayashi S. Case-control study of bowel habits and colorectal adenoma and cancer. J Epidemiol 1993; 3: 1–5.
Burakoff R, Percy WH. Studies in vivo and in vitro on effects of PGE2 on colonic motility in rabbits. Am J Physiol 1992; 262: G23–9.
Reddy BS, Rao CV, Rivenson A, Kelloff G. Inhibitory effect of aspirin on azoxymethane-induced colon carcinogenesis in F334 rats. Carcinogenesis 1993; 14: 1493–7.
Yamaguchi A, Ishida T, Nishimura G, Katoh M, Miyazaki I. Investigation of colonic prostaglandins in carcinogenesis in the rat colon. Dis Colon Rectum 1991; 34: 572–6.
Potter JD, McMichael AJ. Diet and cancer of the colon and rectum: a case-control study. JNCI 1986; 76: 557–69.
Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 1990; 323: 1664–72.
Tominaga S, Ogawa H, Kuroishi T. Usefulness of correlation analyses in the epidemiology of stomach cancer. NCI Monogr 1982; 62: 135–40.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 1991; 2: 427–42.
Ministry of Health and Welfare. The National Nutritional Survey Report (1991). Tokyo, Japan: Daiichi-Shuppan, 1993.
Additional information
Drs Inoue and Tajima, Ms Hirose, and Drs Hamajima and Takezaki are with the Division of Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan. Authors are also affiliated with the Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan (Drs Hirai and Kato), and the Department of Preventive Medicine, Nagoya University School of Medicine, Nagoya, Japan (Drs Inoue and Ohno). Address correspondence to Dr Inoue, Division of Epidemiology, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan, 464. This study was funded in part by a Grant-in-Aid for Cancer Research (4-2) and the Comprehensive 10-year Strategy for Cancer Control from the Ministry of Health and Welfare, Japan.
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Inoue, M., Tajima, K., Hirose, K. et al. Subsite-specific risk factors for colorectal cancer: a hospital-based case-control study in Japan. Cancer Causes Control 6, 14–23 (1995). https://doi.org/10.1007/BF00051676
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DOI: https://doi.org/10.1007/BF00051676