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Environmental factors affect colon carcinoma and rectal carcinoma in men and women differently

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Colon cancer is thought to be more closely associated with environmental factors than rectal cancer, but evidence is currently insufficient. We examined whether there are differences in the degree of environmental effect on colon cancer and rectal cancer in Japan.

Methods

We performed a birth cohort analysis for colon and rectal cancers using Japanese vital statistics from 1950 to 1998 and analyzed time trends by cancer site and gender.

Results

The mean annual increase in age-adjusted mortality rate from colon cancer was greater than that from rectal cancer and was greater in men than in women. In men left colon cancer showed the greatest rate of increase whereas cancer of the right colon showed only a slight change. Although left colon cancer rapidly increased until the middle 1980s and thereafter showed no change, right colon cancer showed no change until the middle 1980s and thereafter rapidly increased in men. However, the rates of increase in left colon cancer were greater than those in right colon cancer until the middle 1980s, after which a reversal in trend was seen in women. Birth cohort analysis indicates that for all cohorts the mortality rates at the same age were higher in the recent cohorts than in the previous ones. This trend was more marked for colon cancer than for rectal cancer and was stronger among men than among women.

Conclusion

Colon cancer is more closely associated than rectal cancer with environmental factors, and this association is more pronounced in men than in women. Consequently cancers at these two sites should not be combined in studies of the role of lifestyle factors in causing these neoplasms. Furthermore, the causes of these diseases may differ in men and women.

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References

  1. Potter JD (1996) Nutrition and colorectal cancer. Cancer Causes Control 7:127–146

    CAS  PubMed  Google Scholar 

  2. Tavani A, Braga C, La Vecchia C, Conti E, Filiberti R, Montella M, et al (1999) Physical activity and risk of cancers of the colon and rectum: an Italian case-control study. Br J Cancer 79:1912–1916

    Article  CAS  PubMed  Google Scholar 

  3. Tavani A, Fioretti F, Franceschi S, Gallus S, Negri E, Montella M, et al (1999) Education, socioeconomic status and risk of cancer of the colon and rectum. Int J Epidemiol 28:380–385

    Article  CAS  PubMed  Google Scholar 

  4. Chyou PH, Nomura AM, Stemmermann GN (1996) A prospective study of colon and rectal cancer among Hawaii Japanese men. Ann Epidemiol 6:276–282

    Article  CAS  PubMed  Google Scholar 

  5. La Vecchia C, Negri E, Decarli A, D'Avanzo B, Gallotti L, Gentile A, et al (1988) A case-control study of diet and colo-rectal cancer in northern Italy. Int J Cancer 41:492–498

    Google Scholar 

  6. Hu JF, Liu YY, Yu YK, Zhao TZ, Liu SD, Wang QQ (1991) Diet and cancer of the colon and rectum: a case-control study in China. Int J Epidemiol 20:362–367

    CAS  PubMed  Google Scholar 

  7. Graham S, Dayal H, Swanson M, Mittelman A, Wilkinson G (1978) Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst 61:709–714

    CAS  PubMed  Google Scholar 

  8. Phillips RL, Snowdon DA (1985) Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists. J Natl Cancer Inst 74:307–317

    CAS  PubMed  Google Scholar 

  9. Freudenheim JL, Graham S, Marshall JR, Haughey BP, Cholewinski S, Wilkinson G (1991) Folate intake and carcinogenesis of the colon and rectum. Int J Epidemiol 20:368–374

    CAS  PubMed  Google Scholar 

  10. Kreger BE, Anderson KM, Schatzkin A, Splansky GL (1992) Serum cholesterol level, body mass index, and the risk of colon cancer. The Framingham Study. Cancer 70:1038–1043

    CAS  PubMed  Google Scholar 

  11. Garabrant DH, Peters JM, Mack TM, Bernstein L (1984) Job activity and colon cancer risk. Am J Epidemiol 119:1005–1014

    CAS  PubMed  Google Scholar 

  12. Gerhardsson M, Norell SE, Kiviranta H, Pedersen NL, Ahlbom A (1986) Sedentary jobs and colon cancer. Am J Epidemiol 123:775–780

    CAS  PubMed  Google Scholar 

  13. Kune GA, Kune S, Vitetta L, Watson LF (1992) Smoking and colorectal cancer risk: data from the Melbourne Colorectal Cancer Study and brief review of literature. Int J Cancer 50:369–372

    CAS  PubMed  Google Scholar 

  14. Ishiguro S (1988) An epidemiological study on the incidence of colorectal cancer in Aomori Prefecture (in Japanese). Jpn J Gastroenterol 85:1475–1482

    CAS  Google Scholar 

  15. Bureau of Public Health, Ministry of Health and Welfare (1948–1995) The state of national nutrition in Japan (in Japanese). Daiich, Tokyo

  16. Ministry of Health and Welfare (1999) Vital statistics of Japan 1997 (in Japanese). Statistics and Information Department, Minister's Secretariat, Tokyo

  17. Ministry of Finance (1953–1998) Population of Japan, 1950–1995. Bureau of Statistics, Office of the Prime Minister Yamato Sogo, Tokyo

  18. Jernvall P, Makinen MJ, Karttunen TJ, Makela J, Vihko P (1999) Microsatellite instability: impact on cancer progression in proximal and distal colorectal cancers. Eur J Cancer 35:197–201

    Article  CAS  PubMed  Google Scholar 

  19. Bleeker WA, Hayes VM, Karrenbeld A, Hofstra RM, Hermans J, Buys CC, Plukker JT (2000) Impact of KRAS and TP53 mutations on survival in patients with left- and right-sided Dukes' C colon cancer. Am J Gastroenterol 95:2953–2957

    Article  CAS  PubMed  Google Scholar 

  20. Gardner W, Mulvey EP, Shaw EC (1995) Regression analyses of counts and rates: Poisson, overdispersed Poisson and negative binomial models. Psychol Bull 118:392–404

    Article  CAS  PubMed  Google Scholar 

  21. McCullagh P, Nelder JA (1989) Generalized linear models, 2nd edn. Chapman & Hall, London

  22. Anonymous (ed) (1999) Development and achievement for 2 years. 51th Meeting of Japanese Association of Colorectal Cancer

  23. Levin B (1992) Nutrition and colorectal cancer. Cancer 70:1723–1726

    CAS  PubMed  Google Scholar 

  24. Boutron MC, Wilpart M, Faivre J (1991) Diet and colorectal cancer. Eur J Cancer Prev [Suppl 2]:13–20

    Google Scholar 

  25. Munakata A, Iwane S, Ohta M, Nakaji S, Sugawara K, Mori B (1995) Time trend of dietary fiber in Japan, 1917–1991. J Epidemiol 5:205–210

    Google Scholar 

  26. Nakaji S, Sugawara K, Saito D, Yoshioka Y, MacAuley D, Bradley T, Kernohan G, Baxter D (2002) Trends in dietary fiber intake in Japan over the last century. Eur J Nutr 41:222–227

    Article  PubMed  Google Scholar 

  27. Haenszel W, Kurihara M (1968) Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst 40:43–68

    CAS  PubMed  Google Scholar 

  28. Mamazza J, Gordon PH (1982) The changing distribution of large intestinal cancer. Dis Colon Rectum 25:558–562

    CAS  PubMed  Google Scholar 

  29. Loffeld R, Putten A, Balk A (1996) Changes in the localization of colorectal cancer: implications for clinical practice. J Gastroenterol Hepatol 11:47–50

    CAS  PubMed  Google Scholar 

  30. Miller A, Gorska M, Bassett M (2000) Proximal shift of colorectal cancer in the Australian Capital Territory over 20 years. Aust N Z J Med 30:221–225

    CAS  PubMed  Google Scholar 

  31. Slater G, Papatestas AE, Tartter PI, Mulvihill M, Aufses AH Jr (1982) Age distribution of right- and left-sided colorectal cancers. Am J Gastroenterol 77:63–66

    CAS  PubMed  Google Scholar 

  32. Pfister DG, Horwitz RI (1987) The rightward shift of colon cancer. Aging or artifact? J Clin Gastroenterol 9:58–61

    CAS  PubMed  Google Scholar 

  33. Demers RY, Severson RK, Schottenfeld D, Lazar L (1997) Incidence of colorectal adenocarcinoma by anatomic subsite. An epidemiologic study of time trends and racial differences in the Detroit, Michigan area. Cancer 79:441–447

    Article  CAS  PubMed  Google Scholar 

  34. Fleshner P, Slater G, Aufses AH Jr (1989) Age and sex distribution of patients with colorectal cancer. Dis Colon Rectum 32:730

    Google Scholar 

  35. Slater GI, Haber RH, Aufses AH Jr (1984) Changing distribution of carcinoma of the colon and rectum. Surg Gynecol Obstet 158:216–28

    CAS  PubMed  Google Scholar 

  36. Davila J, El-Serag H, Rabeneck L (2002) Is there a true "shift" to the right in the incidence of colorectal cancer? Ann Epidemiol 12:515–519

    Article  Google Scholar 

  37. Parkin DM, Muir CS, Whelan SL, Gao, YT, Ferlay J, Powell J (eds) (1992) Cancer incidence in five continents, vols II–VI. International Agency for Research on Cancer, Lyon

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Authors and Affiliations

  1. Department of Hygiene, Hirosaki University School of Medicine, 5 Zaifu-cho, 036-8562, Hirosaki, Japan

    Shigeyuki Nakaji, Takashi Umeda, Tadashi Shimoyama & Kazuo Sugawara

  2. First Department of Internal Medicine, Hirosaki University School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan

    Ken Tamura, Shinsaku Fukuda & Juichi Sakamoto

  3. Department of Environmental Epidemiology, National Cancer Research Institute, Largo R. Benzi, 10, 16132, Genova, Italy

    Stefano Parodi

Authors
  1. Shigeyuki Nakaji
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  2. Takashi Umeda
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  3. Tadashi Shimoyama
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  4. Kazuo Sugawara
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  5. Ken Tamura
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  6. Shinsaku Fukuda
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  7. Juichi Sakamoto
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  8. Stefano Parodi
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Correspondence to Shigeyuki Nakaji.

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Nakaji, S., Umeda, T., Shimoyama, T. et al. Environmental factors affect colon carcinoma and rectal carcinoma in men and women differently. Int J Colorectal Dis 18, 481–486 (2003). https://doi.org/10.1007/s00384-003-0485-0

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  • DOI: https://doi.org/10.1007/s00384-003-0485-0

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