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The Comparison of the Risk Factors and Clinical Manifestations of Proximal and Distal Colorectal Cancer

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

Colorectal cancers in the proximal or distal site have distinct clinical characteristics. In this study, the authors compared the risk factors of proximal and distal colorectal cancer.

Methods

A 16-page questionnaire was administered to 529 patients with colorectal cancer before operation. Cancers were classified as proximal or distal relative to the splenic flexure. Of these 529 patients, 6 patients were excluded because of the presence of synchronous colorectal cancers. Data of the 523 patients were analyzed.

Results

Total numbers of proximal and distal cancers were 123 and 400. The proportion of patients with Type 2 diabetes was significantly higher for distal cancer (P = 0.034), whereas a greater proportion of patients with proximal cancer had a gallstone history (P = 0.005). Multivariate analysis revealed Type 2 diabetes to be a risk factor for distal colorectal cancer (P = 0.027) and cholelithiasis to be a risk factor for proximal cancer (P = 0.049). The odds ratio for distal colorectal cancer among males with Type 2 diabetes was 4.1 (95 percent confidence interval, 1.4–12.1). On the other hand, a gallstone history was more associated with proximal colon cancer, especially in females (odds ratio = 5.5; 95 percent confidence interval, 1.4–20.9).

Conclusions

A comparison of the risk factors of proximal and distal colorectal cancer showed that Type 2 diabetes is associated with distal colorectal cancer in males and that cholelithiasis is associated with proximal colon cancer in females.

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Author information

Authors and Affiliations

  1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Sung-Wook Oh M.D., Young-Ho Kim M.D., Yong Sung Choi M.D., Dong Kyung Chang M.D., Hee Jung Son M.D., Poong-Lyul Rhee M.D., Jae J. Kim M.D. & Jong Chul Rhee M.D.

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Seong-Hyeon Yun M.D., Woo-Yong Lee M.D. & Ho-Kyung Chun M.D.

  3. Department of Molecular Cell Biology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Duk-Hwan Kim M.D.

  4. Department of Medicine, Masan Samsung Medical Center, Sungkyunkwan University School of Medicine, Masan, South Korea

    Sang Goon Shim M.D.

  5. Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Young-Ho Kim M.D.

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  1. Sung-Wook Oh M.D.
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  7. Jae J. Kim M.D.
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  8. Jong Chul Rhee M.D.
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  11. Ho-Kyung Chun M.D.
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  12. Duk-Hwan Kim M.D.
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  13. Sang Goon Shim M.D.
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Corresponding author

Correspondence to Young-Ho Kim M.D..

Additional information

Poster presentation at the United European Gastroenterology Week (UEGW), Berlin, German, October 21 to 25, 2006.

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Oh, SW., Kim, YH., Choi, Y.S. et al. The Comparison of the Risk Factors and Clinical Manifestations of Proximal and Distal Colorectal Cancer. Dis Colon Rectum 51, 56–61 (2008). https://doi.org/10.1007/s10350-007-9083-5

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  • DOI: https://doi.org/10.1007/s10350-007-9083-5

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