Skip to main content

Advertisement

SpringerLink
Log in

Environmental risk factors and colorectal neoplasia: Recent developments

  • Published:
Current Colorectal Cancer Reports

Abstract

The vast majority of new cases of colorectal cancer, the second most common cause of death in men and women in the United States, are attributable to environmental rather than genetic causes. Recent research has clarified inconsistencies in the literature and has explored new pathways through which risk factors may act. This review discusses newly published, selected interesting and important findings in colorectal cancer etiology; these include postmenopausal hormone use, nonsteroidal anti-inflammatory drug use, obesity, physical activity, diet, and other confirmed epidemiologic associations. This research provides insight into mechanisms and offers opportunities for prevention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Jemal A, Murray T, Ward E, et al.: Cancer statistics, 2005. CA Cancer J Clin 2005, 55:10–30.

    PubMed  Google Scholar 

  2. Potter JD: Colorectal cancer: molecules and populations. J Natl Cancer Inst 1999, 91:916–932.

    Article  PubMed  CAS  Google Scholar 

  3. Potter JD: Colorectal cancer. In World Cancer Report. Edited by Stewart BW, Kleihues O. Lyon: IARC Press; 2003:198–202.

    Google Scholar 

  4. Morson BC: The evolution of colorectal carcinoma. Clin Radiol 1984, 35:425–431.

    Article  PubMed  CAS  Google Scholar 

  5. Hersh AL, Stefanick ML, Stafford RS: National use of postmenopausal hormone therapy: annual trends and response to recent evidence. JAMA 2004, 291:47–53.

    Article  PubMed  CAS  Google Scholar 

  6. Anderson GL, Limacher M, Assaf AR, et al.: Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA 2004, 291:1701–1712. Results from the Women’s Health Initiative randomized trial of conjugated equine estrogen demonstrated no association with CRC risk.

    Article  PubMed  CAS  Google Scholar 

  7. Chlebowski RT, Wactawski-Wende J, Ritenbaugh C, et al.: Estrogen plus progestin and colorectal cancer in postmenopausal women. N Engl J Med 2004, 350:991–1004. Results from the Women’s Health Initiative randomized trial of estrogen plus progestin demonstrated a statistically significant reduction in CRC risk for women who used estrogen plus progestin compared with placebo.

    Article  PubMed  CAS  Google Scholar 

  8. Grodstein F, Newcomb PA, Stampfer MJ: Postmenopausal hormone therapy and the risk of colorectal cancer: a review and meta-analysis. Am J Med 1999, 106:574–582.

    Article  PubMed  CAS  Google Scholar 

  9. English MA, Kane KF, Cruickshank N, et al.: Loss of estrogen inactivation in colonic cancer. J Clin Endocrinol Metab 1999, 84:2080–2085.

    Article  PubMed  CAS  Google Scholar 

  10. Morimoto LM, Newcomb PA, White E, et al.: Insulin-like growth factor polymorphisms and colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 2005, 14:1204–1211.

    Article  PubMed  CAS  Google Scholar 

  11. Brown JR, DuBois RN: COX-2: a molecular target for colorectal cancer prevention. J Clin Oncol 2005, 23:2840–2855.

    Article  PubMed  CAS  Google Scholar 

  12. Asano TK, McLeod RS: Nonsteroidal anti-inflammatory drugs and aspirin for the prevention of colorectal adenomas and cancer: a systematic review. Dis Colon Rectum 2004, 47:665–673. The results from this review of three randomized trials indicate that there was a significant reduction in the recurrence of sporadic adenomatous polyps when aspirin was used.

    Article  PubMed  CAS  Google Scholar 

  13. Cook NR, Lee IM, Gaziano JM, et al.: Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. JAMA 2005, 294:47–55.

    Article  PubMed  CAS  Google Scholar 

  14. Thun MJ, Henley SJ, Patrono C: Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst 2002, 94:252–266.

    PubMed  CAS  Google Scholar 

  15. Slattery ML, Samowitz W, Hoffman M, et al.: Aspirin, NSAIDs, and colorectal cancer: possible involvement in an insulinrelated pathway. Cancer Epidemiol Biomarkers Prev 2004, 13:538–545.

    PubMed  CAS  Google Scholar 

  16. Michels KB, Giovannucci E, Joshipura KJ, et al.: Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst 2000, 92:1740–1752.

    Article  PubMed  CAS  Google Scholar 

  17. Papas MA, Giovannucci E, Platz EA: Fiber from fruit and colorectal neoplasia. Cancer Epidemiol Biomarkers Prev 2004, 13:1267–1270.

    PubMed  CAS  Google Scholar 

  18. Sandhu MS, White IR, McPherson K: Systematic review of the prospective cohort studies on meat consumption and colorectal cancer risk: a meta-analytical approach. Cancer Epidemiol Biomarkers Prev 2001, 10:439–446.

    PubMed  CAS  Google Scholar 

  19. Norat T, Lukanova A, Ferrari P, Riboli E: Meat consumption and colorectal cancer risk: dose-response meta-analysis of epidemiological studies. Int J Cancer 2002, 98:241–256.

    Article  PubMed  CAS  Google Scholar 

  20. Lin J, Zhang SM, Cook NR, et al.: Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States). Cancer Causes Control 2005, 16:225–233.

    Article  PubMed  Google Scholar 

  21. Michels KB, Fuchs CS, Giovannucci E, et al.: Fiber intake and incidence of colorectal cancer among 76,947 women and 47,279 men. Cancer Epidemiol Biomarkers Prev 2005, 14:842–849.

    Article  PubMed  Google Scholar 

  22. Slattery ML, Curtin KP, Edwards SL, Schaffer DM: Plant foods, fiber, and rectal cancer. Am J Clin Nutr 2004, 79:274–281.

    PubMed  CAS  Google Scholar 

  23. Brink M, Weijenberg MP, de Goeij AF, et al.: Meat consumption and K-ras mutations in sporadic colon and rectal cancer in The Netherlands Cohort Study. Br J Cancer 2005, 92:1310–1320.

    Article  PubMed  CAS  Google Scholar 

  24. English DR, MacInnis RJ, Hodge AM, et al.: Red meat, chicken, and fish consumption and risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2004, 13:1509–1514.

    PubMed  Google Scholar 

  25. Larsson SC, Rafter J, Holmberg L, et al.: Red meat consumption and risk of cancers of the proximal colon, distal colon and rectum: the Swedish Mammography Cohort. Int J Cancer 2005, 113:829–834.

    Article  PubMed  CAS  Google Scholar 

  26. Chao A, Thun MJ, Connell CJ, et al.: Meat consumption and risk of colorectal cancer. JAMA 2005, 293:172–182.

    Article  PubMed  CAS  Google Scholar 

  27. Tiemersma EW, Voskuil DW, Bunschoten A, et al.: Risk of colorectal adenomas in relation to meat consumption, meat preparation, and genetic susceptibility in a Dutch population. Cancer Causes Control 2004, 15:225–236.

    Article  PubMed  Google Scholar 

  28. Mathew A, Sinha R, Burt R, et al.: Meat intake and the recurrence of colorectal adenomas. Eur J Cancer Prev 2004, 13:159–164.

    Article  PubMed  CAS  Google Scholar 

  29. Butler LM, Sinha R, Millikan RC, et al.: Heterocyclic amines, meat intake, and association with colon cancer in a population-based study. Am J Epidemiol 2003, 157:434–445.

    Article  PubMed  CAS  Google Scholar 

  30. Cross AJ, Sinha R: Meat-related mutagens/carcinogens in the etiology of colorectal cancer. Environ Mol Mutagen 2004, 44:44–55.

    Article  PubMed  CAS  Google Scholar 

  31. Sanjoaquin MA, Allen N, Couto E, et al.: Folate intake and colorectal cancer risk: a meta-analytical approach. Int J Cancer 2005, 113:825–828.

    Article  PubMed  CAS  Google Scholar 

  32. Larsson SC, Bergkvist L, Wolk A: Magnesium intake in relation to risk of colorectal cancer in women. JAMA 2005, 293:86–89.

    Article  PubMed  CAS  Google Scholar 

  33. Jacobs ET, Jiang R, Alberts DS, et al.: Selenium and colorectal adenoma: results of a pooled analysis. J Natl Cancer Inst 2004, 96:1669–1675.

    Article  PubMed  CAS  Google Scholar 

  34. Chia VM, Newcomb PA: Calcium and colorectal cancer: some questions remain. Nutr Rev 2004, 62:115–120.

    Article  PubMed  Google Scholar 

  35. Lin J, Zhang SM, Cook NR, et al.: Intakes of calcium and vitamin D and risk of colorectal cancer in women. Am J Epidemiol 2005, 161:755–764.

    Article  PubMed  Google Scholar 

  36. Flood A, Peters U, Chatterjee N, et al.: Calcium from diet and supplements is associated with reduced risk of colorectal cancer in a prospective cohort of women. Cancer Epidemiol Biomarkers Prev 2005, 14:126–132.

    PubMed  CAS  Google Scholar 

  37. Hartman TJ, Albert PS, Snyder K, et al.: The association of calcium and vitamin D with risk of colorectal adenomas. J Nutr 2005, 135:252–259.

    PubMed  CAS  Google Scholar 

  38. Lamprecht SA, Lipkin M: Chemoprevention of colon cancer by calcium, vitamin D and folate: molecular mechanisms. Nature Reviews Cancer 2003, 3:601–614.

    Article  PubMed  CAS  Google Scholar 

  39. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL: Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord 1998, 22:39–47.

    Article  PubMed  CAS  Google Scholar 

  40. Doria-Rose VP, Newcomb PA, Morimoto LM, et al.: Body mass index and the risk of death following the diagnosis of colorectal cancer in postmenopausal women. Cancer Causes Control 2005, in press.

  41. Giovannucci E: Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 2001, 131:3109S-3120S.

    PubMed  CAS  Google Scholar 

  42. Wei EK, Ma J, Pollak MN, et al.: A prospective study of C-peptide, insulin-like growth factor-I, insulin-like growth factor binding protein-1, and the risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev 2005, 14:850–855.

    Article  PubMed  CAS  Google Scholar 

  43. Ma J, Giovannucci E, Pollak M, et al.: A prospective study of plasma C-peptide and colorectal cancer risk in men. J Natl Cancer Inst 2004, 96:546–553.

    Article  PubMed  CAS  Google Scholar 

  44. Considine RV, Caro JF: Leptin: genes, concepts and clinical perspective. Horm Res 1996, 46:249–256.

    Article  PubMed  CAS  Google Scholar 

  45. Hardwick JC, Van Den Brink GR, Offerhaus GJ, et al.: Leptin is a growth factor for colonic epithelial cells. Gastroenterology 2001, 121:79–90.

    Article  PubMed  CAS  Google Scholar 

  46. Stattin P, Palmqvist R, Soderberg S, et al.: Plasma leptin and colorectal cancer risk: a prospective study in Northern Sweden. Oncol Rep 2003, 10:2015–2021.

    PubMed  Google Scholar 

  47. Tessitore L, Vizio B, Jenkins O, et al.: Leptin expression in colorectal and breast cancer patients. Int J Mol Med 2000, 5:421–426.

    PubMed  CAS  Google Scholar 

  48. Stattin P, Lukanova A, Biessy C, et al.: Obesity and colon cancer: does leptin provide a link? Int J Cancer 2004, 109:149–152.

    Article  PubMed  CAS  Google Scholar 

  49. Colditz GA, Cannuscio CC, Frazier AL: Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Causes Control 1997, 8:649–667.

    Article  PubMed  CAS  Google Scholar 

  50. Chao A, Connell CJ, Jacobs EJ, et al.: Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 2004, 13:2187–2195.

    PubMed  Google Scholar 

  51. Giovannucci E, Martinez ME: Tobacco, colorectal cancer, and adenomas: a review of the evidence. J Natl Cancer Inst 1996, 88:1717–1730.

    Article  PubMed  CAS  Google Scholar 

  52. Giovannucci E: An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2001, 10:725–731.

    PubMed  CAS  Google Scholar 

  53. Tiemersma EW, Bunschoten A, Kok FJ, et al.: Effect of SULT1A1 and NAT2 genetic polymorphism on the association between cigarette smoking and colorectal adenomas. Int J Cancer 2004, 108:97–103.

    Article  PubMed  CAS  Google Scholar 

  54. Tranah GJ, Giovannucci E, Ma J, et al.: Epoxide hydrolase polymorphisms, cigarette smoking and risk of colorectal adenoma in the Nurses’ Health Study and the Health Professionals Follow-up Study. Carcinogenesis 2004, 25:1211–1218.

    Article  PubMed  CAS  Google Scholar 

  55. Slattery ML, Curtin K, Anderson K, et al.: Associations between cigarette smoking, lifestyle factors, and microsatellite instability in colon tumors. J Natl Cancer Inst 2000, 92:1831–1836.

    Article  PubMed  CAS  Google Scholar 

  56. Colangelo LA, Gapstur SM, Gann PH, Dyer AR: Cigarette smoking and colorectal carcinoma mortality in a cohort with long-term follow-up. Cancer 2004, 100:288–293.

    Article  PubMed  Google Scholar 

  57. Cho E, Smith-Warner SA, Ritz J, et al.: Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies. Ann Intern Med 2004, 140:603–613.

    PubMed  Google Scholar 

  58. Su LJ, Arab L: Alcohol consumption and risk of colon cancer: evidence from the national health and nutrition examination survey I epidemiologic follow-up study. Nutr Cancer 2004, 50:111–119.

    Article  PubMed  Google Scholar 

  59. Morimoto LM, Newcomb PA, Ulrich CM, et al.: Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential?. Cancer Epidemiol Biomarkers Prev 2002, 11:1012–1018. Results indicate that there are similar risk factors for colorectal hyperplastic polyps, adenomatous polyps, and cancer.

    PubMed  Google Scholar 

  60. Lieberman DA, Prindiville S, Weiss DG, Willett W: Risk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals. JAMA 2003, 290:2959–2967.

    Article  PubMed  Google Scholar 

  61. Mori H, Yamada Y, Kuno T, Hirose Y: Aberrant crypt foci and beta-catenin accumulated crypts; significance and roles for colorectal carcinogenesis. Mutat Res 2004, 566:191–208.

    Article  PubMed  CAS  Google Scholar 

  62. Slattery ML, Potter JD, Curtin K, et al.: Estrogens reduce and withdrawal of estrogens increase risk of microsatellite instability- positive colon cancer. Cancer Res 2001, 61:126–130.

    PubMed  CAS  Google Scholar 

  63. Jubb AM, Quirke P, Oates AJ: DNA methylation, a biomarker for colorectal cancer: implications for screening and pathological utility. Ann N Y Acad Sci 2003, 983:251–267.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M4-B402, 98109-1024, Seattle, WA, USA

    Victoria M. Chia MPH

Authors
  1. Victoria M. Chia MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Polly A. Newcomb PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chia, V.M., Newcomb, P.A. Environmental risk factors and colorectal neoplasia: Recent developments. Curr colorectal cancer rep 1, 67–72 (2005). https://doi.org/10.1007/s11888-005-0002-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11888-005-0002-7

Keywords

Search

Navigation