COLORECTAL CANCER AND ITS RISK FACTORS AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN SOUTHERN KARNATAKA, INDIA
Objective: To determine the association between certain socio-demographic and life style factors with colorectal cancer.
Methods: This case-control study was conducted using a pre-designed questionnaire among 100 incident colorectal cancer patients and 200 unmatched controls attending a tertiary care hospital in southern Karnataka. Cases and the controls were interviewed and details regarding their socio-demographic factors were collected. Information on lifestyle factors such as dietary habits, physical activity levels and substance use were documented. They were also assessed for presence of existing co-morbidities and family history of colorectal and other cancers. Multivariable logistic regression was performed to determine the association between various risk factors and colorectal cancer.
Results: In the present hospital based study, mean age of the participants was less than 55 years. Sixty three percent of the cases and 54.5% of the controls were males. On multivariable analysis age â‰¥50years (OR=1.87; 95%CI=1.02-3.45), low physical activity (OR=5.66; 95%CI=3.10-10.34) and low frequency of fruits consumption (OR=4.10; 95%CI=2.21-7.50) and hypertension (OR= 4.65; 95% CI=1.32-16.44) showed a positive association with colorectal cancer.
Conclusion: Promoting healthy dietary practices and physical activity among the middle aged population appears to be significant in the context of colorectal cancer prevention in the Indian subcontinent.
Keywords: Colorectal cancer, Caseâ€“control, Risk factors, Lifestyle, Comorbidities.
2. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127(12):2893-917.
3. Saranath D, Khanna A. Current status of cancer burden: Global and Indian scenario. Biomed Res J 2014;1(1):1-5.
4. Almurshed KS. Colorectal cancer: Case-control study of sociodemographic, lifestyle and anthropometric parameters in Riyadh. East Mediterr Health J 2009;15(4):817-26.
5. Pareek U, Trivedi G. Manual of Socio-economic Status Scale (Rural). Delhi: Manasayan; 1980.
6. International Physical Activity Questionnaire. Available from: https://www.sites.google.com/site/theipaq/questionnaire_links. [Last accessed on 2016 Jan 14].
7. Iswarya SK, Premarajan KC, Kar SS, Kumar SS, Kate V. Risk factors for the development of colorectal carcinoma: A case control study from South India. World J Gastrointest Oncol 2016;8(2):207-14.
8. Ries LA, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, et al. SEER Cancer Statistics Review, 1975-2005. Bethesda, MD: National Cancer Institute; 2008.
9. Simons CC, Hughes LA, van Engeland M, Goldbohm RA, van den Brandt PA, Weijenberg MP. Physical activity, occupational sitting time, and CRC risk in the Netherlands cohort study. Am J Epidemiol 2013;177:514-30.
10. Huxley RR, Ansary-Moghaddam A, Clifton P, Czernichow S, Parr CL, Woodward M. The impact of dietary and lifestyle risk factors on risk of colorectal cancer: A quantitative overview of the epidemiological evidence. Int J Cancer 2009;125(1):171-80.
11. Batty D, Thunee I. Does physical activity prevent cancer? Evidence suggests protection against colon cancer and probably breast cancer. BMJ 2000;128:1696-716.
12. Terry P, Giovannucci E, Michels KB, Bergkvist L, Hansen H, Holmberg L, et al. Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst 2001;93(7):525-33.
13. Murphy N, Norat T, Ferrari P, Jenab M, Bueno-de-Mesquita B, Skeie G, et al. Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). PLoS One 2012;7(6):e39361.
14. Aune D, Chan DS, Lau R, Vieira R, Greenwood DC, Kampman E, et al. Dietary fibre, whole grains, and risk of colorectal cancer: Systematic review and dose-response meta-analysis of prospective studies. BMJ 2011;343:d6617.
15. Ramzi NH, Chahil JK, Lye SH, Munretnam K, Sahadevappa KI, Velapasamy S, et al. Role of genetic and environment risk factors in the aetiology of colorectal cancer in Malaysia. Indian J Med Res 2014;139(6):873-82.
16. Nayak SP, Sasi MP, Sreejayan MP, Mandal S. A case-control study of roles of diet in colorectal carcinoma in a South Indian Population. Asian Pac J Cancer Prev 2009;10(4):565-8.
17. Heber D. Vegetables, fruits and phytoestrogens in the prevention of diseases. J Postgrad Med 2004;50(2):145-9.
18. Chao A, Thun MJ, Connell CJ, McCullough ML, Jacobs EJ, Flanders WD, et al. Meat consumption and risk of colorectal cancer. JAMA 2005;293(2):172-82.
19. Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, et al. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 2007;121(9):2065-72.
20. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: A meta-analysis. J Natl Cancer Inst 2005;97(2):1679-87.
21. Berster JM, GÃ¶ke B. Type 2 diabetes mellitus as risk factor for colorectal cancer. Arch Physiol Biochem 2008;114(1):84-98.
22. Nerkar D, Mukherjee A, Mehta BK, Banerjee S. Metabolic syndrome associated complications. Int J Pharm Pharm Sci 2015;7:22-5.
23. Aarnio M, Mecklin JP, Aaltonen LA, NystrÃ¶m-Lahti M, JÃ¤rvinen HJ. Life-time risk of different cancers in hereditary non-polyposis colorectal cancer (HNPCC) syndrome. Int J Cancer 1995;64(6):430-3.
24. Murff HJ, Spigel DR, Syngal S. Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 2004;292(12):1480-9.
25. Hamilton W, Lancashire R, Sharp D, Peters TJ, Cheng K, Marshall T. The risk of colorectal cancer with symptoms at different ages and between the sexes: A case-control study. BMC Med 2009;7:17.
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