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@ARTICLE{Carr:132935,
      author       = {P. Carr$^*$ and E. Alwers$^*$ and S. Bienert$^*$ and J.
                      Weberpals$^*$ and M. Kloor and H. Brenner$^*$ and M.
                      Hoffmeister$^*$},
      title        = {{L}ifestyle factors and risk of sporadic colorectal cancer
                      by microsatellite instability status: a systematic review
                      and meta-analyses.},
      journal      = {Annals of oncology},
      volume       = {29},
      number       = {4},
      issn         = {1569-8041},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DKFZ-2018-00574},
      pages        = {825 - 834},
      year         = {2018},
      abstract     = {The association of lifestyle factors with molecular
                      pathological subtypes of colorectal cancer (CRC), such as
                      microsatellite instability (MSI), could provide further
                      knowledge about the colorectal carcinogenic process. The aim
                      of this review was to evaluate possible associations between
                      lifestyle factors and risk of sporadic CRC by MSI
                      status.PubMed and Web of Science were searched for studies
                      investigating the association between alcohol, body mass
                      index, dietary fiber, hormone replacement therapy (HRT),
                      non-steroidal anti-inflammatory drugs, physical activity,
                      red meat, smoking, or statin use, with MSI-high (MSI-H) and
                      microsatellite stable (MSS) CRC. Meta-analyses were carried
                      out to calculate summary relative risks (sRR).Overall, 31
                      studies reporting on the association between lifestyle
                      factors and CRC according to MSI status were included in
                      this review. Ever smoking was associated with MSI-H
                      (sRR = 1.62; $95\%$ CI: 1.40-1.88) and MSS/MSI-low CRC
                      (sRR = 1.10; $95\%$ CI: 1.01-1.20), but the association
                      was significantly stronger for MSI-H CRC. The use of HRT was
                      associated with a $20\%$ decrease (sRR = 0.80; $95\%$
                      CI: 0.73-0.89) in the risk of MSS CRC, but was not
                      associated with MSI-H CRC. An increase in body mass index
                      per 5 kg/m2 was equally associated with MSS and MSI-H CRC
                      (sRR = 1.22, in both cases), but was statistically
                      significant for MSS CRC only $(95\%$ CI: 1.11-1.34 and
                      0.94-1.58, respectively). Limited evidence for associations
                      between other lifestyle factors and CRC by MSI status
                      exists.Lifestyle factors, such as HRT and smoking are
                      differentially associated with the risk of MSI-H and MSS
                      CRC. Further research on associations of lifestyle factors
                      and CRC subtypes is necessary to provide a better
                      understanding of the CRC disease pathway.},
      subtyp        = {Review Article},
      cin          = {C070 / G110 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29438474},
      doi          = {10.1093/annonc/mdy059},
      url          = {https://inrepo02.dkfz.de/record/132935},
}