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000141424 0247_ $$2doi$$a10.1016/j.cgh.2018.07.030
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000141424 037__ $$aDKFZ-2018-01930
000141424 041__ $$aeng
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000141424 1001_ $$aMurphy, Neil$$b0
000141424 245__ $$aHeterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.
000141424 260__ $$aNew York, NY$$bElsevier Science$$c2019
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000141424 520__ $$aColorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision.In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests.After a median of 14.9 years of follow-up evaluation of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors.The physical activity, anthropometry, and smoking relationships with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
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000141424 7001_ $$aWard, Heather A$$b1
000141424 7001_ $$aJenab, Mazda$$b2
000141424 7001_ $$aRothwell, Joseph A$$b3
000141424 7001_ $$aBoutron-Ruault, Marie-Christine$$b4
000141424 7001_ $$aCarbonnel, Franck$$b5
000141424 7001_ $$aKvaskoff, Marina$$b6
000141424 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b7$$udkfz
000141424 7001_ $$0P:(DE-He78)0907a10ba1dc8f53f04907f54f6fdcfe$$aKühn, Tilman$$b8$$udkfz
000141424 7001_ $$aBoeing, Heiner$$b9
000141424 7001_ $$aAleksandrova, Krasimira$$b10
000141424 7001_ $$aWeiderpass, Elisabete$$b11
000141424 7001_ $$aSkeie, Guri$$b12
000141424 7001_ $$aBorch, Kristin Benjaminsen$$b13
000141424 7001_ $$aTjønneland, Anne$$b14
000141424 7001_ $$aKyrø, Cecilie$$b15
000141424 7001_ $$aOvervad, Kim$$b16
000141424 7001_ $$aDahm, Christina C$$b17
000141424 7001_ $$aJakszyn, Paula$$b18
000141424 7001_ $$aSánchez, Maria-Jose$$b19
000141424 7001_ $$aGil, Leire$$b20
000141424 7001_ $$aHuerta, José M$$b21
000141424 7001_ $$aBarricarte, Aurelio$$b22
000141424 7001_ $$aQuirós, J Ramón$$b23
000141424 7001_ $$aKhaw, Kay-Tee$$b24
000141424 7001_ $$aWareham, Nick$$b25
000141424 7001_ $$aBradbury, Kathryn E$$b26
000141424 7001_ $$aTrichopoulou, Antonia$$b27
000141424 7001_ $$aLa Vecchia, Carlo$$b28
000141424 7001_ $$aKarakatsani, Anna$$b29
000141424 7001_ $$aPalli, Domenico$$b30
000141424 7001_ $$aGrioni, Sara$$b31
000141424 7001_ $$aTumino, Rosario$$b32
000141424 7001_ $$aFasanelli, Francesca$$b33
000141424 7001_ $$aPanico, Salvatore$$b34
000141424 7001_ $$aBueno-de-Mesquita, Bas$$b35
000141424 7001_ $$aPeeters, Petra H$$b36
000141424 7001_ $$aGylling, Björn$$b37
000141424 7001_ $$aMyte, Robin$$b38
000141424 7001_ $$aJirström, Karin$$b39
000141424 7001_ $$aBerntsson, Jonna$$b40
000141424 7001_ $$aXue, Xiaonan$$b41
000141424 7001_ $$aRiboli, Elio$$b42
000141424 7001_ $$aCross, Amanda J$$b43
000141424 7001_ $$aGunter, Marc J$$b44
000141424 773__ $$0PERI:(DE-600)2102638-5$$a10.1016/j.cgh.2018.07.030$$gp. S1542356518307560$$n7$$p1323-1331.e6$$tClinical gastroenterology and hepatology$$v17$$x1542-3565$$y2019
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