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@ARTICLE{Murphy:141424,
author = {N. Murphy and H. A. Ward and M. Jenab and J. A. Rothwell
and M.-C. Boutron-Ruault and F. Carbonnel and M. Kvaskoff
and R. Kaaks$^*$ and T. Kühn$^*$ and H. Boeing and K.
Aleksandrova and E. Weiderpass and G. Skeie and K. B. Borch
and A. Tjønneland and C. Kyrø and K. Overvad and C. C.
Dahm and P. Jakszyn and M.-J. Sánchez and L. Gil and J. M.
Huerta and A. Barricarte and J. R. Quirós and K.-T. Khaw
and N. Wareham and K. E. Bradbury and A. Trichopoulou and C.
La Vecchia and A. Karakatsani and D. Palli and S. Grioni and
R. Tumino and F. Fasanelli and S. Panico and B.
Bueno-de-Mesquita and P. H. Peeters and B. Gylling and R.
Myte and K. Jirström and J. Berntsson and X. Xue and E.
Riboli and A. J. Cross and M. J. Gunter},
title = {{H}eterogeneity of {C}olorectal {C}ancer {R}isk {F}actors
by {A}natomical {S}ubsite in 10 {E}uropean {C}ountries:
{A} {M}ultinational {C}ohort {S}tudy.},
journal = {Clinical gastroenterology and hepatology},
volume = {17},
number = {7},
issn = {1542-3565},
address = {New York, NY},
publisher = {Elsevier Science},
reportid = {DKFZ-2018-01930},
pages = {1323-1331.e6},
year = {2019},
abstract = {Colorectal 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.},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:30056182},
doi = {10.1016/j.cgh.2018.07.030},
url = {https://inrepo02.dkfz.de/record/141424},
}