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Kim GJ, Han KD, Joo YH. Association of Metabolic Syndrome with the Risk of Head and Neck Cancer: A 10-Year Follow-Up Study of 10 Million Initially Healthy Individuals. Cancers (Basel) 2023; 15:4118. [PMID: 37627146 PMCID: PMC10452383 DOI: 10.3390/cancers15164118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/13/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of this national population-based retrospective study was to analyze the relationship between MetS and the incidence of HNC. In this Korean population-based cohort study, 9,598,085 subjects above the age of 20 were monitored from 1 January 2009 to 31 December 2018. In the study population, a total of 10,732 individuals were newly diagnosed with HNC during the 10-year follow-up. The hazard ratio (HR), after adjusting for age, gender, smoking status, alcohol intake, and exercise, indicated that participants with MetS were at a 1.06-fold (95% CI: 1.01-1.10) higher risk of having HNC than those without MetS. Participants with MetS showed an increased risk of developing oral cavity cancer (HR, 1.12; 95% CI, 1.03-1.23) and laryngeal cancer (HR, 1.18; 95% CI, 1.09-1.27). Among the components of MetS, elevated fasting glucose (HR = 1.04, 95% CI: 1.00-1.08) and elevated blood pressure (HR = 1.08, 95% CI: 1.04-1.13) were significantly associated with an increased HR for HNC in an adjusted multivariable model. The association between HNC and MetS remained significant even among individuals who had never smoked or were ex-smokers (HR: 1.09; 95% CI: 1.04-1.15), as well as those who did not drink or were mild drinkers (HR: 1.07; 95% CI: 1.02-1.12). The findings of this cohort study suggest MetS was associated with an increased risk for some types of HNCs. The results of this study could assist with etiological investigations and prevention strategies.
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Affiliation(s)
- Geun-Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
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Choi SY, Cheong HK, Lee MK, Kang JW, Lee YC, Oh IH, Eun YG. Metabolic Diseases and Risk of Head and Neck Cancer: A Cohort Study Analyzing Nationwide Population-Based Data. Cancers (Basel) 2022; 14. [PMID: 35805048 DOI: 10.3390/cancers14133277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of the study was to investigate the association between metabolic diseases and the risk of head and neck cancer (HNC) using nationwide population-based big data. This retrospective cohort study was conducted using the Korean National Health Insurance Service health checkup database. A total of 4,575,818 participants aged >40 years who received a health checkup in 2008 were enrolled, and we studied the incidence of HNC until 2019. We analyzed the risk of HNC according to the presence of metabolic diseases, such as obesity, dyslipidemia, hypertension, and diabetes. Although metabolic syndrome itself was not associated with HNC, each component of metabolic syndrome was associated with HNC. Underweight and diabetes were risk factors for HNC (HR: 1.694). High total cholesterol and high low-density lipoprotein cholesterol levels were factors that decreased the risk (HR 0.910 and 0.839). When we analyzed men and women separately, low total cholesterol level, low low-density lipoprotein cholesterol level, and hypertension were risk factors only in men. In addition, pre-obesity, obesity, and central obesity decreased the risk only in men. Each metabolic disease affects HNC in different ways. Underweight and diabetes increased the risk of HNC, whereas high total cholesterol and high low-density lipoprotein cholesterol levels decreased the risk of HNC.
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Lee H, Lee HW, Kim SU, Chang Kim H. Metabolic Dysfunction-Associated Fatty Liver Disease Increases Colon Cancer Risk: A Nationwide Cohort Study. Clin Transl Gastroenterol 2022; 13:e00435. [PMID: 35080508 PMCID: PMC8806363 DOI: 10.14309/ctg.0000000000000435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The association between nonalcoholic fatty liver disease (NAFLD) and colorectal cancer (CRC) has been controversial. Using the new consensus-driven definition, we evaluated the association of metabolic dysfunction-associated fatty liver disease (MAFLD) with the risk of developing CRC. METHODS From a nationwide health screening database, we included 8,933,017 participants (48.6% male) aged 40-64 years between 2009 and 2010. Participants were categorized by the presence of fatty liver disease (FLD)-NAFLD and MAFLD, separately-and by the combination of the 2 definitions: neither FLD, NAFLD only, MAFLD only, or both FLD. The primary outcome was the development of CRC. RESULTS Among the participants, 2,517,330 (28.2%) had NAFLD, and 3,337,122 (37.4%) had MAFLD, whereas 2,465,151 (27.6%) met both NAFLD and MAFLD definitions. Over a median follow-up period of 10.1 years, 60,888 new CRC cases developed. NAFLD and MAFLD were each associated with a significantly higher risk of developing CRC. When the neither FLD group was the reference, multivariable-adjusted hazard ratios (95% confidence interval) for CRC were 1.16 (1.06-1.28) in the NAFLD only group, 1.18 (1.16-1.20) in the both FLD group, and 1.32 (1.28-1.35) in the MAFLD only group. The presence of advanced liver fibrosis further increased CRC risk in each FLD group. DISCUSSION FLD was associated with a higher risk of CRC development. CRC risk was higher in the presence of MAFLD, especially when accompanied by liver fibrosis.
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Affiliation(s)
- Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Jimba T, Kaneko H, Yano Y, Itoh H, Yotsumoto H, Seki H, Morita K, Kiriyama H, Kamon T, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Nishiyama A, Node K, Yasunaga H, Komuro I. Relation of the Metabolic Syndrome to Incident Colorectal Cancer in Young Adults Aged 20 to 49 Years. Am J Cardiol 2021; 158:132-138. [PMID: 34481589 DOI: 10.1016/j.amjcard.2021.07.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022]
Abstract
Onco-cardiology is the emerging field, and the concept of shared risk factor holds an important position in this field. The increasing prevalence of colorectal cancer (CRC) in young adults is a critical epidemiological issue. Although metabolic syndrome, which is a major risk factor for cardiovascular disease, is known to be associated with CRC incidence in middle-aged and elderly individuals, it is unclear whether this association is present in young adults. We assessed whether metabolic syndrome was associated with CRC events in young adults (aged <50 years), and whether the association differed by the definition of metabolic syndrome. We retrospectively analyzed 902,599 adults (20 to 49 years of age) enrolled in the JMDC Claims Database which is a nationwide epidemiological database in Japan between January 2005 and August 2018. Participants who had a history of CRC, colorectal polyps, or inflammatory bowel disease were excluded. Study participants were categorized into 2 groups according to the presence of metabolic syndrome, defined using the Japanese criteria (waist circumference ≥85 cm for men and ≥90 cm for women, and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). Clinical outcomes were collected between January 2005 and August 2018. The primary outcome was CRC of any stage. Median (interquartile range) age was 41 (37 to 45), and 55.4% were men. Over a median follow-up of 1,008 (429 to 1,833) days, there were 1,884 incidences of CRC. After multivariable adjustment, the hazard ratio (HR) of metabolic syndrome for CRC events was 1.26 (95% confidence interval [CI] = 1.07 to 1.49). Cox regression analysis after multiple imputation for missing values showed that metabolic syndrome was associated with CRC incidence (HR = 1.35, 95% CI = 1.17 to 1.56). Metabolic syndrome was also associated with a higher incidence of CRC in individuals with a follow-up period of ≥365 days (HR = 1.33, 95% CI = 1.10 to 1.60). This association was observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR = 1.30, 95% CI = 1.09 to 1.55) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR = 1.39, 95% CI = 1.12 to 1.72). In conclusion, metabolic syndrome was associated with a higher incidence of CRC among individuals aged <50 years. These results could be informative for risk stratification of subsequent CRC among young adults.
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Affiliation(s)
- Takahiro Jimba
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidehiro Kaneko
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
| | - Yuichiro Yano
- YCU Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Yokohama, Japan; The Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| | - Hidetaka Itoh
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruki Yotsumoto
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hikari Seki
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- The Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Kiriyama
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Kamon
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Nobuaki Michihata
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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Itoh H, Kaneko H, Okada A, Yano Y, Morita K, Seki H, Kiriyama H, Kamon T, Fujiu K, Matsuoka S, Nakamura S, Michihata N, Jo T, Takeda N, Morita H, Nishiyama A, Node K, Yasunaga H, Komuro I. Fasting Plasma Glucose and Incident Colorectal Cancer: Analysis of a Nationwide Epidemiological Database. J Clin Endocrinol Metab 2021; 106:e4448-e4458. [PMID: 34378781 DOI: 10.1210/clinem/dgab466] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 12/24/2022]
Abstract
CONTEXT Although diabetes mellitus (DM) was reported to be associated with incident colorectal cancer (CRC), the detailed association between fasting plasma glucose (FPG) and incident CRC has not been fully understood. OBJECTIVE We assessed whether hyperglycemia is associated with a higher risk for CRC. DESIGN Analyses were conducted using the JMDC Claims Database [n = 1 441 311; median age (interquartile range), 46 (40-54) years; 56.6% men). None of the participants were taking antidiabetic medication or had a history of CRC, colorectal polyps, or inflammatory bowel disease. Participants were categorized as normal FPG (FPG level < 100 mg/dL; 1 125 647 individuals), normal-high FPG (FPG level = 100-109 mg/dL; 210 365 individuals), impaired fasting glucose (IFG; FPG level = 110-125 mg/dL; 74 836 individuals), and DM (FPG level ≥ 126 mg/dL; 30 463 individuals). RESULTS Over a mean follow-up of 1137 ± 824 days, 5566 CRC events occurred. After multivariable adjustment, the hazard ratios for CRC events were 1.10 (95% CI 1.03-1.18) for normal-high FPG, 1.24 (95% CI 1.13-1.37) for IFG, and 1.36 (95% CI 1.19-1.55) for DM vs normal FPG. We confirmed this association in sensitivity analyses excluding those with a follow-up of< 365 days and obese participants. CONCLUSION The risk of CRC increased with elevated FPG category. FPG measurements would help to identify people at high-risk for future CRC.
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Affiliation(s)
- Hidetaka Itoh
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-related Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yuichiro Yano
- YCU Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Yokohama, Japan
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Kojiro Morita
- Global Nursing Research Center, Graduate School of Medicine, University of Tokyo
| | - Hikari Seki
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroyuki Kiriyama
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Tatsuya Kamon
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan
| | - Satoshi Matsuoka
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Sunao Nakamura
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- Department of Health Services Research, University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
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Cheng WC, Chen PJ, Kang JW, Chen WY, Sheu BS. Age, male sex, smoking and metabolic syndrome as risk factors of advanced colorectal neoplasia for fecal immunochemical test negative patients. J Formos Med Assoc 2021; 121:402-408. [PMID: 34127350 DOI: 10.1016/j.jfma.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/02/2021] [Accepted: 05/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Fecal immunochemical test (FIT) is worldwide strategy for colorectal cancer screening. The subjects with negative FIT still have the risk of an advanced colorectal neoplasia (AN), including adenoma with villous histology, high grade dysplasia or larger than 1 cm in size, or adenocarcinoma. The study determined the risk factors associated with AN in FIT-negative subjects. METHODS The study included asymptomatic subjects who received health checkup colonoscopy and have provided FIT study within 6 months prior to colonoscopy. The risk factors to have AN in cases with negative FIT were analyzed. The numbers of colonoscopies needed to detect one AN were calculated for the subjects with different risk factors. RESULTS There were 1411 cases, 85 with positive FIT and 1326 with negative FIT within 6 months before colonoscopy. In FIT positive and FIT negative cases, 45.9% and 34.6% were found to have colorectal adenoma, while 20.2% and 4.6% had AN, respectively. The univariate and multivariate logistic regression analyses showed that age more than 50 years old, male sex, smoking history and metabolic syndrome were the significant risk factors to have AN in the FIT negative cases. For cases with negative FIT to have these risk factors, the number of colonoscopies needed to detect one AN was 3.7, lower than 4.5 of the cases with positive FIT. CONCLUSION For the cases with negative FIT, colonoscopy screening should be considered for those male patients over 50 years old, with a history of smoking and metabolic syndrome to detect AN.
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Affiliation(s)
- Wei-Chun Cheng
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Gastroenterology Department, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Wen Kang
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Ku MS, Chiu SYH, Chien KL, Lee YC, Chen SLS, Chen CD. Gender difference in metabolic syndrome and incident colorectal adenoma: A prospective observational study (KCIS No.42). Medicine (Baltimore) 2021; 100:e26121. [PMID: 34087861 PMCID: PMC8183717 DOI: 10.1097/md.0000000000026121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 04/18/2021] [Accepted: 05/10/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13-1.58) in males and 1.33 (95% CI: 1.06-1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100-125 mg/dL, aHR = 1.44, 95% CI: 1.12-1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.
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Affiliation(s)
- Mei-Sheng Ku
- Institute of Environmental and Occupational Health Science, College of Public Health, National Taiwan University, Taipei
| | - Sherry Yueh-Hsia Chiu
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public School
- Department of Internal Medicine, College of Medicine
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University
| | - Yi-Chia Lee
- Institute of Epidemiology and Preventive Medicine, College of Public School
- Department of Internal Medicine, College of Medicine
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University
- Department of Medical Research, National Taiwan University Hospital
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine
- TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei
| | - Chih-Dao Chen
- Department of Family Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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Jiang H, Zhou L, He Q, Jiang K, Yuan J, Huang X. The effect of metabolic syndrome on head and neck cancer incidence risk: a population-based prospective cohort study. Cancer Metab 2021; 9:25. [PMID: 34082811 PMCID: PMC8173864 DOI: 10.1186/s40170-021-00261-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/24/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There are limited evidences clarifying the impact of metabolic syndrome (MS) and its components on head and neck cancer (HNC) incidence risk. We explored the correlation between MS, MS components, and the combined effects of MS and C-reactive protein (CRP) and HNC risk. METHODS This is a prospective analysis of 474,929 participants from the UK Biobank cohort. Cox proportional hazard regression was utilized to assess the hazard ratio (HR) and 95% confidence interval (CI) and to explore the non-linear correlation between an individual MS component and HNC risk. RESULTS Individuals with MS (HR, 1.05; 95%CI, 0.90-1.22) had no higher HNC risk than those without MS. More MS components showed no higher HNC risk. Nevertheless, hyperglycemia (HR, 1.22; 95%CI, 1.02-1.45) was independently correlated with elevated HNC risk. In a non-linear manner, waist circumference and high-density lipoprotein cholesterol (HDL-C) showed a U-shaped association with HNC risk. Further, piecewise linear model analysis indicated that higher male waist circumference, female waist circumference (≥93.16 cm), blood glucose (≥4.70 mmol/L) and male HDL-C (≥1.26mmo/L), and lower male HDL-C (<1.26mmo/L) were correlated with higher HNC risk. Increased CRP (≥1.00mg/dL) elevated HNC risk and individuals with MS and CRP≥1.00mg/dL had the highest HNC risk (HR, 1.29; 95%CI, 1.05-1.58). But no joint effect between MS and CRP was detected (p-interaction=0.501). CONCLUSIONS MS are not correlated with elevated HNC risk. High waist circumference and blood glucose are independent risk factor of HNC incidence. Controlling HDL-C in an appropriate range can get the lowest risk of male HNC. No joint effect of MS and CRP exists in HNC tumorigenesis.
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Affiliation(s)
- Huaili Jiang
- Department of Otolaryngology, Zhongshan Hospital, Fudan University, Shanghai, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lei Zhou
- Department of Otolaryngology, Zhongshan Hospital, Fudan University, Shanghai, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiangsheng He
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, 628 Zhenyuan Road, Shenzhen, 518107, Guangdong, China
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Kanglun Jiang
- Department of Otolaryngology, Zhongshan Hospital, Fudan University, Shanghai, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jinqiu Yuan
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, 628 Zhenyuan Road, Shenzhen, 518107, Guangdong, China.
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Xinsheng Huang
- Department of Otolaryngology, Zhongshan Hospital, Fudan University, Shanghai, China.
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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Xuan K, Zhao T, Sun C, Patel AS, Liu H, Chen X, Qu G, Sun Y. The association between hypertension and colorectal cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2021; 30:84-96. [PMID: 32039929 DOI: 10.1097/cej.0000000000000578] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The relationship between hypertension and risk of colorectal cancer (CRC) is unclear. This meta-analysis aims to explore the association between them. Six databases were searched for studies published before August 2019. The pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated to estimate the association between the hypertension and CRC risk. A total of 2841 potentially relevant articles were obtained, and 25 studies with a pooled 1.95 million participants were finally included in the meta-analysis. These results suggested a positive association between hypertension and risk of CRC with a pooled RR of 1.15 (95% CI: 1.08, 1.23). Male patients with hypertension had a 13% (95% CI: 1.06, 1.20) increased risk of CRC. The risk of colon cancer and rectal cancer in male patients was 1.17 (95% CI: 1.01, 1.36) and 1.35 (95% CI: 1.04, 1.74), respectively, while no association between hypertension and the risk of CRC in females was elucidated. This meta-analysis demonstrated that a positive association between hypertension and CRC exists, with male patients having a higher risk of developing CRC than female patients.
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Affiliation(s)
- Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago
| | - Akash S Patel
- University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China
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Ku MS, Fann JCY, Chiu SYH, Chen HH, Hsu CY. Elucidating bidirectional relationship between metabolic syndrome and elevated faecal haemoglobin concentration: a Taiwanese community-based cohort study. BMJ Open 2019; 9:e021153. [PMID: 30826754 PMCID: PMC6429718 DOI: 10.1136/bmjopen-2017-021153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To elucidate the bidirectional temporal relationship between elevated faecal haemoglobin (f-Hb) concentration and metabolic syndrome (MetS). DESIGN A longitudinal cohort study was conducted by utilising data on community-based periodical screening for colorectal cancer with faecal immunochemical test (FIT) and health check-up for MetS. SETTING Population-based organised integrated service screening in Keelung city, Taiwan. PARTICIPANTS We enrolled a total of 62,293 community residents aged 40-79 years. MAIN OUTCOMES AND MEASURES Bidirectional outcomes of FIT-positive and MetS were measured. RESULTS The presence of MetS at baseline led to a statistically significant 31% elevated risk of being incident FIT-positive (adjusted HR, (aHR)=1.31, 95% CI: 1.14 to 1.51) whereas the effect of those with FIT-positive at baseline on incident MetS was not statistically significant (aHR=1.06, 95% CI: 0.89 to 1.25) after adjusting for relevant confounders. Such an effect was particularly noted for three individual components (abnormal waist circumference, higher fasting plasma glucose and lower high-density lipoprotein). CONCLUSIONS Our finding on the presence of MetS before FIT-positive based on bidirectional relationship assessment suggests the control of MetS may contribute to reducing the risk of colorectal neoplasia through the early surveillance of f-Hb. However, such a temporal epidemiological finding still needs to be verified by using other external data.
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Affiliation(s)
- Mei-Sheng Ku
- Graduate Institute of Environmental Health, College of PublicHealth, National Taiwan University, Taipei, Taiwan
| | - Jean Ching-Yuan Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Taoyuan, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - Hsiu-Hsi Chen
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chen-Yang Hsu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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11
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Abstract
It is unknown whether the presence of metabolic syndrome (MetS) affects the incidence of laryngeal cancer. The aim of this national population-based retrospective study was to analyze the relationship between MetS and the incidence of laryngeal cancer. Patients with laryngeal cancer (ICD-10: C32) between 2009 and 2010 were retrospectively identified and tracked until 2015 using the Korean Health Insurance claims database. During the seven-year follow-up period, 5,322 subjects were newly diagnosed with larynx cancer. The mean age of people with laryngeal cancer was much higher than those without (63.29 vs. 47.7 years, p < 0.0001), and the incidence of larynx cancer in men was much higher than that in women (93.16% vs. 6.84%, p < 0.0001). Age, gender, smoking status, alcohol intake, and exercise-adjusted hazard ratios indicated that participants with MetS had a 1.13-fold higher hazard of having larynx cancer than those without MetS. The number of MetS components was a strong risk factor for laryngeal cancer with a higher risk estimate of this cancer in both ex- and current smokers as well as people who have never smoked. MetS was found to be an independent risk factor for the incidence of laryngeal cancer. In Korea, MetS and its components are significantly associated with the development of laryngeal cancer.
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Affiliation(s)
- Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung-do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Milano A, Bianco MA, Buri L, Cipolletta L, Grossi E, Rotondano G, Tessari F, Efthymakis K, Neri M. Metabolic syndrome is a risk factor for colorectal adenoma and cancer: a study in a White population using the harmonized criteria. Therap Adv Gastroenterol 2019; 12:1756284819867839. [PMID: 31523276 PMCID: PMC6727097 DOI: 10.1177/1756284819867839] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/12/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has been associated with colorectal adenomas and cancer. However, MetS definitions have changed over time, leading to a heterogeneity of patients included in previous studies and a substantial inextensibility of observations across time or eastern and western populations. Our aim was to evaluate the association of 'harmonized' criteria-defined MetS and its individual components with colorectal neoplasia and cancer in a western population. METHODS In this multicenter, cross-sectional study, we prospectively evaluated consecutive outpatients who underwent open-access colonoscopy over a 3-month period. MetS was diagnosed according to the 2009 'harmonized' criteria. RESULTS Out of 5707 patients enrolled, we found 213 cancers (3.7%), 1614 polyps (28.3%), 240 nonpolypoid lesions (4.2%), 95 laterally spreading tumors (1.6%). Polyps presented histological low-grade dysplasia in 72.9% of samples, while in 9.8%, high-grade dysplasia or in situ carcinoma was present; dysplasia rates for nonpolypoid lesions were 66.2% (low-grade) and 2.9% (high-grade/in situ carcinoma), while for laterally spreading tumors, 29.6% and 37%, respectively. Overall, MetS prevalence was 41.6%. MetS correlated with both adenomas [odds ratio (OR): 1.76, 95% confidence interval (CI) 1.54-2.00] and cancer (OR: 1.92, 95% CI 1.42-2.58). MetS was the only risk factor for such colonic lesions in subjects younger than 50 years. For all colonic neoplasia, we found MetS and not its individual components to be significantly associated. CONCLUSIONS MetS is risk factor for cancer and adenoma in Whites, especially when younger than 50 years. MetS patients might be considered as a high-risk population also in colorectal cancer screening programs.
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Affiliation(s)
- Angelo Milano
- Department of Medicine and Aging Sciences and Center of Aging Sciences and Translational Medicine (CeSI-MeT), ‘G.D.’ Annunzio University and Foundation, Chieti, Italy
- Digestive Endoscopy and Gastroenterology Unit, ‘SS Annunziata’ University Hospital, Chieti, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology and Digestive Endoscopy Unit, Hospital ‘A Maresca’, Torre del Greco, Italy
| | - Luigi Buri
- Gastroenterology and Digestive Endoscopy Unit, Cattinara Hospital, Trieste, Italy
| | - Livio Cipolletta
- Division of Gastroenterology and Digestive Endoscopy Unit, Hospital ‘A Maresca’, Torre del Greco, Italy
| | | | | | | | - Konstantinos Efthymakis
- Department of Medicine and Aging Sciences and Center of Aging Sciences and Translational Medicine (CeSI-MeT), ‘G.D.’ Annunzio University and Foundation, Chieti, Italy
- Digestive Endoscopy and Gastroenterology Unit, ‘SS Annunziata’ University Hospital, Chieti, Italy
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018. [PMID: 30279628 DOI: 10.3164/jcbn.18.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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14
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Yen AM, Wang S, Feng S, Lin C, Chen SL. The association between fecal hemoglobin concentration and oral potentially malignant disorders. Oral Dis 2018; 25:108-116. [DOI: 10.1111/odi.12978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/30/2018] [Accepted: 09/08/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Amy Ming‐Fang Yen
- School of Oral Hygiene, College of Oral Medicine Taipei Medical University Taipei Taiwan
- Oral Health Care Research Center, College of Oral Medicine Taipei Medical University Taipei Taiwan
| | - Sen‐Te Wang
- Department of Family Medicine, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan
- Department of Family Medicine Taipei Medical University Hospital Taipei Taiwan
| | - Sheng‐Wei Feng
- School of Oral Hygiene, College of Oral Medicine Taipei Medical University Taipei Taiwan
- Oral Health Care Research Center, College of Oral Medicine Taipei Medical University Taipei Taiwan
- Department of DentistryTaipei Medical University Hospital Taipei Taiwan
| | - Che‐Tong Lin
- Department of DentistryTaipei Medical University Hospital Taipei Taiwan
- School of Dentistry, College of Oral Medicine Taipei Medical University Taipei Taiwan
| | - Sam Li‐Sheng Chen
- School of Oral Hygiene, College of Oral Medicine Taipei Medical University Taipei Taiwan
- Oral Health Care Research Center, College of Oral Medicine Taipei Medical University Taipei Taiwan
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15
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Zarzavadjian Le Bian A, Denet C, Tabchouri N, Donatelli G, Wind P, Louvet C, Bennamoun M, Christidis C, Perniceni T, Fuks D, Gayet B. Specific features of colorectal cancer in patients with metabolic syndrome: a matched case-control analysis of 772 patients. Langenbecks Arch Surg 2018; 403:443-50. [PMID: 29704123 DOI: 10.1007/s00423-018-1677-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/18/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Although association between colorectal cancer (CRC) and metabolic syndrome (MetS) is established, specific features of CRC arising in patients presenting with MetS have not been clearly identified. METHOD All patients who underwent colectomy for CRC from January 2005 to December 2014 at Institut Mutualiste Montsouris were identified from a prospectively collected database and characteristics were compared in the entire population and in a 1:2 matched case-control analysis [variables on which matching was performed were CRC localization (right- or left-sided) and AJCC stage (0 to IV)]. RESULTS Out of the 772 identified patients, 98 (12.7%) presented with MetS. Entire population analysis revealed that CRC associated with MetS was more frequent in men (71.4 vs. 47.8%, p < 0.001), more often right-sided (71.4 vs. 50.4%, p < 0.001) and presented with less synchronous liver metastasis (4.1 vs. 8.7%, p = 0.002). Case-control analysis confirmed the gender association (p < 0.001) and showed HNPCC (p < 0.001) and history family of CRC (p = 0.010) to be significantly more frequent in Non-MetS patients. CONCLUSIONS CRC associated with MetS is more frequent in men, more often right-sided, and presents with fewer synchronous metastasis. Further investigations should be designed in order to confirm these results and to enhance our knowledge of carcinogenesis related to MetS.
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16
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018; 63:154-163. [PMID: 30279628 PMCID: PMC6160732 DOI: 10.3164/jcbn.18-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 12/14/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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17
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Kim GA, Lee HC, Choe J, Kim MJ, Lee MJ, Chang HS, Bae IY, Kim HK, An J, Shim JH, Kim KM, Lim YS. Association between non-alcoholic fatty liver disease and cancer incidence rate. J Hepatol 2017; 68:S0168-8278(17)32294-8. [PMID: 29150142 DOI: 10.1016/j.jhep.2017.09.012] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 08/11/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Little is known about the association between non-alcoholic fatty liver disease (NAFLD) and cancer development. This study investigated the cancer incidence rates in NAFLD and analysed the association between NAFLD and cancer development. METHODS This historical cohort study included subjects who were followed up for >1 year after having a heath checkup at a tertiary hospital in Korea from September 1, 2004 to December 31, 2005. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other known liver disease, including alcoholic or viral hepatitis. Cox proportional hazards regression model was conducted to assess the association between NAFLD and cancer development. RESULTS Of 25,947 subjects, 8,721 (33.6%) had NAFLD. During the total follow-up of 164,671 person-years (median 7.5 years), the cancer incidence rate of the NAFLD group was higher than that of the non-NAFLD group (782.9 vs. 592.8 per 100,000 person-years; hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.17-1.49; p <0.001). When demographic and metabolic factors were adjusted for, NAFLD showed a strong association with three cancers: hepatocellular carcinoma ([HCC]; HR 16.73; 95% CI 2.09-133.85; p = 0.008), colorectal cancer in males (HR 2.01; 95% CI 1.10-3.68; p = 0.02), and breast cancer in females (HR 1.92; 95% CI 1.15-3.20; p = 0.01). A high NAFLD fibrosis score (NFS) and a high fibrosis-4 (FIB-4) score were associated with the development of all cancers and HCC. CONCLUSION NAFLD was associated with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NFS and a high FIB-4 score showed a strong association with the development of all cancers and HCC. LAY SUMMARY Non-alcoholic fatty liver disease (NAFLD) is associated with developing hepatocellular carcinoma (HCC). There have been limited data on the association between NAFLD and extrahepatic cancers. This study demonstrated that patients with NAFLD showed a higher association with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NAFLD fibrosis score and a high fibrosis-4 score showed a strong association with the development of all cancers and HCC.
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Affiliation(s)
- Gi-Ae Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye-Sook Chang
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In Young Bae
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jihyun An
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyun Shim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Suk Lim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Nikitenko TM, Shcherbakova LV, Malyutina SK, Mustafina SV, Verevkin EG, Ragino YI, Voytsitsky VE, Pyatibratova AV, Rymar OD. The metabolic syndrome as a risk factor for colorectal cancer. Obes metabol 2017. [DOI: 10.14341/omet2017224-32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective. To evaluate the prognostic significance of metabolic syndrome (MS) in the development of colorectal cancer (CRC) using various MS criteria in Novosibirsk population.
Materials and Methods. The study was designed as nested case-control. Baseline population cohort (9360 men, women aged 4569) was examined in the HAPIEE project and followed-up during 11 years. The cases included all subjects, who had CRC during 11-year follow-up according to the Register of Cancer (n=99, M-52, M-47). The matched control group (2/1) was selected from HAPIEE cohort (n=198, m-104, w-94). The prospective study of CRC was supported by RSF. MS criteria were determined in accordance to VNOK (2009), IDF (2005), NCEP ATP III (2001). Statistical package SPSS v.11.0 was used. Logistic regression was used to estimate the association between MS and risk of CRC.
Results. Women with glucose levels 6.1 mmol/l had 3 times higher 11-year risk of CRC then those with glucose 6.1 mmol/l (OR=3.11;
95%CI:1.237.87, VNOK, 2009; OR=3.20; 95%CI:1.278.08, NCEP ATP III, 2001). Blood pressure (BP) 130/85 mmHg was associated with decreased risk of CRC in women and in both sexes, but the relationship became insignificant after controlling for antihypertensive treatment. Other components of the MS were not significantly associated with CRC risk.
Conclusions. In studied sample the 11-year risk of developing CRC was significantly increased in women with elevated glucose levels. The negative relationship between elevated BP and the risk of CRC in women and both sexes became insignificant when adjusted for antihypertensive treatment; this finding requires further exploration.
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Yang HJ, Choi S, Park SK, Jung YS, Choi KY, Park T, Kim JY, Park DI. Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages. J Gastroenterol Hepatol 2017; 32:1328-1335. [PMID: 28012211 DOI: 10.1111/jgh.13711] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Little is known about how to include adults < 50 years in colonoscopy screening. This study aimed to derive a risk-scoring model incorporating laboratory indicators for metabolic risks to predict advanced colorectal neoplasia (ACN) in asymptomatic Korean adults both younger and older than 50 years. METHODS In this cross-sectional study, 70 812 consecutive adult recipients of a screening colonoscopy in a single health check-up center in Korea between 2003 and 2012 were enrolled. A risk score model was developed using multiple logistic regression model and internally validated. RESULTS Overall prevalence of ACN was 1.4% (956/70 812). A 15-point score model was developed to comprise age, sex, family history of colorectal cancer, smoking, body mass index, serum levels of fasting glucose, low-density lipoprotein cholesterol, and carcinoembryonic antigen. Based on the score, the validation cohort could be categorized into five risk groups (low, borderline, moderate, high, and very high) with an ACN prevalence of 0.7%, 1.3%, 2.7%, 6.6%, and 13.2%, respectively. Compared with the borderline risk group, the low-risk group showed a 50.3% reduced risk of ACN. Meanwhile, the moderate, high, and very high risk groups showed 2, 5, and 10-fold increased risk of ACN. The score showed significantly superior discriminative power than the Asian-Pacific colorectal screening score (P = 0.003). CONCLUSIONS Our scoring model based on both clinical and laboratory risk factors is useful for the prediction of ACN. This score may be used to include adults < 50 years in colonoscopy screening.
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Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungkyoung Choi
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yong Choi
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Taesung Park
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea.,Department of Statistics, Seoul National University, Seoul, Korea
| | - Ji Yeon Kim
- Comprehensive Health Care Center, Korea Cancer Center Hospital, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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20
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Tseng PH, Lee PL, Hsu WC, Ma Y, Lee YC, Chiu HM, Ho YL, Chen MF, Wu MS, Peng CK. A Higher Proportion of Metabolic Syndrome in Chinese Subjects with Sleep-Disordered Breathing: A Case-Control Study Based on Electrocardiogram-Derived Sleep Analysis. PLoS One 2017; 12:e0169394. [PMID: 28081171 PMCID: PMC5231382 DOI: 10.1371/journal.pone.0169394] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 12/16/2016] [Indexed: 12/11/2022] Open
Abstract
Objective The prevalence of metabolic syndrome (MS) has increased rapidly in Taiwan and worldwide. We aim to determine the association between sleep-disordered breathing (SDB) and MS in a Chinese general population. Methods This case-control study recruited subjects who have undergone a prospective electrocardiogram-based cardiopulmonary coupling (CPC) sleep spectrogram as part of the periodic health check-ups at the National Taiwan University Hospital. Comprehensive anthropometrics, blood biochemistry, prevalence of MS and its individual components were compared with Bonferroni correction between 40 subjects with SDB, defined as the CPC-derived apnea–hypopnea index (CPC-AHI) >5 event/hour and 80 age- and sex-matched controls, defined as CPC-AHI <1 event/hour. MS was diagnosed based on the Adult Treatment Panel III, with a modification of waist circumference for Asians. Results Subjects with SDB were more obese with larger waist circumferences (95.1±12.9 vs. 87.3±6.9, P < .001) and borderline higher BMI (27.0±4.9 vs. 24.3±2.5, P = .002). Waist circumference was independently associated with the presence of SDB after adjustment for BMI, systolic blood pressure and fasting blood glucose in multiple regression analyses. Subjects with SDB had a higher prevalence of central obesity (72.5% vs. 42.5%, P = .002), hyperglycemia (45.0% vs. 26.3%, P = .04), MS (45.0% vs. 22.5%, P = .01) and number of MS components (2.4 ± 1.6 vs. 1.7 ± 1.4, P = .01) than the control group. Waist circumference was significantly correlated with both CPC-AHI (r = .492, P = .0013) and PSG-AHI (r = .699, P < .0001) in the SDB group. Conclusions SDB was associated with a higher prevalence of MS and its individual components, notably central obesity, in a Chinese general population. Large-scale screening of high risk population with MS to identify subjects with SDB for appropriate management is warranted.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Lin Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chung Hsu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yan Ma
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Fong Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
| | - Chung-Kang Peng
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
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21
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Feakins RM. Obesity and metabolic syndrome: pathological effects on the gastrointestinal tract. Histopathology 2016; 68:630-40. [DOI: 10.1111/his.12907] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 11/17/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Roger M Feakins
- Department of Cellular Pathology; Royal London Hospital; London UK
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22
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Leung WK, Chen WQ, Gu L, Long D, Law WL. Distributions of colorectal cancer in two Chinese cities with contrasting colorectal cancer epidemiology. J Gastroenterol Hepatol 2015; 30:1726-30. [PMID: 26095432 DOI: 10.1111/jgh.13018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/14/2015] [Accepted: 05/17/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM The incidence of colorectal cancer (CRC) is rising rapidly in Chinese. We studied the anatomic distributions and characteristics of CRC in Hong Kong (HK) and Chongqing (CQ) with different CRC epidemiology. METHODS It was a retrospective study conducted in three large regional hospitals of the two cities. We identified all patients newly diagnosed with CRC between 2003 and 2012. The distribution and characteristics of CRC of the two cities were compared. RESULTS Of CRC, 3664 new cases were diagnosed within the study period. CRC was more common in men (>56%) in both cities. The mean age at diagnosis was significantly younger in CQ, the lower prevalence area, than in HK (62.1 vs 70.4 years; P < 0.001). Rectal cancer was the predominant (61.3%) cancer in CQ, but only 18% of cancers in HK were rectal cancer (P = 0.0001). Right-sided colonic cancer, however, was more common in HK than CQ (27.2% vs 17.4%; P < 0.001). Women had more right-sided colonic cancer than men in both cities (P < 0.002), and there was an age-related increase in right-sided colonic cancer in HK but not in CQ. Multivariate analysis showed that older age, female, and living in HK were independent risk factors associated with right-sided colonic cancer. CONCLUSIONS There are significant differences in the distribution of CRC between HK and CQ. The discrepancy may be partly accounted by older population and an increase in proximal colonic cancer, particularly in women, in HK.
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Affiliation(s)
- Wai K Leung
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Wei-Qing Chen
- Department of Gastroenterology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Li Gu
- Department of Gastroenterology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Dan Long
- Department of Gastroenterology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.,Department of Gastroenterology, The First People Hospital of Neijiang City, Neijiang, China
| | - W L Law
- Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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Lu Y, Ness-Jensen E, Hveem K, Martling A. Metabolic predispositions and increased risk of colorectal adenocarcinoma by anatomical location: a large population-based cohort study in Norway. Am J Epidemiol 2015; 182:883-93. [PMID: 26511906 DOI: 10.1093/aje/kwv141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/28/2015] [Indexed: 01/08/2023] Open
Abstract
Whether different definitions of metabolic syndrome (MetS) are differently associated with colorectal adenocarcinoma (CA) by anatomical location is unclear. A population-based cohort study, the Cohort of Norway (CONOR) Study, was conducted in Norway from 1995 to 2010. Anthropometric measurements, blood samples, and lifestyle data were collected at recruitment. CAs were identified through linkage to the Norwegian Cancer Register. A composite index of MetS as defined by the International Diabetes Federation (IDF) or/and the National Cholesterol Education Program's Adult Treatment Panel III (ATP III) and single components of MetS, including anthropometric factors, blood pressure, lipids, triglycerides, and glucose, were analyzed. Cox proportional hazards regression was performed to estimate hazard ratios and 95% confidence intervals. Significant associations between single MetS components and CA, except for reduced high-density lipoprotein cholesterol and nonfasting glucose levels, were observed. MetS defined by 2 criteria separately showed a similar association with CA in general, and MetS defined by both the IDF and ATP III showed consistent results. Stronger associations were observed in the proximal colon among men (IDF: hazard ratio (HR) = 1.51, 95% confidence interval (CI): 1.24, 1.84; ATP III: HR = 1.40, 95% CI: 1.15, 1.70) and in the rectum among women (IDF: HR = 1.42, 95% CI: 1.07, 1.89; ATP III: HR = 1.43, 95% CI: 1.08, 1.90).
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Chiu HM, Lee YC, Tu CH, Chang LC, Hsu WF, Chou CK, Tsai KF, Liang JT, Shun CT, Wu MS. Effects of metabolic syndrome and findings from baseline colonoscopies on occurrence of colorectal neoplasms. Clin Gastroenterol Hepatol 2015; 13:1134-42.e8. [PMID: 25445768 DOI: 10.1016/j.cgh.2014.10.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 10/20/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Metabolic syndrome is associated with increased risk of colorectal neoplasm, but little is known about its effects on the occurrence of neoplasm after colonoscopy. We investigated the effects of metabolic syndrome on the risk of advanced neoplasm after colonoscopy. METHODS We performed a prospective study of 4483 subjects age 50 years and older who underwent screening and surveillance colonoscopies as part of an annual health check-up at National Taiwan University Hospital. Baseline demographic data and colonoscopic findings were recorded. Subjects with either advanced adenoma or 3 or more adenomas detected at baseline were classified as high risk; those with fewer than 3 nonadvanced adenomas were classified as low risk; and those without any neoplastic lesions were classified as normal. The cumulative risk of detecting an advanced neoplasm during surveillance colonoscopies (3 and 5 years later) was correlated with risk group and metabolic syndrome. Hazard ratios (HRs) were calculated for occurrence of neoplasm according to baseline colonoscopic findings and clinical risk factors, including metabolic syndrome. RESULTS Advanced neoplasms were detected during the surveillance colonoscopies in 1.3% of subjects in the normal group and in 2.4% of those in the low-risk group at 5 years, and in 8.5% of subjects in the high-risk group at 3 years. Subjects with metabolic syndrome had a significantly higher risk for subsequent advanced neoplasms (P < .0001). After stratification based on findings from baseline colonoscopies, the risk for neoplasm was significant in the normal (P < .001) and low-risk groups (P = .04), but not in the high-risk group (P = .48). In Cox regression analysis, metabolic syndrome had significant effects on the risk for advanced neoplasms in the normal (HR, 2.07; 95% confidence interval, 1.13-3.81) and low-risk groups (HR, 2.34; 95% confidence interval, 1.01-5.41), but not in the high-risk group. CONCLUSIONS Metabolic syndrome is a significant risk factor for occurrence of an advanced adenoma after a negative or low-risk finding from a baseline colonoscopy. Metabolic syndrome should be considered in risk stratification for surveillance intervals.
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Affiliation(s)
- Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
| | - Wen-Feng Hsu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Taipei, Taiwan
| | - Chu-Kuang Chou
- Division of Gastroenterology and Hepatology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Kun-Feng Tsai
- Department of Internal Medicine, National Taiwan University Hospital, Jin-Shan Branch, Taipei, Taiwan
| | - Jin-Tung Liang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan.
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Jung YS, Ryu S, Chang Y, Yun KE, Park JH, Kim HJ, Cho YK, Sohn CI, Jeon WK, Kim BI, Park DI. Risk factors for colorectal neoplasia in persons aged 30 to 39 years and 40 to 49 years. Gastrointest Endosc 2015; 81:637-645.e7. [PMID: 25442324 DOI: 10.1016/j.gie.2014.09.031] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/10/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Very little is known about risk factors associated with colorectal neoplasia in persons aged <50 years. In particular, there has been no study thus far focusing on the risk factors for colorectal neoplasia in persons aged 30 to 39 years. OBJECTIVE To investigate risk factors for colorectal neoplasia in persons aged 30 to 39 years and 40 to 49 years and to compare those data with those of persons aged 50 to 59 years. DESIGN Cross-sectional observational study. SETTING Screening center in a university hospital in Korea. PATIENTS A cohort of 28,504 Korean adults (13,678 aged 30-39 years, 12,507 aged 40-49 years, and 2319 aged 50-59 years) who underwent colonoscopy as part of their routine preventive health care. INTERVENTIONS Colonoscopy. MAIN OUTCOME MEASUREMENTS Risk factors for colorectal neoplasia in persons aged 30 to 39 years and 40 to 49 years. RESULTS In the 30-to-39-years group, male sex, smoking, fatty liver, metabolic syndrome (MetS), obesity, elevated fasting blood glucose levels, and elevated triglyceride levels were associated with overall neoplasia, whereas for advanced neoplasia, the independent risk factors were smoking, fatty liver, and elevated triglyceride levels. Moreover, the prevalence of overall neoplasia in men aged 30 to 39 years exhibiting all risk factors was not lower than that in average-risk women aged >50 years (20.8% vs 18.8%; P = .546). The risk factors of overall neoplasia in the 40-to-49-years group were similar to those in the 30-to-39-years group. For advanced neoplasia, the independent risk factors in the 40-to-49-years group were male sex, smoking, MetS, and obesity. LIMITATIONS Selection bias may exist for participants of ethnic Korean heritage in 2 centers. CONCLUSION Obese male smokers with fatty liver and MetS might benefit from screening colonoscopy starting before age 50 years.
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Affiliation(s)
- Yoon Suk Jung
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Kyung Eun Yun
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Hong Joo Kim
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Yong Kyun Cho
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Woo Kyu Jeon
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Byung Ik Kim
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Dong Il Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
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Taniguchi L, Higurashi T, Uchiyama T, Kondo Y, Uchida E, Uchiyama S, Jono F, Hamanaka J, Kuriyama H, Hata Y, Endo H, Takahashi H, Nagase H, Matsuhashi N, Nakajima A. Metabolic factors accelerate colorectal adenoma recurrence. BMC Gastroenterol 2014; 14:187. [PMID: 25341954 PMCID: PMC4287308 DOI: 10.1186/1471-230x-14-187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 10/15/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Metabolic factors have been reported to increase the prevalence of colorectal adenomas, however, whether metabolic factors might also accelerate the recurrence after removal of adenomas has not yet been discussed. In this retrospective multicenter study, we clarified the risk factors for adenoma recurrence focusing on metabolic factors. METHODS We analyzed the medical records of 43,195 patients who had undergone colonoscopy between January 2005 and December 2011 at 5 hospitals in Japan. Of these, the data of 1111 patients who had undergone removal of adenomas at the first screening colonoscopy, and then been followed up by colonoscopy 1 year and 2 years later were analyzed. RESULTS The following 8 factors were demonstrated with a multivariate analysis as being associated with colorectal adenomas recurrence: for adenoma-related factors, 5 factors (villous features, grade of dysplasia, location and size of the largest removed adenoma, and number of the removed adenomas) were identified; for metabolic factors and other factors, 3 factors (age, body mass index (BMI), and fasting blood glucose (FBG)) were identified. A risk score (0-10 points) was developed based on these 8 factors. The risk of adenoma recurrence increased as the risk score increased. When the risk score was ≥3 (3-10) points, the odds ratio relative to <3 (0-2) points was 7.07 (95% CIs 5.30-9.43). CONCLUSIONS In addition to adenoma-related factors (villous features, grade of dysplasia, location, size and number), 3 factors (age, BMI and FBG) were demonstrated to influence the recurrence rate of colorectal adenoma. When the risk score was ≥3, the risk of recurrence was significantly elevated.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Atsushi Nakajima
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004 Yokohama, Kanagawa, Japan.
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Keshk WA, Zineldeen DH, Wasfy RELS, El-Khadrawy OH. Fatty acid synthase/oxidized low-density lipoprotein as metabolic oncogenes linking obesity to colon cancer via NF-kappa B in Egyptians. Med Oncol 2014; 31:192. [PMID: 25173531 DOI: 10.1007/s12032-014-0192-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 08/13/2014] [Indexed: 12/17/2022]
Abstract
Obesity is a major health problem which heightens the risk of several chronic illnesses including cancer development particularly colon cancer. The underlying pathophysiology of obesity associated colon cancer remains to be elucidated. The purpose of this current study was to determine fatty acid synthase (FASN) activity/expression, oxidized low-density lipoprotein (ox-LDL) level and redox status under the context of anthropometric measurements and lipid profile to find their potential role as interacting biomarkers relating obesity to colon cancer initiation and progression via nuclear factor kappa-B (NF-κB) signaling. This study was conducted upon Egyptian individuals; 30 obese subjects with colon cancer, 11 nonobese and 11 obese subjects without colon cancer. FASN gene expression, NF-κB immunoreactivity, and serum ox-LDL level were estimated by real-time PCR, immunohistochemistry and immunoassay, respectively. FASN activity, glycemic status, obesity, and oxidative stress indices were also assessed. It was found that FASN expression and activity were statistically increased in obese with colon cancer (P=0.021 and 0.018, respectively), with statistically significant increase in patients with advanced grading. Moreover, NF-κB immunoreactivity and serum ox-LDL level were significantly increased in obese colon cancer patients with significantly higher levels in those with advanced grading (all P<0.05). Dyslipidemia, insulin resistance, and oxidative stress indices were worsened in obese patients with colon cancer. These results revealed that FASN and ox-LDL as well as oxidative stress may increase the risk of obesity related colon cancer, particularly via NF-κB signaling and could be used as potential predictive and prognostic biomarkers for obesity complicated with colon cancer.
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Affiliation(s)
- Walaa Arafa Keshk
- Department of Medical Biochemistry, Faculty of Medicine, Tanta University, El-Geish Street, Tanta, El-Gharbia, Egypt,
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Lee SY, Shin A, Kim BC, Lee JH, Han KS, Hong CW, Sohn DK, Park SC, Chang HJ, Oh JH. Association between family history of malignant neoplasm with colorectal adenomatous polyp in 40s aged relative person. Cancer Epidemiol 2014; 38:623-7. [PMID: 25035156 DOI: 10.1016/j.canep.2014.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/20/2014] [Accepted: 06/21/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE We assessed the association between a family history of malignancy and risk of colorectal adenoma among individuals aged 40-49 years. METHODS The study population consisted of subjects, aged in their 40s, who underwent colonoscopy. Their family histories of cancer were collected with a self-administered questionnaire. A logistic regression model was used to assess the association between a family history of cancer and the risk of colorectal polyp. RESULTS In total, 2275 participants were included in the study. Univariate analysis showed that old age, male sex, current cigarette smoking, BMI>25 kg/m(2), and a family history of colorectal cancer (CRC) were risk factors for the development of sporadic colorectal adenomatous polyps in these patients. A multivariate analysis showed that a family history of CRC or kidney cancer was associated with adenoma development. A family history of CRC was also a risk factor for advanced and multiple adenoma. CONCLUSIONS This study shows that a family history of CRC is a risk factor for advanced and multiple colorectal adenoma in people in their 40s. These results support earlier screening for colorectal neoplasms in individuals with a family history of CRC.
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Affiliation(s)
- Su Young Lee
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Aesun Shin
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
| | - Jeong Hee Lee
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Kyung Su Han
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Chang Won Hong
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Sung Chan Park
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Hee Jin Chang
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
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Yen AMF, Lai H, Fann JCY, Chiu SYH, Chen SLS. Relationship between Community Periodontal Index and Fecal Hemoglobin Concentration, an Indicator for Colorectal Neoplasm. J Dent Res 2014; 93:760-6. [PMID: 24938273 DOI: 10.1177/0022034514539976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/24/2014] [Indexed: 12/31/2022] Open
Abstract
Periodontal disease and colorectal cancer have inflammatory processes in common. It is therefore worthwhile to investigate whether there is an association between periodontal probing depth and fecal hemoglobin concentration (FHbC), an indicator of colorectal neoplasms, in 40- to 44-year-old Taiwanese. We enrolled a total of 6,214 attendees aged 40 to 44 yr who were participating in a community-based integrated screening program and who received both periodontal and FHbC examinations between 2003 and 2008. A proportional odds logistic regression model was used to estimate the odds ratios of different FHbC levels in treating an increased level of community periodontal index (CPI) measuring periodontal probing depth as ordinary data from 0 to 4. Periodontal probing depth with the order of CPI was in parallel with an increase in the mean values of FHbC: 21.3 ± 156.3, 26.0 ± 167.7, 27.2 ± 151.1, and 39.5 ± 255.7 ng/mL for CPI 0, CPI 1, CPI 2, and CPI 3/4, respectively. The log-FHbC varied across the categories of CPI (p = .0078). After adjusting for age, sex, education level, smoking, alcohol intake, exercise, body mass index, and intake of meat and vegetables, subjects with positive fecal immunochemical test results (FHbC ≥ 100 ng/mL) had a 33% higher risk of deteriorating to severe CPI than did those within the normal range of fecal immunochemical test (FHbC < 100 ng/mL) (adjusted odds ratio = 1.33, 95% confidence interval: 1.03-1.73). A positive association was demonstrated between FHbC and periodontal probing depth assessed by CPI among 6,214 Taiwanese aged 40 to 44 yr who participated in a community-based integrated health screening program. These results could have significant implications for early identification of high-risk individuals, as those with deep periodontal pockets should be advised to undergo screening for colorectal cancer at a younger age than commonly recommended.
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Affiliation(s)
- A M-F Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H Lai
- QC Dental Clinic, Taipei, Taiwan Department of Dentistry, National Yang-Ming University, Taipei, Taiwan School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - J C-Y Fann
- Department of Health Industry Management, School of Health Care Management, Kainan University, Taoyuan, Taiwan
| | - S Y-H Chiu
- Department and Graduate Institute of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan
| | - S L-S Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Chang LC, Wu MS, Tu CH, Lee YC, Shun CT, Chiu HM. Metabolic syndrome and smoking may justify earlier colorectal cancer screening in men. Gastrointest Endosc 2014; 79:961-9. [PMID: 24472766 DOI: 10.1016/j.gie.2013.11.035] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 11/21/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Gender, smoking, and metabolic syndrome (MetS) are important risk factors of colorectal neoplasm. Whether presence of these factors may warrant earlier screening remains unclear. OBJECTIVE To compare age- and gender-specific risk of colorectal neoplasms in association with smoking and MetS under endoscopic or stool-based screening. DESIGN Cross-sectional observational study. SETTING Screening center in a university hospital in Taiwan. PATIENTS A cohort of 10,884 average-risk individuals who received concurrent screening colonoscopy and fecal immunochemical testing (FIT). MAIN OUTCOME MEASUREMENTS First, the prevalence of colorectal neoplasms and positive predictive value of FIT relative to age, gender, smoking, and MetS. Second, the number of colonoscopies needed to detect 1 advanced neoplasm with different strategies. RESULTS Male smokers aged 40 to 49 years had a significantly higher prevalence of advanced neoplasms and positive predictive value of stool tests than nonsmoking counterparts. The prevalence of advanced neoplasms in concurrent MetS and smoking (6.2%) or smoking alone (3.8%) men aged 40 to 49 years was higher than that of average-risk women aged 50 to 59 years (2.1%) (P = .03 and .04, respectively). The number of colonoscopies needed to detect 1 advanced neoplasm in men aged 40 to 49 years with concurrent MetS and smoking, smoking, MetS, and women aged 50 to 59 years was, respectively, 14.6, 24.8, 39.8, and 47.4 in the colonoscopy scenario and 1.7, 4.6, 5.7, and 8.3 in the FIT scenario. LIMITATION Self-selective bias may exist for subjects voluntarily submitted to health check-ups. CONCLUSIONS MetS and smoking significantly impact both the prevalence of colorectal neoplasms and the diagnostic yields of screening tests in men aged 40 to 49 years. Whether our findings justify earlier screening in this subgroup requires further study.
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Affiliation(s)
- Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu branch, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
INTRODUCTION There is epidemiological evidence indicating that the metabolic syndrome increases the risk of colorectal cancer. Since there is little information about this issue in Iran, the present study was conducted to evaluate prevalence of metabolic syndrome and its components in patients with colorectal cancer. MATERIAL AND METHODS This cross-sectional survey involved 200 patients with a new diagnosis of colorectal cancer. Demographic information of patients was collected through the interview with them. Components of metabolic syndrome including fasting glucose serum, triglyceride, high density lipoprotein, blood pressure and waist circumference were measured for all of the patients. RESULTS A total of 72 colorectal cancer patients (36%) met metabolic syndrome criteria with rates of 76% for women and 24% for men. BMI in metabolic syndrome patients was higher than other colorectal cancer patients. Disease history including hypertension, diabetes and cardiovascular disease was most frequent in metabolic syndrome patients. Pathological characteristics of colorectal cancer were not significantly associated with the disease. CONCLUSION The findings of present study indicated that the prevalence of metabolic syndrome in CRC patients is relatively high. Therefore, further analytical and multi centric studies are needed to better understand the role of metabolic syndrome in development of CRC in Iran. If this association is confirmed in future studies, metabolic syndrome patients should be considered in CRC screening programs.
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Affiliation(s)
- Mojgan Forootan
- Gastroenterology and Liver Diseases Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Pyo JH, Kim ES, Chun HJ, Keum B, Jeen YT, Lee HS, Kim CD, Ryu HS, Kim YH, Lee JE. Fasting blood sugar and serum triglyceride as the risk factors of colorectal adenoma in korean population receiving screening colonoscopy. Clin Nutr Res 2013; 2:34-41. [PMID: 23429421 PMCID: PMC3572815 DOI: 10.7762/cnr.2013.2.1.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 01/07/2013] [Accepted: 01/14/2013] [Indexed: 01/28/2023] Open
Abstract
In several previously reported studies, metabolic syndrome (MS) was found to be associated with colorectal adenomas. While the incidence of colorectal adenoma is growing in Korean population, there are only few studies that examined the association between MS and colorectal adenoma in Korea. The aim of this study was to investigate relationships between prevalence of colorectal adenoma and MS components. We conducted a cross sectional study using data from individuals who had undergone complete colonoscopy for health examinations at the Health Promotion Center of Korea University Medical Center from July 1, 2004 to July 31, 2010. A total of 7481 subjects (4459 males and 3022 females) were included; 1733 subjects with pathologically proven adenoma were assigned to the case group, and other 5748 subjects were assigned to the non-case group. All the participants underwent colonoscopy and received blood biochemical tests (fasting blood sugar [FBS], insulin, lipid profile, hemoglobin, blood urea nitrogen [BUN], creatinine). Univariate analysis showed that the prevalence of colorectal adenoma was higher in individuals with higher blood pressure, body mass index (BMI), total cholesterol (TC), triglyceride (TG), FBS and lower high-density lipoprotein cholesterols (HDL-C) levels, compared to those with low levels. Multiple logistic regression analysis revealed that high levels of BMI (OR 1.17, 95% CI 1.01-1.34, P trend = 0.01), TG (OR 1.27, 95% CI 1.07-1.51, P trend = 0.006), and FBS (OR 1.19 95% CI 1.01-1.40, P trend = 0.05) were significantly associated with prevalence of colorectal adenoma. Subjects with high levels of BMI, TG and FBS have increased prevalence of developing colorectal adenoma in Korea.
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Affiliation(s)
- Jeung Hui Pyo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul 136-705, Korea
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Fujihara S, Mori H, Kobara H, Nishiyama N, Kobayashi M, Oryu M, Masaki T. Metabolic syndrome, obesity, and gastrointestinal cancer. Gastroenterol Res Pract 2012; 2012:483623. [PMID: 23304125 PMCID: PMC3530232 DOI: 10.1155/2012/483623] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/18/2012] [Accepted: 11/18/2012] [Indexed: 02/07/2023] Open
Abstract
METABOLIC SYNDROME IS A CLUSTER OF METABOLIC ABNORMALITIES AND IS DEFINED AS THE PRESENCE OF THREE OR MORE OF THE FOLLOWING FACTORS: increased waist circumference, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and high fasting glucose. Obesity, which is accompanied by metabolic dysregulation often manifested in the metabolic syndrome, is an established risk factor for many cancers. Adipose tissue, particularly visceral fat, is an important metabolic tissue as it secretes systemic factors that alter the immunologic, metabolic, and endocrine milieu and also promotes insulin resistance. Within the growth-promoting, proinflammatory environment of the obese state, cross-talk between macrophages, adipocytes, and epithelial cells occurs via obesity-associated hormones, adipocytokines, and other mediators that may enhance cancer risk and progression. This paper synthesizes the evidence on key molecular mechanisms underlying the obesity-cancer link.
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Affiliation(s)
- Shintaro Fujihara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Hirohito Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Hideki Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Noriko Nishiyama
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Mitsuyoshi Kobayashi
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Makoto Oryu
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Takamatsu, Kagawa 761-0793, Japan
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Park W, Lee H, Kim EH, Yoon JY, Park JC, Shin SK, Lee SK, Lee YC, Kim WH, Noh SH. Metabolic syndrome is an independent risk factor for synchronous colorectal neoplasm in patients with gastric neoplasm. J Gastroenterol Hepatol 2012; 27:1490-7. [PMID: 22432868 DOI: 10.1111/j.1440-1746.2012.07128.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM There are no data on how metabolic syndrome (MetS) affects the prevalence of synchronous colorectal neoplasm (CRN) in gastric neoplasm (GN) patients. The aim of this study was to investigate a model for risk stratification for colorectal screening by evaluating the clinical characteristics of synchronous CRN in GN patients classified according to the presence of MetS. METHODS A cross-sectional, case-control study of 492 patients (368 males and 124 females) with GN, and 492 age-matched healthy controls undergoing simultaneous upper endoscopy and colonoscopy, was conducted. RESULTS The GN group involved 446 patients without MetS, and 46 patients with MetS. In total, 177 (39.7%) and 28 (60.9%) synchronous CRN were detected in GN patients without MetS and with MetS, respectively (P=0.006). A total of 143 (34.7%) synchronous colorectal adenomas were detected in GN patients without MetS, whereas 17 (48.6%) were detected in GN patients with MetS (P=0.101), as well as more synchronous colorectal cancers (11.2% vs 37.9%, P<0.001). A multivariate logistic regression analysis revealed that the presence of GN (OR=1.54, 95% CI: 1.18-2.00, P=0.001) and the presence of MetS (odds ratio=1.82, 95% confidence interval: 1.19-2.78, P=0.006) were significant independent risk factors associated with the prevalence of CRN. The frequency of synchronous CRN in GN patients with MetS was 1.96 times greater than that in the GN group without MetS. CONCLUSION The risk of synchronous CRN is significantly increased by the presence of GN, especially in MetS patients. Screening for synchronous CRN is highly recommended for GN patients with MetS.
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Affiliation(s)
- Wan Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Tseng CH. Diabetes but not insulin is associated with higher colon cancer mortality. World J Gastroenterol 2012; 18:4182-90. [PMID: 22919252 PMCID: PMC3422800 DOI: 10.3748/wjg.v18.i31.4182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 03/30/2012] [Accepted: 04/22/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate whether diabetic patients had a higher risk of colon cancer mortality and its associated risk factors.
METHODS: The sex-specific crude and age-standardized (to the 2000 World Health Organization population) mortality rates of colon cancer in the Taiwanese general population were first calculated from 1995 to 2006. The trends were evaluated by linear regression. A total of 113 347 diabetic men and 131 573 diabetic women aged ≥ 25 years at recruitment from 1995 to 1998 were followed up until the end of 2006. Age/sex-specific colon cancer mortality rate ratios were calculated comparing the mortality rates of the diabetic patients with the average mortality rates of the general population within 12 years (1995-2006). A sub-cohort of diabetic patients (42 260 men and 49 405 women) was interviewed using a baseline questionnaire and Cox’s regression was used to evaluate the risk factors for colon cancer mortality in these diabetic patients.
RESULTS: The crude and age-standardized trends of colon cancer mortality from 1995 to 2006 increased significantly for both sexes in the general population. A total of 641 diabetic men and 573 diabetic women died of colon cancer, with a mortality rate of 74.4 and 54.3 per 100 000 person-years, respectively. Mortality rate ratios [95% confidence intervals (CIs)] showed a significantly higher risk of mortality from colon cancer for the diabetic patients compared to the general population, with the magnitude increasing with decreasing age: 1.65 (1.40-1.95), 2.01 (1.78-2.27), 2.75 (2.36-3.21) and 5.69 (4.65-6.96) for ≥ 75, 65-74, 55-64 and 25-54 years old, respectively, for men; and 1.46 (1.24-1.72), 2.09 (1.84-2.38), 2.67 (2.27-3.14) and 3.05 (2.29-4.06), respectively, for women. Among the sub-cohort of diabetic patients who had been interviewed with the baseline questionnaire, including information on age, sex, diabetes duration, diabetes type, body mass index, smoking, insulin use and area of residence, age and smoking were significantly predictive for colon cancer mortality, with respective adjusted hazard ratios (HRs) (95% CIs) of 1.077 (1.066-1.088) and 1.384 (1.068-1.792). Diabetes duration became a significant factor when those who died of colon cancer within 5 years of diabetes diagnosis were excluded to minimize the possible contamination of diabetes caused by incipient colon cancer, with an adjusted hazard ratio of 1.021 (1.007-1.034). Sex, diabetes type, insulin use, body mass index and area of residence were not significant predictors for colon cancer mortality in the diabetic patients. Although insulin use was categorized into subgroups of duration of use (non-users and users < 5 years, 5-9 years and ≥ 10 years), none of the HRs for colon cancer mortality was significant with regards to different durations of insulin use.
CONCLUSION: Colon cancer mortality is increasing in Taiwan. A higher risk is observed in diabetic patients. Smoking, but not insulin use, is a modifiable risk factor.
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Abstract
OBJECTIVE To determine the prevalence of gastrointestinal (GI) manifestations associated with diabetes mellitus (DM) in a Taiwanese population undergoing bidirectional endoscopies. RESEARCH DESIGN AND METHODS Subjects voluntarily undergoing upper endoscopy/colonoscopy as part of a medical examination at the National Taiwan University Hospital were recruited during 2009. Diagnosis of DM included past history of DM, fasting plasma glucose ≥ 126 mg/dL, or glycated hemoglobin (HbA(1c)) ≥ 6.5%. Comparisons were made between diabetic and nondiabetic subjects, subjects with lower and higher HbA(1c) levels, and diabetic subjects with and without complications, respectively, for their GI symptoms, noninvasive GI testing results, and endoscopic findings. RESULTS Among 7,770 study subjects, 722 (9.3%) were diagnosed with DM. The overall prevalence of GI symptoms was lower in DM subjects (30.3 vs. 35.4%, P = 0.006). In contrast, the prevalence of erosive esophagitis (34.3 vs. 28.6%, P = 0.002), Barrett's esophagus (0.6 vs. 0.1%, P = 0.001), peptic ulcer disease (14.8 vs. 8.5%, P < 0.001), gastric neoplasms (1.8 vs. 0.7%, P = 0.003), and colonic neoplasms (26.6 vs. 16.5%, P < 0.001) was higher in diabetic subjects. Diagnostic accuracy of immunochemical fecal occult blood test for colonic neoplasms was significantly decreased in DM (70.7 vs. 81.7%, P < 0.001). Higher HbA(1c) levels were associated with a decrease of GI symptoms and an increase of endoscopic abnormalities. Diabetic subjects with complications had a higher prevalence of colonic neoplasms (39.2 vs. 24.5%, P = 0.002) than those without. CONCLUSIONS DM and higher levels of HbA(1c) were associated with lower prevalence of GI symptoms but higher prevalence of endoscopic abnormalities.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Kim BC, Shin A, Hong CW, Sohn DK, Han KS, Ryu KH, Park BJ, Nam JH, Park JW, Chang HJ, Choi HS, Kim J, Oh JH. Association of colorectal adenoma with components of metabolic syndrome. Cancer Causes Control 2012; 23:727-35. [PMID: 22450737 DOI: 10.1007/s10552-012-9942-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 03/07/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE Recently, some studies have shown that diabetes mellitus and metabolic syndrome increase the risk of colorectal neoplasms. Although the mechanism is not known, those have been proposed to contribute to this phenomenon, including insulin resistance, oxidative stress, and adipokine production. The objective of this study was to assess the association between metabolic risk factors and colorectal neoplasm. METHODS Study participants visited the National Cancer Center, Korea, for screening (2007-2009). A total of 1,771 diagnosed adenoma patients and 4,667 polyp-free controls were included. The association between risk factors and colorectal neoplasm was evaluated using logistic regression models. RESULTS High waist circumference, blood pressure, and serum triglyceride levels were associated with an increased risk of colorectal adenoma. Metabolic syndrome (MS) was associated with an increased risk of adenoma (OR = 1.44, 95 % CI = 1.23-1.70). The association between MS and colorectal adenoma was observed regardless of advanced/low-risk adenoma, and multiplicity. MS affected right colon adenomas (OR = 1.50, 95 % CI = 1.22-1.85), left colon adenomas (OR = 1.36, 95 % CI = 1.05-1.76), and adenomas in multiple anatomical locations (OR = 1.59, 95 % CI = 1.19-2.12), but was not associated with rectum. CONCLUSION Central obesity, triglyceride level, and MS are risk factors for colorectal adenoma including advanced adenoma and multiplicity.
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Affiliation(s)
- Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital of National Cancer Center, Goyang-si, Korea
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Muhidin SO, Magan AA, Osman KA, Syed S, Ahmed MH. The relationship between nonalcoholic fatty liver disease and colorectal cancer: the future challenges and outcomes of the metabolic syndrome. J Obes 2012; 2012:637538. [PMID: 23304464 PMCID: PMC3523590 DOI: 10.1155/2012/637538] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 11/11/2012] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is closely related to insulin resistance, metabolic syndrome, obesity, type 2 diabetes, and dyslipidaemia. Obesity and metabolic syndrome are associated with an increased cancer risk, and recent evidence demonstrated an association between NAFLD and colorectal cancer (CRC). The mechanism of how NAFLD can be associated with increased risk of CRC is not fully understood; however, NAFLD represents a condition of profound insulin resistance and a proinflammatory state. Insulin and insulin-like growth factors may promote the development of CRC through their proliferative and antiapoptotic effects. Patients with NAFLD have reduced expression of adiponectin, an adipokine with anti-inflammatory effects. Importantly, hypoadiponectinemia is associated with an increased risk of CRC. Decreased levels of adiponectin lead to increased insulin levels due to marked insulin resistance and in turn increased insulin growth factor-1 (IGF-1). Insulin binds to IGF-1 receptors and plays an important role in cell proliferation, apoptosis, and increased production of vascular endothelial growth factor, an angiogenic factor that supports cancer growth. Further studies are needed to establish (i) the pathophysiology of NAFLD with colorectal cancer, (ii) the benefit of early screening of CRC in NAFLD patients, and (iii) the impact of treatment of NAFLD in the modulation of the risk of colorectal cancer.
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Affiliation(s)
- Said O. Muhidin
- Department of Ophthalmology, Southampton University Hospitals, Southampton SO16 6YD, UK
| | - Ahmed A. Magan
- Department of Trauma & Orthopedics, Cambridge University Hospitals, Cambridge CB2 0QQ, UK
| | - Khalid A. Osman
- Department of Surgery, North Tyneside General Hospital, North Shields NE29 8NH, UK
| | - Shareef Syed
- Department of General Surgery, CMU Healthcare, Central Michigan University, Saginaw, MI 48602, USA
| | - Mohamed H. Ahmed
- Department of Medicine, Wexham Park Hospital, Slough, Berkshire SL2 4HL, UK
- *Mohamed H. Ahmed:
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Chiang TH, Lee YC, Tu CH, Chiu HM, Wu MS. Performance of the immunochemical fecal occult blood test in predicting lesions in the lower gastrointestinal tract. CMAJ 2011; 183:1474-81. [PMID: 21810951 DOI: 10.1503/cmaj.101248] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have suggested that the immunochemical fecal occult blood test has superior specificity for detecting bleeding in the lower gastrointestinal tract even if bleeding occurs in the upper tract. We conducted a large population-based study involving asymptomatic adults in Taiwan, a population with prevalent upper gastrointestinal lesions, to confirm this claim. METHODS We conducted a prospective cohort study involving asymptomatic people aged 18 years or more in Taiwan recruited to undergo an immunochemical fecal occult blood test, colonoscopy and esophagogastroduodenoscopy between August 2007 and July 2009. We compared the prevalence of lesions in the lower and upper gastrointestinal tracts between patients with positive and negative fecal test results. We also identified risk factors associated with a false-positive fecal test result. RESULTS Of the 2796 participants, 397 (14.2%) had a positive fecal test result. The sensitivity of the test for predicting lesions in the lower gastrointestinal tract was 24.3%, the specificity 89.0%, the positive predictive value 41.3%, the negative predictive value 78.7%, the positive likelihood ratio 2.22, the negative likelihood ratio 0.85 and the accuracy 73.4%. The prevalence of lesions in the lower gastrointestinal tract was higher among those with a positive fecal test result than among those with a negative result (41.3% v. 21.3%, p < 0.001). The prevalence of lesions in the upper gastrointestinal tract did not differ significantly between the two groups (20.7% v. 17.5%, p = 0.12). Almost all of the participants found to have colon cancer (27/28, 96.4%) had a positive fecal test result; in contrast, none of the three found to have esophageal or gastric cancer had a positive fecal test result (p < 0.001). Among those with a negative finding on colonoscopy, the risk factors associated with a false-positive fecal test result were use of antiplatelet drugs (adjusted odds ratio [OR] 2.46, 95% confidence interval [CI] 1.21-4.98) and a low hemoglobin concentration (adjusted OR 2.65, 95% CI 1.62-4.33). INTERPRETATION The immunochemical fecal occult blood test was specific for predicting lesions in the lower gastrointestinal tract. However, the test did not adequately predict lesions in the upper gastrointestinal tract.
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Affiliation(s)
- Tsung-Hsien Chiang
- Department of Internal Medicine, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Hu NC, Chen JD, Lin YM, Chang JY, Chen YH. Stepwise relationship between components of metabolic syndrome and risk of colorectal adenoma in a Taiwanese population receiving screening colonoscopy. J Formos Med Assoc 2011; 110:100-8. [PMID: 21377064 DOI: 10.1016/s0929-6646(11)60016-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 12/01/2009] [Accepted: 03/19/2010] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/PURPOSE Metabolic syndrome (MS) is a cluster of diseases related to insulin resistance and is an important cardiovascular risk factor. In addition, MS has been linked to some malignancies, including colorectal cancer. Colon adenoma is a well-established pre-malignant lesion of colorectal cancer. The aim of this study was to determine the effect of various components of MS on the risk of colorectal adenoma. METHODS From October 2004 to April 2006, 3106 subjects who had undergone complete colonoscopy for health examinations at the hospital were enrolled. MS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III definition for South Asians and Chinese. Multivariate logistic regression was used to analyze the association between components of MS and colorectal adenoma. RESULTS Of the 3106 subjects, the mean age was 47.1 ± 10.8 years and there were 397 (13%) subjects with pathologically proven colorectal adenoma. Male sex, old age (=50 years), current smokers, and abdominal obesity were associated with increasing risk of colorectal adenoma. MS was associated with increased risk of colorectal adenoma (odds ratio: 1.71, 95% confidence interval: 1.34-2.71), and this risk increased with the number of metabolic components. Multiple and synchronous adenomas of the proximal and distal colon were positively associated with MS. CONCLUSION Subjects with metabolic syndrome have increased risk of developing colorectal adenoma. Screening colonoscopy for prevention of colorectal adenoma might be warranted when abdominal obesity or more than three components of MS are present.
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Affiliation(s)
- Nien-Chih Hu
- Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Shih Lin, Taipei 111, Taiwan
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Abstract
BACKGROUND Although metabolic syndrome (MS) has received a lot of attention in recent years, the correlation between MS and colorectal carcinoma is still not very clear. This study aims at exploring the relationship between MS and colorectal carcinoma. METHODS Data was collected from 507 cases of colorectal carcinoma and 507 cases of healthy patients between January 2002 and March 2007 to establish the database. The patients with colorectal cancer were divided into two groups based on the presence of MS. Multivariate analysis of these data for the overall survival and recurrence was performed with the Cox proportional hazard model. Variables examined by multivariate analysis were sex , age, location, histotype, differentiation, tumour, node, metastasis (TNM) stage, the number of lymph nodes detected, etc. RESULTS The existence of MS in the colorectal carcinoma group was clearly more than that in the control group. The existence of two to four types of abnormal metabolic diseases was significantly more in the colorectal cancer group than in the control group. MS is one of the important elements that can independently influence the survival (odds ratio (OR) = 1.501, 95% confidence interval (CI) = 1.057-2.131) and have the highest risk with worse survival compared with other parameters. CONCLUSION There is a close relationship between MS and colorectal carcinoma, and MS is a significantly independent element that influences the survival of the colorectal carcinoma. Decreasing the incidence of MS maybe play a role in improving therapeutic efficacy and prognosis of the cancer.
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Affiliation(s)
- Zhanlong Shen
- Department of Gastroenterological Surgery, Peking University, People's Hospital, Beijing, China
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Miyasaka K, Hosoya H, Tanaka Y, Uegaki S, Kino K, Shimokata H, Kawanami T, Funakoshi A. Association of aldehyde dehydrogenase 2 gene polymorphism with pancreatic cancer but not colon cancer. Geriatr Gerontol Int 2010; 10 Suppl 1:S120-6. [PMID: 20590827 DOI: 10.1111/j.1447-0594.2010.00616.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS Most of the acetaldehyde, a recognized animal carcinogen, generated during alcohol metabolism is eliminated by liver mitochondrial aldehyde dehydrogenase 2 (ALDH2). More than 40% of Japanese people have the inactive form of ALDH2, and inactive ALDH2 is a risk factor for multiple cancer of the esophagus, as well as head and neck cancer. Possible associations between pancreatic cancer and ALDH2 gene polymorphism, as well as between colon cancer and ALDH2 gene polymorphism, in conjunction with smoking and/or drinking habits, were examined in a Japanese population. METHODS Patients with pancreatic cancer (n = 187) and with colon cancer (n = 49) were examined. The drinking (5 g ethanol consumption/day) and/or smoking habits as well as ALDH2 gene polymorphism were examined. The age-matched control subjects were recruited in the NILS Longitudinal Study of Aging (LSA). RESULTS Aging, smoking and inactive ALDH2, but not alcohol, are independent risk factors for pancreatic cancer. The frequency of smoking habits tended to be higher in patients with colon cancer compared with the patients without cancer. However, age, body mass index or the distribution of ALDH2 genotypes did not differ significantly among the patients with colon cancer, colon polyps and others. CONCLUSIONS Inactive ALDH2 is an independent risk factor for pancreatic cancer, but inactive ALDH2 might not be a risk for colon cancer.
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Affiliation(s)
- Kyoko Miyasaka
- Department of Clinical Physiology, Tokyo Metropolitan Institute of Gerontology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
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Hong SN, Kim JH, Choe WH, Han HS, Sung IK, Park HS, Shim CS. Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age. Gastrointest Endosc 2010; 72:480-9. [PMID: 20638061 DOI: 10.1016/j.gie.2010.06.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Accepted: 06/10/2010] [Indexed: 02/08/2023]
Abstract
BACKGROUND A paucity of information exists regarding colorectal neoplasm in asymptomatic, average-risk individuals 40 to 49 years of age. OBJECTIVE To evaluate the prevalence and risk factors of colorectal neoplasms in those in their 40s. DESIGN Cross-sectional study. SETTING Results offered to subjects of a health care provider that offers screening services as part of an employer-provided wellness program. PATIENTS A consecutive series of 1761 asymptomatic, average-risk screenees 40 to 59 years of age. INTERVENTION First screening colonoscopy. RESULTS The prevalence of overall colorectal neoplasm in subjects of ages 40 to 44 years, 45 to 49 years, 50 to 54 years, and 55 to 59 years increased significantly with increasing age (13.7%, 20.2%, 21.0%, and 23.8%, respectively; P < .001). The prevalence of advanced adenomas in subjects of ages 40 to 44 years, 45 to 49 years, 50 to 54 years, and 55 to 59 years increased significantly with age (1.9%, 3.0%, 3.2%, and 5.9%, respectively; P = .004). Multivariate analysis of data from the 40- to 49-year age group identified an increased risk of colorectal neoplasm associated with ages 45 years and older (odds ratio [OR], 1.68; 95% CI, 1.20-2.35), male sex (OR, 1.76; 95% CI, 1.15-2.69), presence of abdominal obesity (OR, 1.57; 95% CI, 1.12-2.21), and metabolic syndrome (OR, 1.56; 95% CI, 1.03-2.35), whereas for advanced adenomas, abdominal obesity (OR, 2.37; 95% CI, 1.06-5.27) and metabolic syndrome (OR, 2.83; 95% CI, 1.23-6.53) were the independent risk factors. LIMITATIONS Single-center study and the cohort composed of ethnic Korean subjects who lived in the same geographic region. CONCLUSION In average-risk individuals 40 to 49 years of age, men with abdominal obesity or metabolic syndrome might benefit from screening colonoscopy starting at 45 years of age to detect colorectal neoplasm.
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Affiliation(s)
- Sung Noh Hong
- Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Gwangjin-gu, Seoul, Republic of Korea
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Chen MJ, Chiu HM, Chen CL, Yang WS, Yang YS, Ho HN. Hyperandrogenemia is independently associated with elevated alanine aminotransferase activity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2010; 95:3332-41. [PMID: 20427499 DOI: 10.1210/jc.2009-2698] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Women with polycystic ovary syndrome (PCOS) have been implicated to have higher levels of alanine aminotransferase (ALT) because of the high prevalence of obesity. OBJECTIVE Our aim was to investigate the relationship between elevated ALT and aspartate aminotransferase (AST) activity and characteristic hyperandrogenism in women with PCOS. DESIGN AND SETTING We conducted a cross-sectional case-control study in a reproductive endocrinology clinic and voluntary annual medical health check-up program of the health management center in a tertiary medical center. PATIENTS A total of 279 women with PCOS and 279 age-frequency-matched healthy women were studied. INTERVENTIONS There were no interventions. MAIN OUTCOME MEASURES All subjects underwent anthropometric measurement, clinical history recorded by questionnaires, and biochemical tests after an overnight fast. RESULTS The prevalence of elevated ALT and AST levels was significantly higher in women with PCOS than healthy control subjects. Multivariate regression analysis for women revealed that the presence of PCOS was significantly associated with elevated ALT but not AST after adjustment for age, obesity, and dyslipidemia. The level of androgenicity represented by free androgen index in women with PCOS was significantly related to elevated ALT and AST levels in multivariate regression models. Women with PCOS who had the highest quartile of free androgen index level had the highest risk of elevated ALT level after adjustment for age, obesity, insulin resistance, and dyslipidemia. CONCLUSIONS The risk of elevated ALT level is significantly higher in women with PCOS than those without, independent of obesity. The elevated ALT levels in women with PCOS were associated with the increased androgen levels, independent of obesity, insulin resistance, and dyslipidemia.
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Affiliation(s)
- Mei-Jou Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, No. 7 Chung-Shan South Road, 100, Taipei, Taiwan
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Abstract
BACKGROUND There is emerging evidence of a strong association between obesity and gastrointestinal cancer. This review summarizes the evidence from an epidemiological and pathophysiological perspective. METHODS Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles were identified. Selection of articles was based on peer review, journal and relevance. RESULTS Numerous epidemiological studies consistently identified an increased risk of developing oesophageal adenocarcinoma and colorectal carcinoma in the obese. The association between obesity and other gastrointestinal malignancies was less robust. Sex seems important with respect to cancer risk. Adipose tissue, particularly viscerally located fat, is metabolically active and exerts systemic endocrine effects. Putative pathophysiological mechanisms linking obesity and carcinogenesis include the insulin-like growth factor axis, adipocytokines and sex steroids. CONCLUSION A better understanding of the mechanisms that link obesity and cancer may uncover targets for intervention. Tackling obesity may result in a reduction in the incidence in addition to mortality of certain cancers in future.
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Affiliation(s)
- C L Donohoe
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/St James' Hospital, Dublin 8, Ireland
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46
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Abstract
PURPOSE The purpose of this study was to determine the effects of metabolic syndrome on the short-term outcomes of colorectal cancer surgery. METHODS A prospective, observational study of colorectal cancer patients who underwent elective oncological resection was conducted between June 2007 and August 2008 at the Faculty of Medicine, Siriraj Hospital, Bangkok. Each patient received preoperative screening for metabolic syndrome using the criteria of the American Heart Association and the National Heart, Lung, and Blood Institute. Factors influencing 30-day postoperative morbidity and mortality were analyzed. RESULTS The study included 114 patients with colorectal cancer, with an average age of 61 years (range 29-91). Forty-two (36.8%) patients had metabolic syndrome. There was no significant difference in age, sex, tumor, or operative parameters between patients with or without metabolic syndrome. There was no postoperative mortality, and overall postoperative morbidity was 21.9%. Patients with metabolic syndrome had a higher rate of complications and a longer length of hospital stay than those without metabolic syndrome (40.5% vs 11.1%, P < .001 and 11.2 vs 8.1 day, P = .006, respectively). The presence of metabolic syndrome, tumor location, American Society of Anesthesiologists' score III, elevated blood pressure, and high triglycerides level were risk factors for postoperative complications in the univariate analysis; however, in the multivariate analysis, the presence of metabolic syndrome and rectal cancer surgery were the only 2 independent factors for the development of complications. CONCLUSIONS Patients with metabolic syndrome had a higher rate of postoperative complication and a longer length of hospital stay than patients without metabolic syndrome.
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Affiliation(s)
- Varut Lohsiriwat
- Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Shen Z, Ye Y, Bin L, Yin M, Yang X, Jiang K, Wang S. Metabolic syndrome is an important factor for the evolution of prognosis of colorectal cancer: survival, recurrence, and liver metastasis. Am J Surg 2010; 200:59-63. [PMID: 20074697 DOI: 10.1016/j.amjsurg.2009.05.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Revised: 05/07/2009] [Accepted: 05/07/2009] [Indexed: 01/01/2023]
Abstract
BACKGROUND Several studies have shown that metabolic syndrome (MS) was a risk factor for colorectal cancer, but few studies have reported the relationship between MS and the prognosis of colorectal cancer. METHODS Data were collected from 507 cases of colorectal carcinoma between January 2002 and March 2007 to establish the database. These patients were divided into 2 groups based on the presence of MS. We tested the prognostic value of MS in the patients. The risk of adverse events was examined by Cox proportional hazard modeling. RESULTS The rates of liver metastasis and tumor recurrence were higher in the group of patients with colorectal cancer accompanied by MS. Moreover, MS is one of the important elements that independently can influence the survival (colonic carcinoma: hazard ratio [HR], 1.633; 95% confidence interval [CI], 1.039-2.565; rectal carcinoma: HR, 1.939, 95% CI, 1.076-3.494) and liver metastasis (colonic carcinoma: HR, 2.619; 95% CI, 1.288-5.324; rectal carcinoma: HR, 2.814; 95% CI, .962-2.888) of both colonic and rectal carcinoma patients, and MS patients have the highest risk with worse survival and liver metastases compared with other parameters. CONCLUSIONS The results suggest that MS may be an important prognostic factor for colorectal cancer, decreasing the incidence of MS may improve the therapeutic efficacy of colorectal cancer.
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Affiliation(s)
- Zhanlong Shen
- Department of Gastroenterological Surgery, Peking University, People's Hospital, Beijing, People's Republic of China
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Abstract
Since its first description by Reavan in 1988, accepted criteria for clinical identification of the components of metabolic syndrome have been promulgated by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) and the World Health Organization (WHO) as well as the International Diabetes Federation (IDF), and the American Association of Clinical Endocrinologists (AACE). Insulin resistance is a common metabolic abnormality underlying type 2 diabetes mellitus and is also an independent risk factor for cardiovascular disease. Although ATP III identified cardiovascular disease (CVD) as the primary clinical outcome of the metabolic syndrome, we now have evidence that metabolic syndrome is associated with type 2 diabetes mellitus, polycystic ovarian disease, nonalcoholic fatty liver disease, and possibly some cancers. This review summarizes evidence in support of the relationship between metabolic syndrome and various cancers and possible underlying mechanisms and therapeutic interventions.
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Affiliation(s)
- Pooja Pothiwala
- Department of Endocrinology and Metabolism, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
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Chiu HM, Lin JT, Wu MS, Wang HP. Current status and future perspective of endoscopic diagnosis and treatment for colorectal neoplasia - situation in Taiwan. Dig Endosc 2009; 21 Suppl 1:S17-21. [PMID: 19691726 DOI: 10.1111/j.1443-1661.2009.00853.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The incidence of colorectal cancer (CRC) is rising substantially in Taiwan. Hence, both effective screening and management of colorectal neoplasms, including precursor lesions and early cancers, have become critically important. Colorectal cancer is not only curable, but also can be managed endoscopically if detected at the stage of precursor lesions or early cancer. Optimal management of colorectal neoplasia relies largely on accurate evaluation of the characteristics of lesions, including malignant transformation, and the depth of invasion of the malignant lesions. In this context, observation using image enhancing endoscopy (IEE) to magnify the image during colonoscopy is of utmost importance. Polypectomy or endoscopic mucosal resection is now the standard procedure for the treatment of colorectal adenoma or early cancerous lesions in Taiwan. Endoscopic submucosal dissection (ESD) is performed at only a few institutions; its long-term efficacy and cost-effectiveness require further elucidation. More attention from the government, academic societies, and individual clinicians is necessary.
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Affiliation(s)
- Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Chiu HM, Lin JT, Chen CC, Lee YC, Liao WC, Liang JT, Shun CT, Wang HP, Wu MS. Prevalence and characteristics of nonpolypoid colorectal neoplasm in an asymptomatic and average-risk Chinese population. Clin Gastroenterol Hepatol 2009; 7:463-70. [PMID: 19264577 DOI: 10.1016/j.cgh.2008.11.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 11/10/2008] [Accepted: 11/27/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Evidence from Japanese studies suggests that nonpolypoid colorectal neoplasia (NP-CRN) tends to be more pathologically advanced than polypoid neoplasia. However, data are limited regarding the prevalence of NP-CRN in an average-risk population. In addition, the diagnostic yield of the fecal occult blood test (FOBT) in relation to different types of colorectal neoplasms remains unclear. We prospectively investigated the prevalence and characteristics of polypoid and nonpolypoid colorectal lesions in an asymptomatic and average-risk Chinese population. METHODS The study included 12,731 asymptomatic Chinese subjects (8372 of whom were average-risk subjects) who underwent screening colonoscopy. The prevalence, histopathologic findings, and topographic distribution of polypoid and nonpolypoid colorectal lesions were determined and analyzed. The diagnostic yield of FOBT, in relation to lesion morphology, also was assessed. RESULTS NP-CRN was detected in 552 (4.3%) asymptomatic and 348 (4.2%) average-risk subjects. The prevalence of depressed NP-CRN was 0.18% in both asymptomatic and average-risk subjects. A higher proportion of smaller-sized but high-grade dysplasia and invasive carcinoma beyond the submucosal layer was noted for depressed NP-CRN compared with flat NP-CRN or polypoid neoplasia. The diagnostic yield of FOBT was comparable in depressed lesions and their polypoid counterparts. CONCLUSIONS The prevalence of NP-CRN is substantial in both asymptomatic and average-risk Chinese individuals. Some subcategories of NP-CRN in this population tend to have more advanced pathologic characteristics. These findings may lead to modification of screening and prevention strategies for colorectal cancer.
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