DOI QR코드

DOI QR Code

Dietary Practices, Addictive Behavior and Bowel Habits and Risk of Early Onset Colorectal Cancer: a Case Control Study

  • Khan, Naveed Ali ;
  • Hussain, Mehwish ;
  • Rahman, Ata ur ;
  • Farooqui, Waqas Ahmed ;
  • Rasheed, Abdur ;
  • Memon, Amjad Siraj
  • Published : 2015.12.03

Abstract

Background: The abrupt rise of colorectal cancer in developing countries is raising concern in healthcare settings. Studies on assessing relationships with modifiable and non-modifiable risk factors in the Pakistani population have been limited. The present investigation was designed to examine associations of dietary practices, addictive behavior and bowel habits in developing colorectal cancer (CRC) among patients in a low-resource setup. Materials and Methods: An age-gender matched case control study was conducted from October 2011 to July 2015 in Karachi, Pakistan. Cases were from the surgical oncology department of a public sector tertiary care hospital, while their two pair-matched controls were recruited from the general population. A structured questionnaire was used which included questions related to demographic characteristics, family history, dietary patterns, addictive behavior and bowel habits. Results: A family history of cancer was associated with a 2.2 fold higher chance of developing CRC. Weight loss reduced the likelihood 7.6 times. Refraining from a high fat diet and consuming more vegetables showed protective effects for CRC. The risk of CRC was more than twice among smokers and those who consumed Asian specific addictive products as compared to those who avoid using these addictions (ORsmoking: 2.12, 95% CI: 1.08 - 4.17, ORpan: 2.92, 95% CI: 1.6 - 5.33, ORgutka: 2.13, 95% CI: 1.14 - 3.97). Use of NSAID attenuated risk of CRC up to 86% (OR: 0.14, 95% CI: 0.07 - 0.31). Conclusions: Most of the findings showed concordance with the literature elucidating protective effects of consuming vegetables and low fat diet while documenting adverse associations with family history, weight loss, constipation and hematochezia. Moreover, this study highlighted Asian specific indigenous addictive products as important factors. Further studies are needed to validate the findings produced by this research.

Keywords

Colorectal cancer;dietary practices;addictive behaviors;bowel habits;risk factors;Pakistan

References

  1. Alvarez-Cuenllas B, Diez-Rodriguez R, Vaquero L, et al (2015). Descriptive analysis of endoscopic findings in patients with a family history of colorectal cancer. Revista de gastroenterologia de Mexico.
  2. Amini AQ, Samo KA, Memon AS (2013). Colorectal cancer in younger population: our experience. J Pak Med Assoc, 63, 1275-7.
  3. Anwar N, Badar F, Yusuf MA (2008). Profile of patients with colorectal cancer at a tertiary care cancer hospital in Pakistan. Annals of the New York Academy of Sciences, 1138, 199-203. https://doi.org/10.1196/annals.1414.026
  4. Aykan NF, Yalcin S, Turhal NS, et al (2015). Epidemiology of colorectal cancer in Turkey: A cross-sectional disease registry study (A Turkish Oncology Group trial). Turk J Gastroenterol, 26, 145-53. https://doi.org/10.5152/tjg.2015.5685
  5. Banerjee SC, Ostroff JS, Bari S, et al (2014). Gutka and tambaku paan use among South asian immigrants: a focus group study. J Immigrant Minority Health, 16, 531-9. https://doi.org/10.1007/s10903-013-9826-4
  6. Barbosa LRL, Lacerda-Filho A, Barbosa LCL (2014). Immediate preoperative nutritional status of patients with colorectal cancer: a warning. Arquivos de gastroenterologia, 51, 331-6. https://doi.org/10.1590/S0004-28032014000400012
  7. Basharat S, Kassim S, Croucher R (2012). Availability and use of Naswar: an exploratory study. J Pub Health, 34, 60-4. https://doi.org/10.1093/pubmed/fdr044
  8. Bhurgri Y, Khan T, Kayani N, et al (2011). Incidence and current trends of colorectal malignancies in an unscreened, low risk population. Asian Pac J Cancer Prev, 12, 703-8.
  9. Bishehsari F, Mahdavinia M, Vacca M, et al (2014). Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol, 20, 6055. https://doi.org/10.3748/wjg.v20.i20.6055
  10. Chen Z, Wang PP, Woodrow J, et al (2015). Dietary patterns and colorectal cancer: results from a Canadian population-based study. Nutr J, 14, 8. https://doi.org/10.1186/1475-2891-14-8
  11. Garg A, Chaturvedi P, Gupta PC (2014). A review of the systemic adverse effects of areca nut or betel nut. Ind J Med Paed Oncol, 35, 3. https://doi.org/10.4103/0971-5851.133702
  12. Gong J, Hutter C, Baron JA, et al (2012). A pooled analysis of smoking and colorectal cancer: timing of exposure and interactions with environmental factors. Cancer Epidemiol Biomarkers Prev, 21, 1974-85. https://doi.org/10.1158/1055-9965.EPI-12-0692
  13. Ho C, Kornfield R, Vittinghoff E, et al (2013). Late presentation of colorectal cancer in a vulnerable population. Am J Gastroenterol, 108, 466-70. https://doi.org/10.1038/ajg.2012.256
  14. Hooper GW, Biega T, Ginat DT (2015). Betel Nuts. In 'Neuroimaging Pharmacopoeia', Eds Springer, 79-81
  15. Jess T, Rungoe C, Peyrin-Biroulet L (2012a). Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. Clin Gastroenterol Hepatol, 10, 639-45. https://doi.org/10.1016/j.cgh.2012.01.010
  16. Jess T, Simonsen J, Jorgensen KT, et al (2012b). Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology, 143, 375-81. https://doi.org/10.1053/j.gastro.2012.04.016
  17. Katsidzira L, Gangaidzo IT, Mapingure MP, et al (2015). Retrospective study of colorectal cancer in Zimbabwe: Colonoscopic and clinical correlates. World J Gastroenterol, 21, 2374. https://doi.org/10.3748/wjg.v21.i8.2374
  18. Khan M, Bari H, Raza S (2011a). Early postoperative outcome after curative colorectal cancer surgery. Singapore Medical Journal, 52, 195-200.
  19. Khan MR, Bari H, Zafar SN, et al (2011b). Impact of age on outcome after colorectal cancer surgery in the elderly-a developing country perspective. BMC surgery, 11, 17. https://doi.org/10.1186/1471-2482-11-17
  20. Lund EK, Belshaw NJ, Elliott GO, et al (2011). Recent advances in understanding the role of diet and obesity in the development of colorectal cancer. Proc Nutr Society, 194-204.
  21. Mahfouz EM, Sadek RR, Abdel-Latief WM, et al (2014). The role of dietary and lifestyle factors in the development of colorectal cancer: case control study in Minia, Egypt. Central European journal of public health, 22, 215-22. https://doi.org/10.21101/cejph.a3919
  22. Malekzadeh F, Sadaf GS, Poustchi H, et al (2015). Burden of gastrointestinal and liver diseases in Iran: estimates based on the global burden of disease, injuries, and risk factors study, 2010. Middle East J Digest Disease, 7, 138-54.
  23. Malik AI, Badar F, Syed AA, et al (2015). Surgically treated rectal cancer patients-Outcomes at a tertiary care cancer hospital in Pakistan. Asian J Surg, 38, 13-20. https://doi.org/10.1016/j.asjsur.2014.05.004
  24. Mehta M, Shike M (2014). Diet and physical activity in the prevention of colorectal cancer. J National Comprehensive Cancer Network, 12, 1721-6. https://doi.org/10.6004/jnccn.2014.0174
  25. Merchant AT, Pitiphat W (2015). Total, direct, and indirect effects of paan on oral cancer. Cancer Causes & Control, 26, 487-91. https://doi.org/10.1007/s10552-014-0516-x
  26. NICE (2011). Appendix 1: Summary of the 5th edition of the TNM staging system for colorectal cancer and comparison with Dukes' stage. In 'Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer', Eds Cardiff,
  27. Pan L-H, Tsai Y-F, Chen M-L, et al (2011). Symptom distress and self-care strategies of colorectal cancer patients with diarrhea up to 3 months after surgery. Cancer Nursing, 34, 1-9.
  28. Roswall N, Weiderpass E (2015). Alcohol as a risk factor for cancer: existing evidence in a global perspective. J Prev Med Pub Health, 48, 1.
  29. Saeed M, Muhammad N, Khan SA, et al (2012). Assessment of potential toxicity of a smokeless tobacco product (naswar) available on the Pakistani market. Tobacco control, 21, 396-401. https://doi.org/10.1136/tc.2010.042630
  30. Simons C, Schouten L, Godschalk R, et al (2015). Body size, physical activity, genetic variants in the insulin-like growth factor pathway, and colorectal cancer risk. Carcinogenesis, bgv077.
  31. Tang Y-R, Wang P, Yin R, et al (2013). Five-year followup of 263 cases of functional bowel disorder. World J Gastroenterol, 19, 1466. https://doi.org/10.3748/wjg.v19.i9.1466
  32. Torre LA, Bray F, Siegel RL, et al (2015). Global cancer statistics, 2012. CA: A Cancer J Clin, 65, 87-108. https://doi.org/10.3322/caac.21262
  33. Vargas AJ, Thompson PA (2012). Diet and nutrient factors in colorectal cancer risk. Nutrition in Clinical Practice, 27, 613-23. https://doi.org/10.1177/0884533612454885