Risk Factors for Colorectal Cancer in Thailand

  • Published : 2015.09.02


Background: Colorectal cancer (CRC) is one of the most common cancers worldwide. This study aimed to investigate the risk factors for colorectal cancer in the Thai population. Materials and Methods: A cohort study was carried out in Khon Kaen, Thailand, including 71 cases of histologically confirmed CRC patients among 19,861 participants, aged 30-69 years, who were recruited for a cohort study during the period 1990-2001. Participants were followed-up until 31 December, 2013. To identify factors associated with the incidence of colorectal cancer, hazard ratios were evaluated using Cox proportional hazard regression. Results: No environmental variables could be shown to be significantly related to the risk of CRC. Although in our sample, CRC was more prevalent among males, ex-smokers, and those who drank alcohol beverages ${\geq}50gram/day$, but we could not demonstrate significantly associations (HRmale= 1.67, 95% CI, 0.80-3.49, HR ex-smokers = 1.34, 95% CI, 0.52-3.46, and HRalc ${\geq}50=1.08$, 95% CI, 0.43-2.71). Individuals within the sample with a family history of cancer, working hour >8 hours per day, and current-smokers appeared to have decrease risk of CRC, but again these relationship could not be shown to be significantly associated (HRfam cancer= 0.96, 95% CI, 0.85-1.09, HRwork>8= 0.84, 95% CI, 0.36-1.93, and HRcurrent-smoker = 0.51, 95% CI, 0.18-1.38). Conclusions: We found no evidence of environmental factors effecting the risk of CRC. There is a need for further research to determine why factors identified risk in other populations appear to not be associated with CRC risk in Thais.


  1. Tiemersma EW, Kampman E, Bueno de Mesquita HB, et al (2002). Meat consumption, cigarette smoking, and genetic susceptibility in the etiology of colorectal cancer: results from a Dutch prospective study. Cancer Causes Control, 13, 383-93.
  2. Turati F, Edefonti V, Bosetti C, et al (2013). Family history of cancer and the risk of cancer: A network of case-control studies. Ann Oncol, 24, 2651-6.
  3. Wang J, Zhao Y, Jiang J, et al (2010). Polymorphisms in DNA repair genes XRCC1, XRCC3 and XPD, and colorectal cancer risk: A case-control study in an Indian population. J Cancer Res Clin Oncol, 136, 1517-25.
  4. WangYM, Zhou QY, Zhu JZ, et al (2015). Systematic review with meta-analysis: Alcohol consumption and risk of colorectal serrated polyp. Dig Dis Sci, 60, 1889-902
  5. Weisenberger DJ, Levine AJ, Long TI, et al (2015). Association of the colorectal CpGisland methylator phenotype with molecular features, risk factors, and family history. Cancer Epidemol Biomarker Prev, 24, 512-9.
  6. Yee YK, Tan VP, Chan P, et al (2009). Epidemiology of colorectal cancer in Asia. J Gastroenterol Hepatol, 24, 1810-6.
  7. Zhivotovskiy AS, Kutikhin AG, Azanov AZ, et al (2012). Colorectal cancer risk factors among the population of south-east siberia: A case-control study. Asian Pac J Cancer Prev, 13, 5183-8.
  8. Peng XE, Jiang, YY, Shi, XS, HuZJ (2013). NQO1 609C>T polymorphism interaction with tobacco smoking and alcohol drinking increases colorectal cancer risk in a Chinese population. Gene, 521, 105-10.
  9. Phipps AI, Baron J, Newcomb PA (2011). Prediagnostic smoking history, alcohol consumption, and colorectal cancer survival: the Seattle Colon Cancer Family Registry. Cancer, 117, 4948-57.
  10. Poomphakwaen K, Promthet S, Suwanrungruan K, et al (2014). XRCC1 gene polymorphism, diet and risk of colorectal cancer in Thailand. Asian Pac J Cancer Prev, 13, 4017-23.
  11. Promthet S, Pientong C, Ekalaksananan T, et al (2012). Risk factors for rectal cancer and methylenetetrahydrofolate reductase polymorphisms in a population in Northeast Thailand. Asian Pac J Cancer Prev, 13, 4017-23.
  12. Promthet SS, Pientong C, Ekalaksananan T, et al (2010). Risk factors for colon cancer in Northeastern Thailand: interaction of MTHFR codon 677 and 1298 genotypes with environmental factors. J Epidemiol, 20, 329-38.
  13. Song YK,park YS, Seon CS, et al (2015). Alcohol drinking increased the risk of advanced colorectal adenomas. Intest Res, 13, 74-9.
  14. Sriamporn S, Wiangnon S, Suwanrungruang K, et al (2007). Risk factors for colorectal cancer in northeast Thailand: lifestyle related. Asian Pac J Cancer Prev, 8, 573-7.
  15. StataCorp. (2007). Stata Statistical Software: Release 10. College Station, TX: StataCorp LP.
  16. Stegeman I, De Wijkerslooth TR, Stoop EM, et al (2013). Colorectal cancer risk factors in the detection of advanced adenoma and colorectal cancer. Cancer Epidemiol, 37, 278-83.
  17. Sung JJ, Lau JY, Goh K L, Leung WK (2005). Asia Pacific Working Group on Colorectal Cancer Increasing incidence of colorectal cancer in Asia: implications for screening. Lancet Oncol, 6, 871-6.
  18. De Stefani E, Ronco AL, Boffetta P, et al (2012). Nutrientderived dietary patterns and risk of colorectal cancer: a factor analysis in Uruguay. Asian Pac J Cancer Prev, 13, 231-5.
  19. Durko L, Malecka-Panas E (2014). Lifestyle Modifications and Colorectal Cancer. Curr Colorectal Cancer Rep, 10, 45-54.
  20. Ferlay J, Soerjomataram I, Ervik M, et al (2013). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No.11. International Agency for Research on Cancer. internet. Retrieved May 13, 2014, from
  21. Ganesh B, Talole SD, Dikshit R (2009). A case-control study on diet and colorectal cancer from Mumbai, India. Cancer Epidemiol, 33, 189-93.
  22. 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 Biom Prev, 21, 1974-85.
  23. Hsing AW, McLaughlin JK, Chow WH, et al (1998). Risk factors for colorectal cancer in a prospective study among U.S. white men. Int J Cancer, 77, 549-53.<549::AID-IJC13>3.0.CO;2-1
  24. Leufkens AM, Van Duijnhoven FJ, Siersema PD, et al (2011). Cigarette smoking and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study. Clin Gastroenterol Hepatol, 9, 137-44.
  25. Johns L, Houlston R (2001). A systematic review and meta-analysis of familial colorectal cancer risk. AM J Gastroenterol, 96, 2993-3003
  26. Nisa H, Kono S, Yin G, et al (2010). Cigarette smoking, genetic polymorphisms and colorectal cancer risk: the Fukuoka Colorectal Cancer Study. BMC Cancer, 10, 274.
  27. Askling J, Dickman P, Kalen P, Brostrom O (2001). Family history as a risk factor for colorectal cancer in inflammatory bowel disease. Gastroenterol, 120, 1356-62.
  28. Botteri E, Iodice S, Bagnardi V, et al (2008). Smoking and colorectal cancer: a meta-analysis. J Am Med Associat, 300, 2765-78.
  29. Castiglione G, Visioli CB, Zappa M, et al (2012). Familial risk of colorectal cancer in subjects attending an organised screening programme. Dig Liver Dis, 44, 80-3.
  30. Cho AY, Kim J (2011). Association between alcohol consumption and colorectal carcinogenesis: an ecological study in Korea. Asian Pac J Cancer Prev, 12, 761-4.

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