Back to Search
Start Over
A Comprehensive Model of Colorectal Cancer by Risk Factor Status and Subsite Using Data From the Nurses' Health Study.
- Source :
- American Journal of Epidemiology; 2/1/2017, Vol. 185 Issue 3, p224-237, 14p
- Publication Year :
- 2017
-
Abstract
- We expanded and updated our colon cancer risk model to evaluate colorectal cancer (CRC) and whether subsite-specific risk models are warranted. Using data from 1980-2010 for 90,286 women enrolled in the Nurses' Health Study, we performed competing-risks regression and tests for subsite heterogeneity (proximal colon: n = 821 ; distal colon: n = 521 ; rectum: n = 376). Risk factors for CRC were consistent with those in our colon cancer model. Processed meat consumption was associated with a higher risk of distal (hazard ratio (HR) = 1.45; P = 0.02) but not proximal (HR = 0.95; P = 0.72) colon cancer. Smoking was associated with both colon (HR = 1.21) and rectal (HR = 1.27) cancer and was more strongly associated with proximal (HR = 1.31) than with distal (HR = 1.04) colon cancer (P = 0.029). We observed a significant trend of cancer risk for smoking in subsites from the cecum (HR = 1.41) to the proximal colon (excluding the cecum; HR = 1.27) to the distal colon (HR = 1.04; P for trend = 0.040). The C statistics for colorectal (C = 0.607), colon (C = 0.603), and rectal (C = 0.639) cancer were similar, although C was slightly higher for rectal cancer. Despite evidence for site-specific differences for several risk factors, overall our findings support the application of risk prediction models for colon cancer to CRC. [ABSTRACT FROM AUTHOR]
- Subjects :
- RECTUM tumors
COLON tumors
ASPIRIN
CALCIUM
ALCOHOL drinking
FOLIC acid
FOOD habits
MEAT
PROBABILITY theory
QUESTIONNAIRES
RESEARCH funding
RISK assessment
SMOKING
SURVIVAL analysis (Biometry)
BODY mass index
LIFESTYLES
DISEASE incidence
PROPORTIONAL hazards models
FAMILY history (Medicine)
PHYSICAL activity
DATA analysis software
PHARMACODYNAMICS
TUMOR risk factors
CANCER risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 00029262
- Volume :
- 185
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- American Journal of Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 121071827
- Full Text :
- https://doi.org/10.1093/aje/kww183