AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan Nati...AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of colorectal cancer between the period 2005 and 2008. The controls were matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS: We examined 1156 colorectal cancer cases and 4624 controls. The unadjusted ORs for any statin prescription was 1.10 (95% CI = 0.94-1.30) and the adjusted OR was 1.09 (95% CI = 0.91-1.30). When statin use was categorized by cumulative dose, the adjusted ORs were 0.99 (95% CI = 0.78-1.27) for the group with cumulative statin use below 105 defined daily doses (DDDs); 1.07 (95% CI = 0.78-1.49) for the group with cumulative statin use between 106 and 298.66 DDDs; and 1.30 (95% CI = 0.96-1.75) for the group with cumulative statin use of 298.66 DDDs or more compared with nonusers. CONCLUSION: This study does not provide support for a protective effect of statins against colorectal cancer.展开更多
Objective To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population. Methods 250 PCa patients and 500 controls were enrolled in this case-control study. Info...Objective To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population. Methods 250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk. Results Green vegetables and green tea were associated with a decreased risk of PCa (0R=0.39, 95% CI: 0.28-0.53; 0R=0.59, 95% Cl: 0.40-0.87, respectively). Family history of PCa (0R=7.16, 95% CI: 2.01-25.49), history of prostate diseases (0R=2.28, 95% Cl: 1.53-3.41), alcohol consumption (0R=1.97, 95% CI: 1.33-2.90), red meat consumption (0R=1.74, 95% CI: 1.20-2.52), barbecued (0R=2.29, 95% CI: 1.11-4.73) or fried (0R=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (0R=1.61, 95% CI: 2.00-2.59), marital separation (0R=1.94, 95% CI: 1.29-2.91), self-contained suffering {0R=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (0R=1.73, 95% CI: 1.18-2.54) were related to PCa. Conclusion Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.展开更多
Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostat...Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (〈 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results: After adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion: Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.展开更多
AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients i...AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients indicated for esophagectomy received esophageal stents.A part of patients completed 3D-CRT after stenting.Efficacy was assessed by endoscopy and computed tomographic scan before and 4 wk after completion of the treatment.The median survival,3D-CRT toxicity and complications were compared between 3D-CRT and control groups.RESULTS:From 1999 to 2008,99 consecutive patients with T3/T4 disease and unsuitable for esophagectomy were placed with esophageal stents.Sixty-seven patients received 3D-CRT,while 36 patients treated withendoscopic stents alone were recruited as controls.After 3D-CRT treatment,the median tumor volume of 3D-CRT patients were reduced significantly from 43.7 ± 10.2 cm 3 to 28.8 ± 8.5 cm 3 (P < 0.05).The complete and partial response rate was 85.1%,and no response was 14.9%.After 3D-CRT,the incidence rate of T2 and T3 disease evident on CT scan increased to 78.4% while T4 decreased from 66.7% to 21.6% (P < 0.05).3DCRT Karnofsky Performance Status improved in 3D-CRT patients compared with the control group (P=0.031).3D-CRT patients had a longer survival than the control group (251.7 d vs 91.1 d,P < 0.05).And the median half-year survival rate in 3D-CRT group (91%) was higher than in the control group (50%,P < 0.05).The most common toxicity was leukocytopenia in the 3D-CRT group (46.7% vs 18.8%,P=0.008).The control group had a higher rate of restenosis than the 3D-CRT group (81.3% vs 9.0%,P < 0.05).The rate of nephrotoxicity was increased in 3D-CRT as compared with the control group (31.3% vs 15.6%,P < 0.05).CONCLUSION:3D-CRT can improve dysphagia in patients with inoperable esophageal carcinoma.3D-CRT combined with stenting results in better survival as compared with endoscopic stents used alone.展开更多
AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected f...AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.展开更多
AIM:To assess the diagnostic value of serum interleukin-8(IL-8)in the detection of colorectal cancer(CRC).METHODS:An original study was conducted to explore the potential value of IL-8 in CRC diagnosis.Receiver operat...AIM:To assess the diagnostic value of serum interleukin-8(IL-8)in the detection of colorectal cancer(CRC).METHODS:An original study was conducted to explore the potential value of IL-8 in CRC diagnosis.Receiver operating characteristic(ROC)analysis was performed and the area under the curve(AUC)value was calculated.PUBMED and EMBASE were searched(to October,2013),supplemented with manual screening for relevant publications.Meta-analysis methods were applied to pool sensitivity,specificity,positive and negative likelihood ratios,and diagnostic odds ratios and to construct a summary receiver-operating characteristic(s ROC)curve.Heterogeneity across studies was checked by the I2 test and Deek’s funnel plot method was applied to test publication bias.RESULTS:In our original study,serum IL-8 yielded an AUC of 0.742[95%CI:0.635-0.849].The sensitivity and specificity were 85.42%and 54.05%,respectively,at a cut-off value of 5.39.In this meta-analysis,we included five studies with 668 CRC patients and 374controls and one study in our own center with 48 CRC patients and 37 controls.The pooled sensitivity and specificity of IL-8 were 0.69(95%CI:0.42-0.87)and0.85(95%CI:0.68-0.94)for CRC detection.Besides,the area under the s ROC curve was 0.86(95%CI:0.82-0.88).Subgroup analysis suggested that there was no heterogeneity in the Asian subgroup but some in the European subgroup.In addition,no publication bias was found according to the Deek’s funnel plot asymmetry test.CONCLUSION:Serum IL-8 is a promising biomarker for CRC detection and may become a clinically useful tool to identify high-risk patients.展开更多
AIM To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODS We assessed the relationship between the serum levels...AIM To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODS We assessed the relationship between the serum levels of these molecules and the risk of esophageal cancer in a prospective,nested case-control study of participants from the Japan Collaborative Cohort Study.A baseline survey was conducted from 1988 to 1990.Of the 110585 enrolled participants,35%donated blood samples.Those who had been diagnosed with esophageal cancer were considered cases for nested case-control studies.A conditional logistic model was used to estimate odds ratios for the incidence of esophageal cancer associated with serum IGF1 and IGFBP3 levels.RESULTS Thirty-one cases and 86 controls were eligible for the present assessment.The molar ratio of IGF1/IGFBP3,which represents the free and active form of IGF1,was not correlated with the risk of esophageal carcinoma.A higher molar difference between IGFBP3and IGF1,which estimates the free form of IGFBP3,was associated with a decreased risk of esophageal carcinoma(P=0.0146),and people in the highest tertile had the lowest risk(OR=0.107,95%CI:0.017-0.669).After adjustment for body mass index,tobacco use,and alcohol intake,the molar difference of IGFBP3-IGF1 was inversely correlated with the risk of esophageal carcinoma(P=0.0150).CONCLUSION The free form of IGFBP3,which is estimated by this molar difference,may be inversely associated with esophageal cancer incidence.展开更多
Background:Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case...Background:Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods:PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios (ORs) with their 95% confidence interval (CI) were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale (NOS).All data were analyzed using STATA 1 1.0 software (version 11.0;StataCorp.,College Station,TX,USA).Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results:A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis (7884 patients with cancer and 10,142 controls).Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 (95% CI =1.35-2.29) in spite of significant heterogeneity (P 〈 0.00l).In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles (NOS score of≥ 7).However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles (NOS score of〈7).No evidence of publication bias was found.Conclusions:Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.展开更多
Colorectal cancer remains the third most common cancer in both women and men worldwide.Identifying modifiable dietary factors is crucial in developing primary prevention strategies.Vitamin B6 is involved in more than ...Colorectal cancer remains the third most common cancer in both women and men worldwide.Identifying modifiable dietary factors is crucial in developing primary prevention strategies.Vitamin B6 is involved in more than 100 coenzyme reactions,and may influence colorectal cancer risk in multiple ways including through its role in one-carbon metabolism related DNA synthesis and methylation and by reducing inflammation,cell proliferation,and oxidative stress.Observational studies of dietary or dietary plus supplementary intake of vitamin B6 and colorectal cancer risk have been inconsistent with most studies reporting nonsignificant positive or inverse associations.However,published studies of plasma pyridoxal 5'-phosphate(the active form of vitamin B6) levels consistently support an approximately 30%-50% reduction in risk of colorectal cancer comparing high with low concentrations.The reasons for the discrepancy in the results between dietary-based and plasma-based studies remain unresolved.Other unresolved questions include the effects of vitamin B6 intake in early life(i.e.,childhood or adolescence) and of suboptimal vitamin B6 status on colorectal cancer risk,whether the associations with vitamin B6 differ across molecular subtypes of colorectal cancer,and whether the vitamin B6-colorectal cancer association is modified by genetic variants of one-carbon metabolism.展开更多
Gastric cancer has remained a serious burden worldwide, particularly in East Asian countries. However, nationwide prevention and screening programs for gastric cancer have not yet been established in most countries ex...Gastric cancer has remained a serious burden worldwide, particularly in East Asian countries. However, nationwide prevention and screening programs for gastric cancer have not yet been established in most countries except in South Korea and Japan. Although evidence regarding the effectiveness of endoscopic screening for gastric cancer has been increasingly accumulated, such evidence remains weak because it is based on results from studies other than randomized controlled trials. Specifically, evidence was mostly based on the results of cohort and case-control studies mainly conducted in South Korea and Japan. However, the consistent positive results from these studies suggest promising evidence of mortality reduction from gastric cancer by endoscopic screening. The major harms of endoscopic screening include infection, adverse effects, false-positive results, and overdiagnosis. Despite the possible harms of endoscopic screening, information regarding these harms remains insufficient. To provide appropriate cancer screening, a balance of benefits and harms should always be considered when cancer screening is introduced as a public policy. Quality assurance is very important for the implementation of cancer screening to provide high-quality and safe screening and minimize harms. Endoscopic screening for gastric cancer has shown promising results, and thus deserves further evaluation to reliably establish its effectiveness and optimal use.展开更多
Gastric cancer (GC) is one of the leading causes of cancer death in the world. Numerous efforts are being made to find chemoprotective agents able to reduce its risk. Amongst these, green tea has been reported to have...Gastric cancer (GC) is one of the leading causes of cancer death in the world. Numerous efforts are being made to find chemoprotective agents able to reduce its risk. Amongst these, green tea has been reported to have a protective effect against stomach cancer. This article aims to critically evaluate all epidemiological studies reporting an association between green tea consumption and GC risk. MEDLINE, EBSCOHOST and Google Scholar were used to search for clinical trials of green tea and its correlation to stomach cancer. Studies include cohort and case-control studies. Outcome of interests are inverse association, no association, and positive association. Seventeen epidemiologic studies were reviewed. Eleven studies were conducted in Japan, five in China, and one with Japanese descendent in Hawaii. Ten case-control studies and seven cohortstudies were included. The relative risks or odds ratio of GC for the highest level of green tea consumption was compared. Seven studies suggested no association, eight an inverse association, and one a positive association. One study had shown a significantly lowered GC risk when tea was served warm to cold. Another study also showed a significantly risk with lukewarm tea. All studies that analyzed men and women separately have suggested a reduced risk in women than in men, albeit no significant difference. This review demonstrates that there is insufficient information to support green tea consumption reduces the risk of GC. More studies on the subject matter are warranted.展开更多
AIM: To examine the relationships between pre-diagnostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first pri...AIM: To examine the relationships between pre-diagnostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first primary incident colorectal cancer cases diagnosed between inclusion in the SUpplémentation en VItamines et Minéraux AntioXydants cohort in 1994 and the end of follow-up in 2007. Cases (n = 50) were matched with two randomly selected controls (n = 100). Conditional logistic regression models were used to investigate the associations between pre-diagnostic levels of hs-CRP, adiponectin, leptin, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1, E-selectin, monocyte chemoattractant protein-1 and colorectal cancer risk. Area under the receiver operating curves (AUC) and relative integrated discrimination improvement (RIDI) statistics were used to assess the discriminatory potential of the models. RESULTS: Plasma adiponectin level was associated with decreased colorectal cancer risk (P for linear trend = 0.03). Quartiles of sVCAM-1 were associated with increased colorectal cancer risk (P for linear trend = 0.02). No association was observed with any of the other biomarkers. Compared to standard models with known risk factors, those including both adiponectin and sVCAM-1 had substantially improved performance for colorectal cancer risk prediction (P for AUC improvement = 0.01, RIDI = 26.5%). CONCLUSION: These results suggest that pre-diagnostic plasma adiponectin and sVCAM-1 levels are associated with decreased and increased colorectal cancer risk, respectively. These relationships must be confirmed in large validation studies.展开更多
ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 populati...ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 population controls, we examined the association of self-reported serologic blood type with endometrial cancer risk using a logistic regression model. Women with endometrial cancer were more likely to have blood type A. Compared to women with blood type O, the adjusted odds ratios for endometrial cancer were 1.00 [95% confidence interval (CI), 0.79-1.28] for type B, 1.24 (95% CI, 0.90-1.69) for type AB, and 1.50 (95% CI, 1.19-1.90) for type A. A significant dose-response relationship was observed for cancer risk and level of antigen A (P for trend = 0.0003). The positive association of blood type A with cancer risk was observed regardless of menopausal status, body mass index, oral contraceptive use, or family cancer history. Our results suggest that ABO blood type may be involved in the development of endometrial cancer.展开更多
AIM: To evaluate the association and interaction of genetic polymorphisms in methylenetetrahydrofolate reductase (MTHER) and cytochrome P4502E1 (CY-P4502E1), environment risk factors with esophageal cancer (EC) in Kaz...AIM: To evaluate the association and interaction of genetic polymorphisms in methylenetetrahydrofolate reductase (MTHER) and cytochrome P4502E1 (CY-P4502E1), environment risk factors with esophageal cancer (EC) in Kazakh, a high EC incidence area of Xinjiang Uygur Autonomous Region, China.METHODS: A 1:2 matched case-control study was conducted with 120 cases of EC and 240 population-or hospital-based controls. The controls were matched for sex, nationality, area of residence and age within a 5-year difference. MTHER and CYP4502E1 genotypes were identified by PCR-based restriction fragment length polymorphism (RFLP). A conditional logistic regression model was established to identify risk factors. The strata method was adopted in interaction analysis. RESULTS: Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water (shallow well, or river) were found to be the risk factors for EC. Individuals with the MTHFR677 (C/T + T/T) genotype had a 2.62-fold (95% CI: 1.61-4.28) risk of developing EC compared with those who carried the C/C genotype. Individuals with the CYP4502E1C1/C1 genotype had a 3.00-fold (95% CI: 1.82-4.96) risk compared with those who carried the CYP4502E1 (C1/C2 + C2/C2) genotype.Gene-environment interaction analysis showed that MTHFR677 gene polymorphism was correlated with consumption of green vegetables and fresh fruit, while CYP4502E1 C1/C1 was correlated with alcohol drink-ing and unsafe drinking water. MTHFR and CYP4502E1 analysis of gene-gene interaction showed that individu-als with the MTHFR677 (C/T + T/T) and CYP4502E1C1/C1 genotypes had a 7.41-fold (95% CI: 3.60-15.25) risk of developing EC compared with those who carried the MTHFR677C/C and CYP4502E1 RsaI C1/C2 + C2/C2 genes, and the interaction rate was higher than that of the two factors alone. CONCLUSION: Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water (shallow well, or river) and polymorphisms in MTHFR and CYP4502E1 genes are important risk factors for EC. There is a synergistic interaction among polymorphisms in MTHFR and CYP4502E1 genes and environment factors. MTHFR and CYP4502E1 genes can be used as biomarkers for prevention of EC in Kazakh, Xinjiang Uygur Autonomous Region, China.展开更多
A recent genome-wide association study identified a new susceptibility locus for breast cancer, rs2046210, which is a single nucleotide polymorphism (SNP) located upstream of the estrogen receptor α (ESR1) gene on ch...A recent genome-wide association study identified a new susceptibility locus for breast cancer, rs2046210, which is a single nucleotide polymorphism (SNP) located upstream of the estrogen receptor α (ESR1) gene on chromosome 6q25.1. Given that endometrial cancer shares many risk factors with breast cancer and both are related to estrogen exposure and that rs2046210 is in close proximity to the ESR1 gene, we evaluated the association of SNP rs2046210 with endometrial cancer risk among 953 cases and 947 controls in a population-based, case-control study conducted in Shanghai, China. Logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjusting for potential confounders. We found that the A allele of rs2046210, linked to an increased risk of breast cancer, was associated with increased but not statistically significant risk of endometrial cancer (OR = 1.16, 95% CI = 0.96-1.41 for the GA and AA genotypes compared with the GG genotype); the association was stronger among post-menopausal women (OR = 1.28, 95% CI = 1.00-1.65). The association tended to be stronger among women with higher or longer estrogen exposure than among women with relatively lower or shorter exposure to estrogen. Our study suggests that rs2046210 may play a role in the etiology of endometrial cancer. Additional studies are needed to confirm our findings.展开更多
To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer,we systematically searched the PubMed and EMBASE databases up to May 2012,with a restriction to E...To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer,we systematically searched the PubMed and EMBASE databases up to May 2012,with a restriction to English publications,and the references of the retrieved articles.We combined the studyspecific relative risks(RRs) and 95%CI,comparing the highest with the lowest categories of consumption by using a random-effects model.A total of 4 cohort studies and 23 case-control studies were included in the meta-analysis.The combined RRs(95%CI) of the cohort studies comparing the highest and lowest categories were 1.26(1.00-1.59) for red meat and 1.25(0.83-1.86) for processed meat.For the case-control studies,the combined RRs(95%CI) comparing the highest and lowest categories were 1.44(1.16-1.80)for red meat and 1.36(1.07-1.74) for processed meat.Findings from this meta-analysis suggest that a higher consumption of red meat was associated with a greater risk of esophageal cancer.展开更多
基金Supported by A grant from the National Science Council, Executive Yuan, Taiwan, No. NSC97-2314-B-037-006-MY3
文摘AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of colorectal cancer between the period 2005 and 2008. The controls were matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS: We examined 1156 colorectal cancer cases and 4624 controls. The unadjusted ORs for any statin prescription was 1.10 (95% CI = 0.94-1.30) and the adjusted OR was 1.09 (95% CI = 0.91-1.30). When statin use was categorized by cumulative dose, the adjusted ORs were 0.99 (95% CI = 0.78-1.27) for the group with cumulative statin use below 105 defined daily doses (DDDs); 1.07 (95% CI = 0.78-1.49) for the group with cumulative statin use between 106 and 298.66 DDDs; and 1.30 (95% CI = 0.96-1.75) for the group with cumulative statin use of 298.66 DDDs or more compared with nonusers. CONCLUSION: This study does not provide support for a protective effect of statins against colorectal cancer.
基金supported by grants from the National Natural Science Foundation of China(No.81072377)
文摘Objective To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population. Methods 250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk. Results Green vegetables and green tea were associated with a decreased risk of PCa (0R=0.39, 95% CI: 0.28-0.53; 0R=0.59, 95% Cl: 0.40-0.87, respectively). Family history of PCa (0R=7.16, 95% CI: 2.01-25.49), history of prostate diseases (0R=2.28, 95% Cl: 1.53-3.41), alcohol consumption (0R=1.97, 95% CI: 1.33-2.90), red meat consumption (0R=1.74, 95% CI: 1.20-2.52), barbecued (0R=2.29, 95% CI: 1.11-4.73) or fried (0R=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (0R=1.61, 95% CI: 2.00-2.59), marital separation (0R=1.94, 95% CI: 1.29-2.91), self-contained suffering {0R=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (0R=1.73, 95% CI: 1.18-2.54) were related to PCa. Conclusion Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.
基金We would appreciate the contribution of Prof. Kuwahara (Miyagi Prefecture Cancer Center, Japan) in this project. We would appreciate Mr. Robert Lister's critical reading and revision of our manuscript. This research was supported by the National Natural Science Foundation of China (Grant No. 30700827), Changchun City Science and Technology Department (Grant No. 2007125), and Northeast Normal University (Grant No. NENU-STC07005).
文摘Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (〈 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results: After adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion: Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.
文摘AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients indicated for esophagectomy received esophageal stents.A part of patients completed 3D-CRT after stenting.Efficacy was assessed by endoscopy and computed tomographic scan before and 4 wk after completion of the treatment.The median survival,3D-CRT toxicity and complications were compared between 3D-CRT and control groups.RESULTS:From 1999 to 2008,99 consecutive patients with T3/T4 disease and unsuitable for esophagectomy were placed with esophageal stents.Sixty-seven patients received 3D-CRT,while 36 patients treated withendoscopic stents alone were recruited as controls.After 3D-CRT treatment,the median tumor volume of 3D-CRT patients were reduced significantly from 43.7 ± 10.2 cm 3 to 28.8 ± 8.5 cm 3 (P < 0.05).The complete and partial response rate was 85.1%,and no response was 14.9%.After 3D-CRT,the incidence rate of T2 and T3 disease evident on CT scan increased to 78.4% while T4 decreased from 66.7% to 21.6% (P < 0.05).3DCRT Karnofsky Performance Status improved in 3D-CRT patients compared with the control group (P=0.031).3D-CRT patients had a longer survival than the control group (251.7 d vs 91.1 d,P < 0.05).And the median half-year survival rate in 3D-CRT group (91%) was higher than in the control group (50%,P < 0.05).The most common toxicity was leukocytopenia in the 3D-CRT group (46.7% vs 18.8%,P=0.008).The control group had a higher rate of restenosis than the 3D-CRT group (81.3% vs 9.0%,P < 0.05).The rate of nephrotoxicity was increased in 3D-CRT as compared with the control group (31.3% vs 15.6%,P < 0.05).CONCLUSION:3D-CRT can improve dysphagia in patients with inoperable esophageal carcinoma.3D-CRT combined with stenting results in better survival as compared with endoscopic stents used alone.
基金Supported by The National Scientific and Technological Program in the 11th "Five-Year Plan", the Grant number is 2006BAI02A08
文摘AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.
文摘AIM:To assess the diagnostic value of serum interleukin-8(IL-8)in the detection of colorectal cancer(CRC).METHODS:An original study was conducted to explore the potential value of IL-8 in CRC diagnosis.Receiver operating characteristic(ROC)analysis was performed and the area under the curve(AUC)value was calculated.PUBMED and EMBASE were searched(to October,2013),supplemented with manual screening for relevant publications.Meta-analysis methods were applied to pool sensitivity,specificity,positive and negative likelihood ratios,and diagnostic odds ratios and to construct a summary receiver-operating characteristic(s ROC)curve.Heterogeneity across studies was checked by the I2 test and Deek’s funnel plot method was applied to test publication bias.RESULTS:In our original study,serum IL-8 yielded an AUC of 0.742[95%CI:0.635-0.849].The sensitivity and specificity were 85.42%and 54.05%,respectively,at a cut-off value of 5.39.In this meta-analysis,we included five studies with 668 CRC patients and 374controls and one study in our own center with 48 CRC patients and 37 controls.The pooled sensitivity and specificity of IL-8 were 0.69(95%CI:0.42-0.87)and0.85(95%CI:0.68-0.94)for CRC detection.Besides,the area under the s ROC curve was 0.86(95%CI:0.82-0.88).Subgroup analysis suggested that there was no heterogeneity in the Asian subgroup but some in the European subgroup.In addition,no publication bias was found according to the Deek’s funnel plot asymmetry test.CONCLUSION:Serum IL-8 is a promising biomarker for CRC detection and may become a clinically useful tool to identify high-risk patients.
基金Supported by the Ministry of Education,Culture,Sports,Science,and Technology and from the Ministry of Health,Labour and Welfare,Japan
文摘AIM To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODS We assessed the relationship between the serum levels of these molecules and the risk of esophageal cancer in a prospective,nested case-control study of participants from the Japan Collaborative Cohort Study.A baseline survey was conducted from 1988 to 1990.Of the 110585 enrolled participants,35%donated blood samples.Those who had been diagnosed with esophageal cancer were considered cases for nested case-control studies.A conditional logistic model was used to estimate odds ratios for the incidence of esophageal cancer associated with serum IGF1 and IGFBP3 levels.RESULTS Thirty-one cases and 86 controls were eligible for the present assessment.The molar ratio of IGF1/IGFBP3,which represents the free and active form of IGF1,was not correlated with the risk of esophageal carcinoma.A higher molar difference between IGFBP3and IGF1,which estimates the free form of IGFBP3,was associated with a decreased risk of esophageal carcinoma(P=0.0146),and people in the highest tertile had the lowest risk(OR=0.107,95%CI:0.017-0.669).After adjustment for body mass index,tobacco use,and alcohol intake,the molar difference of IGFBP3-IGF1 was inversely correlated with the risk of esophageal carcinoma(P=0.0150).CONCLUSION The free form of IGFBP3,which is estimated by this molar difference,may be inversely associated with esophageal cancer incidence.
文摘Background:Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods:PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios (ORs) with their 95% confidence interval (CI) were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale (NOS).All data were analyzed using STATA 1 1.0 software (version 11.0;StataCorp.,College Station,TX,USA).Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results:A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis (7884 patients with cancer and 10,142 controls).Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 (95% CI =1.35-2.29) in spite of significant heterogeneity (P 〈 0.00l).In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles (NOS score of≥ 7).However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles (NOS score of〈7).No evidence of publication bias was found.Conclusions:Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.
文摘Colorectal cancer remains the third most common cancer in both women and men worldwide.Identifying modifiable dietary factors is crucial in developing primary prevention strategies.Vitamin B6 is involved in more than 100 coenzyme reactions,and may influence colorectal cancer risk in multiple ways including through its role in one-carbon metabolism related DNA synthesis and methylation and by reducing inflammation,cell proliferation,and oxidative stress.Observational studies of dietary or dietary plus supplementary intake of vitamin B6 and colorectal cancer risk have been inconsistent with most studies reporting nonsignificant positive or inverse associations.However,published studies of plasma pyridoxal 5'-phosphate(the active form of vitamin B6) levels consistently support an approximately 30%-50% reduction in risk of colorectal cancer comparing high with low concentrations.The reasons for the discrepancy in the results between dietary-based and plasma-based studies remain unresolved.Other unresolved questions include the effects of vitamin B6 intake in early life(i.e.,childhood or adolescence) and of suboptimal vitamin B6 status on colorectal cancer risk,whether the associations with vitamin B6 differ across molecular subtypes of colorectal cancer,and whether the vitamin B6-colorectal cancer association is modified by genetic variants of one-carbon metabolism.
基金Supported by the National Cancer Center,Tokyo,Japan,No.26-A-30
文摘Gastric cancer has remained a serious burden worldwide, particularly in East Asian countries. However, nationwide prevention and screening programs for gastric cancer have not yet been established in most countries except in South Korea and Japan. Although evidence regarding the effectiveness of endoscopic screening for gastric cancer has been increasingly accumulated, such evidence remains weak because it is based on results from studies other than randomized controlled trials. Specifically, evidence was mostly based on the results of cohort and case-control studies mainly conducted in South Korea and Japan. However, the consistent positive results from these studies suggest promising evidence of mortality reduction from gastric cancer by endoscopic screening. The major harms of endoscopic screening include infection, adverse effects, false-positive results, and overdiagnosis. Despite the possible harms of endoscopic screening, information regarding these harms remains insufficient. To provide appropriate cancer screening, a balance of benefits and harms should always be considered when cancer screening is introduced as a public policy. Quality assurance is very important for the implementation of cancer screening to provide high-quality and safe screening and minimize harms. Endoscopic screening for gastric cancer has shown promising results, and thus deserves further evaluation to reliably establish its effectiveness and optimal use.
文摘Gastric cancer (GC) is one of the leading causes of cancer death in the world. Numerous efforts are being made to find chemoprotective agents able to reduce its risk. Amongst these, green tea has been reported to have a protective effect against stomach cancer. This article aims to critically evaluate all epidemiological studies reporting an association between green tea consumption and GC risk. MEDLINE, EBSCOHOST and Google Scholar were used to search for clinical trials of green tea and its correlation to stomach cancer. Studies include cohort and case-control studies. Outcome of interests are inverse association, no association, and positive association. Seventeen epidemiologic studies were reviewed. Eleven studies were conducted in Japan, five in China, and one with Japanese descendent in Hawaii. Ten case-control studies and seven cohortstudies were included. The relative risks or odds ratio of GC for the highest level of green tea consumption was compared. Seven studies suggested no association, eight an inverse association, and one a positive association. One study had shown a significantly lowered GC risk when tea was served warm to cold. Another study also showed a significantly risk with lukewarm tea. All studies that analyzed men and women separately have suggested a reduced risk in women than in men, albeit no significant difference. This review demonstrates that there is insufficient information to support green tea consumption reduces the risk of GC. More studies on the subject matter are warranted.
基金Supported by A grant from the French National Cancer Institute (Institut National du Cancer), No. INCa 2007-1-SPC-3
文摘AIM: To examine the relationships between pre-diagnostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first primary incident colorectal cancer cases diagnosed between inclusion in the SUpplémentation en VItamines et Minéraux AntioXydants cohort in 1994 and the end of follow-up in 2007. Cases (n = 50) were matched with two randomly selected controls (n = 100). Conditional logistic regression models were used to investigate the associations between pre-diagnostic levels of hs-CRP, adiponectin, leptin, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1, E-selectin, monocyte chemoattractant protein-1 and colorectal cancer risk. Area under the receiver operating curves (AUC) and relative integrated discrimination improvement (RIDI) statistics were used to assess the discriminatory potential of the models. RESULTS: Plasma adiponectin level was associated with decreased colorectal cancer risk (P for linear trend = 0.03). Quartiles of sVCAM-1 were associated with increased colorectal cancer risk (P for linear trend = 0.02). No association was observed with any of the other biomarkers. Compared to standard models with known risk factors, those including both adiponectin and sVCAM-1 had substantially improved performance for colorectal cancer risk prediction (P for AUC improvement = 0.01, RIDI = 26.5%). CONCLUSION: These results suggest that pre-diagnostic plasma adiponectin and sVCAM-1 levels are associated with decreased and increased colorectal cancer risk, respectively. These relationships must be confirmed in large validation studies.
基金supported by United States Public Health Service (USPHS) grant R01CA92585 from the National Cancer Institute
文摘ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 population controls, we examined the association of self-reported serologic blood type with endometrial cancer risk using a logistic regression model. Women with endometrial cancer were more likely to have blood type A. Compared to women with blood type O, the adjusted odds ratios for endometrial cancer were 1.00 [95% confidence interval (CI), 0.79-1.28] for type B, 1.24 (95% CI, 0.90-1.69) for type AB, and 1.50 (95% CI, 1.19-1.90) for type A. A significant dose-response relationship was observed for cancer risk and level of antigen A (P for trend = 0.0003). The positive association of blood type A with cancer risk was observed regardless of menopausal status, body mass index, oral contraceptive use, or family cancer history. Our results suggest that ABO blood type may be involved in the development of endometrial cancer.
基金Supported by The National Natural Science Foundation of China, No. 30660161Prophase Basic Research Project of Ministry of Science and Technology of China, No. 2005CCA03700, No. 2007CB516804+1 种基金Science and Technology Research Project of Ministry of Education of China, No. 206167Laboratory of Endemic and Ethnic Diseases Program of Xinjiang, No. 200416
文摘AIM: To evaluate the association and interaction of genetic polymorphisms in methylenetetrahydrofolate reductase (MTHER) and cytochrome P4502E1 (CY-P4502E1), environment risk factors with esophageal cancer (EC) in Kazakh, a high EC incidence area of Xinjiang Uygur Autonomous Region, China.METHODS: A 1:2 matched case-control study was conducted with 120 cases of EC and 240 population-or hospital-based controls. The controls were matched for sex, nationality, area of residence and age within a 5-year difference. MTHER and CYP4502E1 genotypes were identified by PCR-based restriction fragment length polymorphism (RFLP). A conditional logistic regression model was established to identify risk factors. The strata method was adopted in interaction analysis. RESULTS: Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water (shallow well, or river) were found to be the risk factors for EC. Individuals with the MTHFR677 (C/T + T/T) genotype had a 2.62-fold (95% CI: 1.61-4.28) risk of developing EC compared with those who carried the C/C genotype. Individuals with the CYP4502E1C1/C1 genotype had a 3.00-fold (95% CI: 1.82-4.96) risk compared with those who carried the CYP4502E1 (C1/C2 + C2/C2) genotype.Gene-environment interaction analysis showed that MTHFR677 gene polymorphism was correlated with consumption of green vegetables and fresh fruit, while CYP4502E1 C1/C1 was correlated with alcohol drink-ing and unsafe drinking water. MTHFR and CYP4502E1 analysis of gene-gene interaction showed that individu-als with the MTHFR677 (C/T + T/T) and CYP4502E1C1/C1 genotypes had a 7.41-fold (95% CI: 3.60-15.25) risk of developing EC compared with those who carried the MTHFR677C/C and CYP4502E1 RsaI C1/C2 + C2/C2 genes, and the interaction rate was higher than that of the two factors alone. CONCLUSION: Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water (shallow well, or river) and polymorphisms in MTHFR and CYP4502E1 genes are important risk factors for EC. There is a synergistic interaction among polymorphisms in MTHFR and CYP4502E1 genes and environment factors. MTHFR and CYP4502E1 genes can be used as biomarkers for prevention of EC in Kazakh, Xinjiang Uygur Autonomous Region, China.
基金supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485)supported by a National Cancer Institute grant (R01 CA92585, PI: Xiao-Ou Shu)
文摘A recent genome-wide association study identified a new susceptibility locus for breast cancer, rs2046210, which is a single nucleotide polymorphism (SNP) located upstream of the estrogen receptor α (ESR1) gene on chromosome 6q25.1. Given that endometrial cancer shares many risk factors with breast cancer and both are related to estrogen exposure and that rs2046210 is in close proximity to the ESR1 gene, we evaluated the association of SNP rs2046210 with endometrial cancer risk among 953 cases and 947 controls in a population-based, case-control study conducted in Shanghai, China. Logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjusting for potential confounders. We found that the A allele of rs2046210, linked to an increased risk of breast cancer, was associated with increased but not statistically significant risk of endometrial cancer (OR = 1.16, 95% CI = 0.96-1.41 for the GA and AA genotypes compared with the GG genotype); the association was stronger among post-menopausal women (OR = 1.28, 95% CI = 1.00-1.65). The association tended to be stronger among women with higher or longer estrogen exposure than among women with relatively lower or shorter exposure to estrogen. Our study suggests that rs2046210 may play a role in the etiology of endometrial cancer. Additional studies are needed to confirm our findings.
文摘To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer,we systematically searched the PubMed and EMBASE databases up to May 2012,with a restriction to English publications,and the references of the retrieved articles.We combined the studyspecific relative risks(RRs) and 95%CI,comparing the highest with the lowest categories of consumption by using a random-effects model.A total of 4 cohort studies and 23 case-control studies were included in the meta-analysis.The combined RRs(95%CI) of the cohort studies comparing the highest and lowest categories were 1.26(1.00-1.59) for red meat and 1.25(0.83-1.86) for processed meat.For the case-control studies,the combined RRs(95%CI) comparing the highest and lowest categories were 1.44(1.16-1.80)for red meat and 1.36(1.07-1.74) for processed meat.Findings from this meta-analysis suggest that a higher consumption of red meat was associated with a greater risk of esophageal cancer.