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dc.contributor.authorMurphy, Neil
dc.contributor.authorWard, Heather A.
dc.contributor.authorJenab, Mazda
dc.contributor.authorRothwell, Joseph A.
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorCarbonnel, Franck
dc.contributor.authorKvaskoff, Marina
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKühn, Tilman
dc.contributor.authorBoeing, Heiner
dc.contributor.authorAleksandrova, Krasimira
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorSkeie, Guri
dc.contributor.authorBorch, Kristin Benjaminsen
dc.contributor.authorTjønneland, Anne
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorOvervad, Kim
dc.contributor.authorDahm, Christina C.
dc.contributor.authorJakszyn, Paula
dc.contributor.authorSánchez, María-José
dc.contributor.authorGil, Leire
dc.contributor.authorHuerta, José María
dc.contributor.authorBarricarte, Aurelio
dc.contributor.authorQuirós, José Ramón
dc.contributor.authorKhaw, Kay-Tee
dc.contributor.authorWareham, Nick
dc.contributor.authorBradbury, Kathryn E.
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorLa Vecchia, Carlo
dc.contributor.authorKarakatsani, Anna
dc.contributor.authorPalli, Domenico
dc.contributor.authorGrioni, Sara
dc.contributor.authorTumino, Rosario
dc.contributor.authorFasanelli, Francesca
dc.contributor.authorPanico, Salvatore
dc.contributor.authorBueno-de-Mesquita, Hendrik Bastiaan
dc.contributor.authorPeeters, Petra H.M.
dc.contributor.authorGylling, Björn
dc.contributor.authorMyte, Robin
dc.contributor.authorJirström, Karin
dc.contributor.authorBerntsson, Jonna
dc.contributor.authorXue, Xiaonan
dc.contributor.authorRiboli, Elio
dc.contributor.authorCross, Amanda J.
dc.contributor.authorGunter, Mark J.
dc.date.accessioned2020-03-16T09:49:57Z
dc.date.available2020-03-16T09:49:57Z
dc.date.issued2018-07-26
dc.description.abstract<i>Background & Aims</i> - Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision.<p><p> <i>Methods</i> - In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests.<p><p> <i>Results</i> - After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (<i>P</i> heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (<i>P</i> heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (<i>P</i> heterogeneity = .008) and waist circumference (<i>P</i> heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (<i>P</i> heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors.<p><p> <i>Conclusions</i> - The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.en_US
dc.identifier.citationMurphy N, Ward HA, Jenab M, Rothwell JA, Boutron-Ruault M, Carbonnel F, Kvaskoff M, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Weiderpass E, Skeie G, Borch KB, Tjønneland A, Kyrø C, Overvad K, Dahm CC, Jakszyn P, Sánchez M, Gil L, Huerta JM, Barricarte A, Quirós JR, Khaw K, Wareham N, Bradbury KE, Trichopoulou A, La Vecchia C, Karakatsani A, Palli D, Grioni S, Tumino R, Fasanelli F, Panico S, Bueno-de-Mesquita HB, Peeters PH, Gylling B, Myte R, Jirström K, Berntsson, Xue, Riboli E, Cross AJ, Gunter MJ. Heterogeneity of colorectal cancer risk factors by anatomical subsite in 10 European countries: A multinational cohort study. Clinical Gastroenterology and Hepatology. 2019;17(7):1323-1331.e6en_US
dc.identifier.cristinIDFRIDAID 1712566
dc.identifier.doi10.1016/j.cgh.2018.07.030
dc.identifier.issn1542-3565
dc.identifier.issn1542-7714
dc.identifier.urihttps://hdl.handle.net/10037/17744
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalClinical Gastroenterology and Hepatology
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/DG-SANCO/?/EU/?/?/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2019 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleHeterogeneity of colorectal cancer risk factors by anatomical subsite in 10 European countries: A multinational cohort studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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