PD-018 - Modifiable risk factors for colorectal cancer: A multinational case-control study

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Aetiology, epidemiology, screening and prevention
Colon and Rectal Cancer
Basic Scientific Principles
Presenter B. Hrinczenko
Citation Annals of Oncology (2015) 26 (suppl_4): 101-107. 10.1093/annonc/mdv234
Authors B. Hrinczenko, T. Lehman, R. Modali, M. Shaik
  • Michigan State University, East Lansing/US



Colorectal cancer (CRC) is the third most common cancer in the world, with nearly 1.4 million new cases diagnosed in 2012. The incidence is highest in the western world and lowest in Africa and south-central Asia. This geographic difference is attributed to differences in dietary and environmental exposures in addition to genetically determined susceptibility. Diet and physical activity are important factors that have impact on the incidence of CRC in the western world. The effect of these factors on the incidence of CRC on other parts of world is unknown. The aim of this multinational case-control study is to evaluate the effect of modifiable risk factors on the incidence of CRC.


Data were obtained from the Global Epidemiological Study, a multinational database to assess disease risk factors. A total of 3488 subjects (CRC: 1744, controls: 1744) matched for age and sex, were recruited from Poland, Vietnam, Western Europe and the USA. After informed consent, information of different risk factors including food intake in number of servings (serv), regular exercise, tobacco use were obtained from all participants. Chi-square and t-test were used for categorical and continuous variables. Adjusted multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI) as estimates of the relative risk of CRC.


Median age of subjects was 65 yrs and median BMI for cases and controls was 25.3 and 25.9, respectively, with 53% males and 47% females. In the multivariate analysis, CRC risk was significantly increased with consumption of red meat (>3 serv/wk), OR = 0.82; 95%CI (0.71–0.95) and smoking (>40 pack yrs), OR = 0.54; 95%CI (0.45–0.74). Whole grains (>6 serv/day), fish (any serv/wk) consumption and exercise (>120 min/wk) had a protective effect with OR = 18.7; 95%CI (10.5–33), OR = 1.63; 95%CI (1.3–1.9) and OR = 1.85; 95%CI (1.5–2.15), respectively. There was no association with BMI, fruits, vegetables, dairy, and alcohol consumption on CRC.


Consumption of fish and whole grains >6 serv/day and regular exercise >120 min/wk was associated with a decreased risk of CRC. Smoking >40 PPY and consumption of red meat >3 serv/week was associated with an increased risk of CRC. Our results are similar to prior studies done in the western world. However, our study is geographically broader since it includes non-western countries, showing similar results. These modifiable risk factors may be important globally. Further prospective studies are needed to validate our findings.

Table: PD-018