Hereditary, environmental, and dietary risk factors of colorectal cancer: a case-control study in the Algerian East

Abstract

Colorectal carcinoma (CRC) is the second most common cancer diagnosed in Algeria. The incidence and the mortality rate of CRC have increased so that the nation now ranks third in Africa in both these variables. Many environmental and genetic factors are suspected to play an important role in the development of the disease. This study aimed to identify the risk factors for CRC in Algeria. We performed a case-control study in five Medical Oncology Services in this region: Tebessa, Batna, Annaba, Setif, and Constantine, from 2016 to 2019. Altogether, 200 patients diagnosed with CRC and 200 age-matched controls without any diagnosis of cancer were included. Study participants were interviewed about environmental, dietary, and hereditary risk factors, i.e., family history of cancer, using a questionnaire. Results showed a significant association between high educational level and a decreased risk of CRC. Diagnoses of any cancer or of CRC in first-degree or in second- or third-degree relatives also were significantly associated with CRC risk. Occupational exposures showed a significant link with an increased risk of CRC, as did obesity, alcohol consumption, and passive smoking. Yogurt, cereals, sugar, butter, and margarine consumption were significant protective factors, while cheese, dried fruits, red meat, juice, and fizzy drink consumption was associated with increased risk. Our findings suggest a benefit of public health campaigns to enhance awareness about CRC and to encourage healthy dietary choices and avoidance of non-dietary risk factors.

This is a preview of subscription content, access via your institution.

References

  1. Aithal RR, Shetty RS, Binu V, Sneha Mallya D, Shenoy R, Nair S (2017) Colorectal cancer and its risk factors among patients attending a tertiary care hospital in southern Karnataka, India. Asian J Pharm Clin Res 10(4):109–112

    Google Scholar 

  2. Alsheridah N, Akhtar S (2018) Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study. BMC Cancer 18:1227

    CAS  Google Scholar 

  3. Aune D, Lau R, Chan DSM, Vieira R, Greenwood DC, Kampman E, Norat T (2012) Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Ann Oncol 23(1):37–45

    CAS  Google Scholar 

  4. Bardou M, Barkun AN, Martel M (2013) Obesity and colorectal cancer. Gut 62(6):933–947

    CAS  Google Scholar 

  5. Beebe-Dimmer JL, Yee C, Paskett E, Schwartz AG, Lane D, Palmer NRA, Bock CH, Nassir R, Simon MS (2017) Family history of prostate and colorectal cancer and risk of colorectal cancer in the Women’s health initiative. BMC Cancer 17:848

    Google Scholar 

  6. Ben Othman R, Ksira I, Smida A, Berriche O, Mahjoub F, Mansour S, Belghith J, Jamoussi H (2018) Malnutrition and risk factors in tunisian patients with colorectal cancer. Ibnosina J Med Biomed Sci 10(3):88–93

    Google Scholar 

  7. Bener A, Moore MA, Ali A, El Ayoubi HR (2010) Impacts of family history and lifestyle habits on colorectal cancer risk: a case-control study in Qatar. Asian Pac J Cancer Prev 11(4):963–968

    Google Scholar 

  8. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, Guha N, Mattock H, Straif K, International Agency for Research on Cancer Monograph Working Group (2015) Carcinogenicity of consumption of red and processed meat: international agency for research on cancer monograph working group. Lancet Oncol 16:1599–1600

    Google Scholar 

  9. Chazelas E, Bernard Srour B, Desmetz E, Kesse-Guyot E, Julia C, Deschamps V, Druesne-Pecollo N, Galan P, Hercberg S, Latino-Martel P, Deschasaux M, Touvier M (2019) Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ 366:l2408

    Google Scholar 

  10. Choi SW, Stickel F, Baik HW, Kim YI, Seitz HK, Mason JB (1999) Chronic alcohol consumption induces genomic but not p53-specific DNA hypomethylation in rat colon. J Nutr 129:1945–1950

    CAS  Google Scholar 

  11. Choudhary L, Ahmad A (2017) A study of psychological well-being among housewives and working women of mithila region, North Bihar, India. Int J Hum Resour Ind Res 4(2):8–15

    Google Scholar 

  12. Cooper C, Block M (2016) General practice cases at a glance. John Wiley & Sons

  13. Coughlin SS, Thompson TD (2004) Colorectal cancer screening practices among men and women in rural and nonrural areas of the United States, 1999. J Rural Health 20(2):118–124

    Google Scholar 

  14. Coughlin SS, Richards TB, Thompson T, Miller BA, VanEenwyk J, Goodman MT, Sherman RL (2006) Rural/nonrural differences in colorectal cancer incidence in the United States, 1998-2001. Cancer 107(5 Suppl):1181–1188

    Google Scholar 

  15. El-taher SM, Alenezy A, Basem MM, Salama BMM, Hassan TMM (2016) Risk factors of colorectal cancer; a case-control study. Egypt J Commun Med 34(1):1–15

    Google Scholar 

  16. Enayatrad M, Yavari P, Etemad K, Khodakarim S, Mahdavi S (2018) Association of urbanization levels and colorectal cancer incidence in Iran. Int J Cancer Manag 11(8):e68476

    Google Scholar 

  17. Ewing I, Hurley JJ, Josephides E, Millar A (2014) The molecular genetics of colorectal cancer. Frontline Gastroenterol 5:26–30

    CAS  Google Scholar 

  18. Ferlay J, Colombet M, Soerjomataram I et al (2018) Global and regional estimates of the incidence and mortality for 38 cancers: GLOBOCAN 2018. International Agency for Research on Cancer/World Health Organization, Lyon https://gco.iarc.fr/today/online-analysis-table. Accessed 06 April 2019

    Google Scholar 

  19. Ferrera LA (2005) Body mass index. Nova Publishers, pp7

  20. Fleisch MA, Illescas AH, Hohl BC, Llanos AA (2017) Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults. PLoS One 12(3):e0173370

    Google Scholar 

  21. Guesmi F, Zoghlami A, Sghaiier D, Nouira R, Dziri C (2010) Les facteurs alimentaires prédisposant au risque de cancers colorectaux : Etude épidémiologique prospective. La Tunisie Med 88(03):184–189

    Google Scholar 

  22. Hamdi Cherif M, Bidoli E, Birri S, Mahnane A, Zaidi Z, Boukharouba H, Moussaoui H, Kara L, Ayat A, Makhloufi K, Bouchaibi I, Atoui VS, Serraino D (2015) Cancer estimation of incidence and survival in Algeria 2014. J Cancer Res Ther 3(9):100–104

    Google Scholar 

  23. Hamoya T, Fujii G, Miyamoto S (2016) Effects of NSAIDs on the risk factors of colorectal cancer: a mini review. Genes Environ 38:6. https://doi.org/10.1186/s41021-016-0033-0

    CAS  Article  Google Scholar 

  24. Hang J, Cai B, Xue P, Wang L, Hu H, Zhou Y, Ren S, Wu J, Zhu M, Chen D, Yang H, Wang L (2015) The joint effects of lifestyle factors and comorbidities on the risk of colorectal cancer: a large Chinese retrospective case-control study. PLoS One 10(12):e0143696

    Google Scholar 

  25. Imad FE, Drissi H, Bendahhou K, Tawfiq N, Tahiri Jouti N, Benider A, Radallah D (2018) Sociodemographic, anthropometric and medical risk factors for colorectal cancer in a Moroccan population case–control study. Int J Recent Sci Res 9(2B):23815–23821

    Google Scholar 

  26. Imad FE, Drissi H, Tawfiq N, Bendahhou K, Tahiri Jouti N, Benider A, Radallah D (2019) Aspects épidémiologiques, nutritionnels et anatomopathologiques des cancers colorectaux dans la région du grand Casablanca. Pan Afr Med J 32:56

    Google Scholar 

  27. International Agency for Research on Cancer IARC (2019) Cancer today. https://gco.iarc.fr/today/. Accessed 17 January 2020

  28. Jansson-Knodell CL, Foster NR, Sargent DJ, Limburg PJ, Thibodeau SN, Smyrk TC, Sinicrope FA, Jahagirdar B, Goldberg RM, Alberts SR (2017) Family history of colorectal cancer and its impact on survival in patients with resected stage III colon cancer: results from NCCTG trial N0147 (Alliance). J Gastrointest Oncol 8(1):1–11

    Google Scholar 

  29. Jeyaraman MM, Abou-Setta AM, Grant L, Farshidfar F, Copstein L, Lys J, Gottschalk T, Desautels D, Czaykowski P, Pitz M, Zarychanski R (2019) Dairy product consumption and development of cancer: an overview of reviews. BMJ Open 9(1):e023625

  30. Katsidzira L, Gangaidzo IT, Makunike-Mutasa R, Manyanga T, Matsena-Zingoni Z, Thomson S, Matenga JA, Rusakaniko S, Ramesar R (2019) A case-control study of risk factors for colorectal cancer in an African population. Eur J Cancer Prev 28(3):145–150

    Google Scholar 

  31. Kispert S, McHowat J (2017) Recent insights into cigarette smoking as a lifestyle risk factor for breast cancer. Breast Cancer (Dove Med Press) 9:127–132

    CAS  Google Scholar 

  32. Kune GA, Vitetta L (1992) Alcohol consumption and the etiology of colorectal cancer: a review of the scientific evidence from 1957 to 1991. Nutr Cancer 18:97–111

    CAS  Google Scholar 

  33. Kunzmann AT, Coleman HG, Huang WY, Kitahara CM, Cantwell MM, Berndt SI (2015) Dietary fiber intake and risk of colorectal cancer and incident and recurrent adenoma in the prostate, lung, colorectal, and ovarian cancer screening trial. Am J Clin Nutr 102(4):881–890

    CAS  Google Scholar 

  34. Lagerlund M, Hvidberg L, Hajdarevic S, Fischer Pedersen A, Runesdotter S, Vedsted P, Tishelman C (2015) Awareness of risk factors for cancer: a comparative study of Sweden and Denmark. BMC Public Health 15:1156

    Google Scholar 

  35. Lee WJ, Sandler DP, Blair A, Samanic C, Cross AJ, Alavanja MCR (2007) Pesticide use and colorectal cancer risk in the agricultural health study. Int J Cancer 121(2):339–346

    CAS  Google Scholar 

  36. Lee J, Shin A, Oh JH, Kim J (2018) The relationship between nut intake and risk of colorectal cancer: a case control study. Nutr J 17:37

    Google Scholar 

  37. LeMasters GK, Genaidy AM, Succop P et al (2006) Cancer risk among firefighters: a review and meta-analysis of 32 studies. J Occup Environ Med 48:1189–1202

    Google Scholar 

  38. Liu PH, Wu K, Ng K, Zauber AG, Nguyen LH, Song M, He X, Fuchs CS, Ogino S, Willett WC, Chan AT, Giovannucci EL, Cao Y (2019) Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncol 5(1):37–44

    Google Scholar 

  39. Lohsoonthorn P, Danvivat D (1995) Colorectal cancer risk factors: a case-control study in Bangkok. Asia Pac J Public Health 8(2):118–122

    CAS  Google Scholar 

  40. Ma J, Giovannucci E, Pollak M, Chan JM, Gaziano JM, Willett W, Stampfer MJ (2001) Milk intake, circulating levels of insulin-like growth factor-I, and risk of colorectal cancer in men. J Natl Cancer Inst 93(17):1330–1336

    CAS  Google Scholar 

  41. Maekawa SJ, Aoyama N, Shirasaka D, Kuroda K, Tamura T, Kuroda Y, Kasuga M (2004) Excessive alcohol intake enhances the development of synchronous cancerous lesion in colorectal cancer patients. Int J Color Dis 19(2):171–175

    Google Scholar 

  42. Miles A, Proescholdbell RJ, Puffer E (2011) Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina. Qual Life Res 20(6):807–815

    Google Scholar 

  43. Nashar RM, Almurshed KS (2008) Colorectal cancer: a case control study of dietary factors, king Faisal specialist hospital and researh center, Riyadh, Saudi Arabia. J Fam Community Med 15(2):57–64

    Google Scholar 

  44. Nathawat SS, Mathur A (1993) Marital adjustment and subjective well-being in Indian educated housewives and working women. J Psychol 127:353–358

    CAS  Google Scholar 

  45. Oddone E, Modonesi C, Gatta G (2014) Occupational exposures and colorectal cancers: a quantitative overview of epidemiological evidence. World J Gastroenterol 21(20(35)):12431–12444

    Google Scholar 

  46. Office National des Statistiques ONS (2018) DEMOGRAPHIE ALGERIENNE N° 853. http://www.ons.dz/IMG/pdf/Demographie2018.pdf. Accessed 08 February 2020

  47. Pacheco LS, Anderson CAM, Lacey JV, Giovannucci EL, Lemus H, Araneta MRG, Sears DD, Talavera GA, Martinez ME (2019) Sugar-sweetened beverages and colorectal cancer risk in the California teachers study. PLoS One 14(10):e0223638

    CAS  Google Scholar 

  48. Pou SA, Díaz Md P, Osella AR (2012) Applying multilevel model to the relationship of dietary patterns and colorectal cancer: an ongoing case-control study in Córdoba, Argentina. Eur J Nutr 51:755–764

    CAS  Google Scholar 

  49. Quang LN, Hien NQ, Quang NT, Chung NT (2019) Active lifestyle patterns reduce the risk of colorectal cancer in the north of Vietnam: a hospital-based case–control study. Cancer Control 26(1):1073274819864666

    Google Scholar 

  50. Rothwell PM, Wilson M, Elwin CE, Norrving B, Algra A, Warlow CP, Meade TW (2010) Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 376(9754):1741–1750

    CAS  Google Scholar 

  51. Ruseva A, Tochev D, Boneva Z, Assyov Y, Georgieva L, Nikolovska D (2019) Marital status and education as risk factors for colorectal cancer. Trakia J Sci 3:224–228

    Google Scholar 

  52. Sidi Deoula M, Huybrechts I, Elkinany K et al (2019) Behavioural, nutritional and genetic risk factors of colorectal cancers in Morocco: protocol for a multi-centre case-control study. J Global Oncol. https://doi.org/10.2196/preprints.13998

  53. Song Y, Liu M, Yang FG, Cui LH, Lu XY, Chen C (2015) Dietary fibre and the risk of colorectal cancer: a case- control study. Asian Pac J Cancer Prev 16(9):3747–3752

    CAS  Google Scholar 

  54. Steinbrecher A, Fish K, Clarke CA, West DW, Gomez SL, Cheng I (2012) Examining the association between socioeconomic status and invasive colorectal cancer incidence and mortality in California. Cancer Epidemiol Biomark Prev 21(10):1814–1822

    Google Scholar 

  55. Talibov M, Sormunen J, Weiderpass E, Kjaerheim K, Martinsen JI, Sparen P, Tryggvadottir L, Hansen J, Pukkala E (2019) Workplace diesel exhausts and gasoline exposure and risk of colorectal cancer in four Nordic countries. Saf Health Work 10(2):141–150

    Google Scholar 

  56. Thanikachalam K, Khan G (2019) Colorectal Cancer Nutr Nutr 11(1):164

    CAS  Google Scholar 

  57. Tollosa DN, Van Camp J, Huybrechts I, Huybregts L, Van Loco J, De Smet S, Sterck E, Rabâi C, Van Hecke T, Vanhaecke L, Vossen E, Peeters M, Lachat C (2017) Validity and reproducibility of a food frequency questionnaire for dietary factors related to colorectal cancer. Nutrients 9(11):1257

    Google Scholar 

  58. Touyar A (2011) facteurs de risque nutritionnels des cancers colorectaux dans la région de Fès : Etude cas-témoins. Dissertation, University of Sidi Mohammed Ben Abdellah

  59. Tsai MH, Xirasagar S, Li YJ, de Groen PC (2015) Colonoscopy screening among US adults aged 40 or older with a family history of colorectal cancer. Prev Chronic Dis 12. https://doi.org/10.5888/pcd12.140533

  60. Vogtmann E, Xiang YB, Li HL et al (2013) Fruit and vegetable intake and the risk of colorectal cancer: results from the Shanghai Men's health study. Cancer Causes Control 24(11):193545

    Google Scholar 

  61. Wada K, Oba S, Tsuji M, Tamura T, Konishi K, Goto Y, Mizuta F, Koda S, Hori A, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C (2017) Meat consumption and colorectal cancer risk in Japan: the Takayama study. Cancer Sci 108(5):1065–1070

    CAS  Google Scholar 

  62. Wanga L, Wilson S, Stewart D, Hollenbeak C (2011) Marital status and colon cancer outcomes in US surveillance, epidemiology and end results registries: does marriage affect cancer survival by gender and stage? Cancer Epidemiol 35:417–422

    Google Scholar 

  63. Wong MCS, Hanyue Ding H, Jingxuan Wang J, Chan PSF, Huang J (2019) Prevalence and risk factors of colorectal cancer in Asia. Intest Res 17(3):317–329

    Google Scholar 

  64. World Cancer Research Fund/American Institute for Cancer Research WCRF/AICR (2017) Continuous update project report: diet, nutrition, physical activity, and colorectal cancer. https://www.wcrf.org/sites/default/files/Colorectal-Cancer-2017-Report.pdf. Accessed 26 February 2020

  65. Zahnd WE, James AS, Jenkins WD, Izadi SR, Fogleman AJ, Steward DE, Colditz GA, Brard L (2018) Rural-urban differences in cancer incidence and trends in the United States. Cancer Epidemiol Biomark Prev 27(11):1265–1274

    Google Scholar 

Download references

Acknowledgments

We would like to thank all the doctors of the oncology departments, patients with colorectal cancer, and controls involved in the study for their cooperation. We would like to thank the anonymous reviewers for their insightful suggestions. Robert J. Marlowe edited the revised version of this manuscript; we would like to thank him for his very helpful work, comments, and suggestions.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Samira Negrichi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Responsible Editor: Lotfi Aleya

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Negrichi, S., Taleb, S. Hereditary, environmental, and dietary risk factors of colorectal cancer: a case-control study in the Algerian East. Environ Sci Pollut Res 28, 12372–12381 (2021). https://doi.org/10.1007/s11356-020-10378-y

Download citation

Keywords

  • Colorectal cancer
  • Risk factors
  • Hereditary
  • Environment
  • Occupational
  • Diet
  • Algerian East