Skip to main content

Risk Factors and Screening for Colorectal Cancer

  • Chapter
  • First Online:
Colorectal Cancer Screening

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Screening for colorectal cancer (CRC) involves consideration of only a patient’s age and their family history of CRC [1, 2], but there are other risk factors which can potentially affect screening. This section will examine known risk factors and how some of these can affect one’s risk and subsequent screening for CRC. Other factors such as personal and family history of colorectal neoplasia as well as aspirin and other chemo-preventative agents will be discussed elsewhere. This section will serve as an overview of the various factors and the respective studies that examine their association with CRC as well as advanced adenomas. Age has been shown to be one of the strongest predictors of CRC [3] and will not be discussed as there is little debate as to the importance of this factor. In addition, this chapter will examine the modifiable risk factors since this is where clinicians can help patients to reduce their risk of CRC. A study by Platz et al. demonstrated that over two thirds of CRC may be preventable in men [4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–95.

    Article  PubMed  CAS  Google Scholar 

  2. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739–50.

    Article  PubMed  Google Scholar 

  3. Wei EK, Giovannucci E, Wu K, Rosner B, Fuchs CS, Willett WC, et al. Comparison of risk factors for colon and rectal cancer. Int J Cancer. 2004;108:433–42.

    Article  PubMed  CAS  Google Scholar 

  4. Platz EA, Willett WC, Colditz GA, Rimm EB, Spiegelman D, Giovannucci E. Proportion of colon cancer risk that might be preventable in a cohort of middle-aged US men. Cancer Causes Control. 2000;11:579–88.

    Article  PubMed  CAS  Google Scholar 

  5. http://www.cancer.org/Research/ResearchProgramsFunding/cancer-prevention-study-overviews, 2010.

  6. http://epic.iarc.fr/about.php.

  7. http://www.hsph.harvard.edu/hpfs/hpfs_about.htm.

  8. http://www.channing.harvard.edu/nhs/index.php/history/.

  9. Norat T, Bingham S, Ferrari P, Slimani N, Jenab M, Mazuir M, et al. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition. J Natl Cancer Inst. 2005;97:906–16.

    Article  PubMed  Google Scholar 

  10. Chao A, Thun MJ, Connell CJ, McCullough ML, Jacobs EJ, Flanders WD, et al. Meat consumption and risk of colorectal cancer. JAMA. 2005;293:172–82.

    Article  PubMed  CAS  Google Scholar 

  11. Gerhardsson de Verdier M, Hagman U, Peters RK, Steineck G, Overvik E. Meat, cooking methods and colorectal cancer: a case-referent study in Stockholm. Int J Cancer. 1991;49:520–5.

    Article  PubMed  CAS  Google Scholar 

  12. Martinez ME, Jacobs ET, Ashbeck EL, Sinha R, Lance P, Alberts DS, et al. Meat intake, preparation methods, mutagens and colorectal adenoma recurrence. Carcinogenesis. 2007;28:2019–27.

    Article  PubMed  CAS  Google Scholar 

  13. Gunter MJ, Probst-Hensch NM, Cortessis VK, Kulldorff M, Haile RW, Sinha R. Meat intake, cooking-related mutagens and risk of colorectal adenoma in a sigmoidoscopy-based case-control study. Carcinogenesis. 2005;26:637–42.

    Article  PubMed  CAS  Google Scholar 

  14. Chan AT, Tranah GJ, Giovannucci EL, Willett WC, Hunter DJ, Fuchs CS. Prospective study of N-acetyltransferase-2 genotypes, meat intake, smoking and risk of colorectal cancer. Int J Cancer. 2005;115:648–52.

    Article  PubMed  CAS  Google Scholar 

  15. Bostick RM, Potter JD, Kushi LH, Sellers TA, Steinmetz KA, McKenzie DR, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control. 1994;5:38–52.

    Article  PubMed  CAS  Google Scholar 

  16. Goldbohm RA, van den Brandt PA, van ’t Veer P, Brants HA, Dorant E, Sturmans F, et al. A prospective cohort study on the relation between meat consumption and the risk of colon cancer. Cancer Res. 1994;54:718–23.

    PubMed  CAS  Google Scholar 

  17. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med. 1990;323:1664–72.

    Article  PubMed  CAS  Google Scholar 

  18. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC. Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res. 1994;54:2390–7.

    PubMed  CAS  Google Scholar 

  19. Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, et al. Multivitamin use, folate, and colon cancer in women in the Nurses’ Health Study. Ann Intern Med. 1998;129:517–24.

    PubMed  CAS  Google Scholar 

  20. Martinez ME, Willett WC. Calcium, vitamin D, and colorectal cancer: a review of the ­epidemiologic evidence. Cancer Epidemiol Biomarkers Prev. 1998;7:163–8.

    PubMed  CAS  Google Scholar 

  21. Kritchevsky D. Epidemiology of fibre, resistant starch and colorectal cancer. Eur J Cancer Prev. 1995;4:345–52.

    Article  PubMed  CAS  Google Scholar 

  22. Potter JD. Colorectal cancer: molecules and populations. J Natl Cancer Inst. 1999;91:916–32.

    Article  PubMed  CAS  Google Scholar 

  23. Schatzkin A, Lanza E, Corle D, Lance P, Iber F, Caan B, et al. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. Polyp Prevention Trial Study Group. N Engl J Med. 2000;342:1149–55.

    Article  PubMed  CAS  Google Scholar 

  24. Alberts DS, Martinez ME, Roe DJ, Guillen-Rodriguez JM, Marshall JR, van Leeuwen JB, et al. Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. Phoenix Colon Cancer Prevention Physicians’ Network. N Engl J Med. 2000;342:1156–62.

    Article  PubMed  CAS  Google Scholar 

  25. Trock B, Lanza E, Greenwald P. Dietary fiber, vegetables, and colon cancer: critical review and meta-analyses of the epidemiologic evidence. J Natl Cancer Inst. 1990;82:650–61.

    Article  PubMed  CAS  Google Scholar 

  26. Bingham SA, Day NE, Luben R, Ferrari P, Slimani N, Norat T, et al. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet. 2003;361:1496–501.

    Article  PubMed  Google Scholar 

  27. Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Stampfer MJ, Rosner B, et al. Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med. 1999;340:169–76.

    Article  PubMed  CAS  Google Scholar 

  28. Michels KB, Edward G, Joshipura KJ, Rosner BA, Stampfer MJ, Fuchs CS, et al. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst. 2000;92:1740–52.

    Article  PubMed  CAS  Google Scholar 

  29. van Duijnhoven FJ, Bueno-De-Mesquita HB, Ferrari P, Jenab M, Boshuizen HC, Ros MM, et al. Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr. 2009;89:1441–52.

    Article  PubMed  Google Scholar 

  30. Thun MJ, Calle EE, Namboodiri MM, Flanders WD, Coates RJ, Byers T, et al. Risk factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst. 1992;84:1491–500.

    Article  PubMed  CAS  Google Scholar 

  31. McCullough ML, Robertson AS, Chao A, Jacobs EJ, Stampfer MJ, Jacobs DR, et al. A prospective study of whole grains, fruits, vegetables and colon cancer risk. Cancer Causes Control. 2003;14:959–70.

    Article  PubMed  Google Scholar 

  32. Dowse GK, Zimmet PZ, Gareeboo H, George K, Alberti MM, Tuomilehto J, et al. Abdominal obesity and physical inactivity as risk factors for NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians. Diabetes Care. 1991;14:271–82.

    Article  PubMed  CAS  Google Scholar 

  33. Regensteiner JG, Mayer EJ, Shetterly SM, Eckel RH, Haskell WL, Marshall JA, et al. Relationship between habitual physical activity and insulin levels among nondiabetic men and women. San Luis Valley Diabetes Study. Diabetes Care. 1991;14:1066–74.

    Article  PubMed  CAS  Google Scholar 

  34. Slattery ML, Potter J, Caan B, Edwards S, Coates A, Ma KN, et al. Energy balance and colon cancer–beyond physical activity. Cancer Res. 1997;57:75–80.

    PubMed  CAS  Google Scholar 

  35. Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med. 1995;122:327–34.

    PubMed  CAS  Google Scholar 

  36. Wolin KY, Yan Y, Colditz GA, Lee IM. Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer. 2009;100:611–6.

    Article  PubMed  CAS  Google Scholar 

  37. Meyerhardt JA, Giovannucci EL, Ogino S, Kirkner GJ, Chan AT, Willett W, et al. Physical activity and male colorectal cancer survival. Arch Intern Med. 2009;169:2102–8.

    Article  PubMed  Google Scholar 

  38. Martinez ME, Giovannucci E, Spiegelman D, Hunter DJ, Willett WC, Colditz GA. Leisure-time physical activity, body size, and colon cancer in women. Nurses’ Health Study Research Group. J Natl Cancer Inst. 1997;89:948–55.

    Article  PubMed  CAS  Google Scholar 

  39. Friedenreich C, Norat T, Steindorf K, Boutron-Ruault MC, Pischon T, Mazuir M, et al. Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev. 2006;15:2398–407.

    Article  PubMed  Google Scholar 

  40. Chao A, Connell CJ, Jacobs EJ, McCullough ML, Patel AV, Calle EE, et al. Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev. 2004;13:2187–95.

    PubMed  Google Scholar 

  41. Roy HK, Bianchi LK. Differences in colon adenomas and carcinomas among women and men: potential clinical implications. JAMA. 2009;302:1696–7.

    Article  PubMed  CAS  Google Scholar 

  42. Zisman AL, Nickolov A, Brand RE, Gorchow A, Roy HK. Associations between the age at diagnosis and location of colorectal cancer and the use of alcohol and tobacco: implications for screening. Arch Intern Med. 2006;166:629–34.

    Article  PubMed  Google Scholar 

  43. Lieberman D. Race, gender, and colorectal cancer screening. Am J Gastroenterol. 2005;100:2756–8.

    Article  PubMed  Google Scholar 

  44. Nguyen SP, Bent S, Chen YH, Terdiman JP. Gender as a risk factor for advanced neoplasia and colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:676–81.

    Article  PubMed  Google Scholar 

  45. Schoenfeld P, Cash B, Flood A, Dobhan R, Eastone J, Coyle W, et al. Colonoscopic screening of average-risk women for colorectal neoplasia. N Engl J Med. 2005;352:2061–8.

    Article  PubMed  CAS  Google Scholar 

  46. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology. 2007;132:96–102.

    Article  PubMed  Google Scholar 

  47. Choi SW, Stickel F, Baik HW, Kim YI, Seitz HK, Mason JB. Chronic alcohol consumption induces genomic but not p53-specific DNA hypomethylation in rat colon. J Nutr. 1999;129:1945–50.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  49. Thygesen LC, Wu K, Gronbaek M, Fuchs CS, Willett WC, Giovannucci E. Alcohol intake and colorectal cancer: a comparison of approaches for including repeated measures of alcohol consumption. Epidemiology. 2008;19:258–64.

    Article  PubMed  Google Scholar 

  50. Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, et al. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer. 2007;121:2065–72.

    Article  PubMed  CAS  Google Scholar 

  51. Park JY, Mitrou PN, Dahm CC, Luben RN, Wareham NJ, Khaw KT, et al. Baseline alcohol consumption, type of alcoholic beverage and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition-Norfolk study. Cancer Epidemiol. 2009;33:347–54.

    Article  PubMed  CAS  Google Scholar 

  52. Cho E, Smith-Warner SA, Ritz J, van den Brandt PA, Colditz GA, Folsom AR, et al. Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies. Ann Intern Med. 2004;140:603–13.

    PubMed  Google Scholar 

  53. Giovannucci E. Should smokers be considered a high-risk group for colorectal cancer? Dig Liver Dis. 2004;36:643–5.

    Article  PubMed  CAS  Google Scholar 

  54. Giovannucci E, Colditz GA, Stampfer MJ, Hunter D, Rosner BA, Willett WC, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. women. J Natl Cancer Inst. 1994;86:192–9.

    Article  PubMed  CAS  Google Scholar 

  55. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Kearney J, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. men. J Natl Cancer Inst. 1994;86:183–91.

    Article  PubMed  CAS  Google Scholar 

  56. Zahm SH, Cocco P, Blair A. Tobacco smoking as a risk factor for colon polyps. Am J Public Health. 1991;81:846–9.

    Article  PubMed  CAS  Google Scholar 

  57. Newcomb PA, Storer BE, Marcus PM. Cigarette smoking in relation to risk of large bowel cancer in women. Cancer Res. 1995;55:4906–9.

    PubMed  CAS  Google Scholar 

  58. Verla-Tebit E, Lilla C, Hoffmeister M, Brenner H, Chang-Claude J. Cigarette smoking and colorectal cancer risk in Germany: a population-based case-control study. Int J Cancer. 2006;119:630–5.

    Article  PubMed  CAS  Google Scholar 

  59. Akhter M, Nishino Y, Nakaya N, Kurashima K, Sato Y, Kuriyama S, et al. Cigarette smoking and the risk of colorectal cancer among men: a prospective study in Japan. Eur J Cancer Prev. 2007;16:102–7.

    Article  PubMed  Google Scholar 

  60. Chao A, Thun MJ, Jacobs EJ, Henley SJ, Rodriguez C, Calle EE. Cigarette smoking and ­colorectal cancer mortality in the cancer prevention study II. J Natl Cancer Inst. 2000;92:1888–96.

    Article  PubMed  CAS  Google Scholar 

  61. Limburg PJ, Vierkant RA, Cerhan JR, Yang P, Lazovich D, Potter JD, et al. Cigarette ­smoking and colorectal cancer: long-term, subsite-specific risks in a cohort study of postmenopausal women. Clin Gastroenterol Hepatol. 2003;1:202–10.

    Article  PubMed  Google Scholar 

  62. Paskett ED, Reeves KW, Rohan TE, Allison MA, Williams CD, Messina CR, et al. Association between cigarette smoking and colorectal cancer in the Women’s Health Initiative. J Natl Cancer Inst. 2007;99:1729–35.

    Article  PubMed  Google Scholar 

  63. Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2001;10:725–31.

    PubMed  CAS  Google Scholar 

  64. Leufkens AM, Van Duijnhoven FJ, Siersema PD, Boshuizen HC, Vrieling A, Agudo A, et al. Cigarette smoking and colorectal cancer risk in the European prospective investigation into cancer and nutrition study. Clin Gastroenterol Hepatol. 2011;9:137–44.

    Google Scholar 

  65. Colangelo LA, Gapstur SM, Gann PH, Dyer AR. Cigarette smoking and colorectal carcinoma mortality in a cohort with long-term follow-up. Cancer. 2004;100:288–93.

    Article  PubMed  Google Scholar 

  66. Buc E, Kwiatkowski F, Alves A, Panis Y, Mantion G, Slim K. Tobacco smoking: a factor of early onset of colorectal cancer. Dis Colon Rectum. 2006;49:1893–6.

    Article  PubMed  Google Scholar 

  67. Michalek AM, Cummings KM. The association between cigarette smoking and age at cancer diagnosis. Hum Biol. 1987;59:631–9.

    PubMed  CAS  Google Scholar 

  68. Campbell RJ, Ferrante JM, Gonzalez EC, Roetzheim RG, Pal N, Herold A. Predictors of advanced stage colorectal cancer diagnosis: results of a population-based study. Cancer Detect Prev. 2001;25:430–8.

    PubMed  CAS  Google Scholar 

  69. Coups EJ, Manne SL, Meropol NJ, Weinberg DS. Multiple behavioral risk factors for ­colorectal cancer and colorectal cancer screening status. Cancer Epidemiol Biomarkers Prev. 2007;16:510–6.

    Article  PubMed  Google Scholar 

  70. Messina CR, Kabat GC, Lane DS. Perceptions of risk factors for breast cancer and attitudes toward mammography among women who are current, ex- and non-smokers. Women Health. 2002;36:65–82.

    Article  PubMed  Google Scholar 

  71. Dai Z, Xu YC, Niu L. Obesity and colorectal cancer risk: a meta-analysis of cohort studies. World J Gastroenterol. 2007;13:4199–206.

    PubMed  Google Scholar 

  72. Ford ES. Body mass index and colon cancer in a national sample of adult US men and women. Am J Epidemiol. 1999;150:390–8.

    PubMed  CAS  Google Scholar 

  73. Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007;86:556–65.

    PubMed  CAS  Google Scholar 

  74. Moore LL, Bradlee ML, Singer MR, Splansky GL, Proctor MH, Ellison RC, et al. BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study adults. Int J Obes Relat Metab Disord. 2004;28:559–67.

    Article  PubMed  CAS  Google Scholar 

  75. Pischon T, Lahmann PH, Boeing H, Tjonneland A, Halkjaer J, Overvad K, et al. Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer. 2006;118:728–38.

    Article  PubMed  CAS  Google Scholar 

  76. Wang Y, Jacobs EJ, Patel AV, Rodriguez C, McCullough ML, Thun MJ, et al. A prospective study of waist circumference and body mass index in relation to colorectal cancer incidence. Cancer Causes Control. 2008;19:783–92.

    Article  PubMed  Google Scholar 

  77. Pischon T, Lahmann PH, Boeing H, Friedenreich C, Norat T, Tjonneland A, et al. Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2006;98:920–31.

    Article  PubMed  Google Scholar 

  78. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:1679–87.

    Article  PubMed  Google Scholar 

  79. Inoue M, Iwasaki M, Otani T, Sasazuki S, Noda M, Tsugane S. Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern Med. 2006;166:1871–7.

    Article  PubMed  Google Scholar 

  80. Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM. Fasting serum glucose level and cancer risk in Korean men and women. JAMA. 2005;293:194–202.

    Article  PubMed  CAS  Google Scholar 

  81. Nilsen TI, Vatten LJ. Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis. Br J Cancer. 2001;84:417–22.

    Article  PubMed  CAS  Google Scholar 

  82. Saydah SH, Platz EA, Rifai N, Pollak MN, Brancati FL, Helzlsouer KJ. Association of markers of insulin and glucose control with subsequent colorectal cancer risk. Cancer Epidemiol Biomarkers Prev. 2003;12:412–8.

    PubMed  CAS  Google Scholar 

  83. Ma J, Giovannucci E, Pollak M, Leavitt A, Tao Y, Gaziano JM, et al. A prospective study of plasma C-peptide and colorectal cancer risk in men. J Natl Cancer Inst. 2004;96:546–53.

    Article  PubMed  CAS  Google Scholar 

  84. Wei EK, Ma J, Pollak MN, Rifai N, Fuchs CS, Hankinson SE, et al. A prospective study of C-peptide, insulin-like growth factor-I, insulin-like growth factor binding protein-1, and the risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev. 2005;14:850–5.

    Article  PubMed  CAS  Google Scholar 

  85. Grimberg A, Cohen P. Role of insulin-like growth factors and their binding proteins in growth control and carcinogenesis. J Cell Physiol. 2000;183:1–9.

    Article  PubMed  CAS  Google Scholar 

  86. Tran TT, Medline A, Bruce WR. Insulin promotion of colon tumors in rats. Cancer Epidemiol Biomarkers Prev. 1996;5:1013–5.

    PubMed  CAS  Google Scholar 

  87. Tran TT, Naigamwalla D, Oprescu AI, Lam L, McKeown-Eyssen G, Bruce WR, et al. Hyperinsulinemia, but not other factors associated with insulin resistance, acutely enhances colorectal epithelial proliferation in vivo. Endocrinology. 2006;147:1830–7.

    Article  PubMed  CAS  Google Scholar 

  88. Gunter MJ, Leitzmann MF. Obesity and colorectal cancer: epidemiology, mechanisms and candidate genes. J Nutr Biochem. 2006;17:145–56.

    Article  PubMed  CAS  Google Scholar 

  89. Sandhu MS, Dunger DB, Giovannucci EL. Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. J Natl Cancer Inst. 2002;94:972–80.

    PubMed  CAS  Google Scholar 

  90. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295:1549–55.

    Article  PubMed  CAS  Google Scholar 

  91. Yamaji Y, Okamoto M, Yoshida H, Kawabe T, Wada R, Mitsushima T, et al. The effect of body weight reduction on the incidence of colorectal adenoma. Am J Gastroenterol. 2008;103:2061–7.

    Article  PubMed  Google Scholar 

  92. Rosen AB, Schneider EC. Colorectal cancer screening disparities related to obesity and gender. J Gen Intern Med. 2004;19:332–8.

    Article  PubMed  Google Scholar 

  93. Limburg PJ, Vierkant RA, Fredericksen ZS, Leibson CL, Rizza RA, Gupta AK, et al. Clinically confirmed type 2 diabetes mellitus and colorectal cancer risk: a population-based, retrospective cohort study. Am J Gastroenterol. 2006;101:1872–9.

    Article  PubMed  Google Scholar 

  94. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.

    Article  PubMed  Google Scholar 

  95. Flood A, Strayer L, Schairer C, Schatzkin A. Diabetes and risk of incident colorectal cancer in a prospective cohort of women. Cancer Causes Control. 2010;21:1277–84.

    Article  PubMed  Google Scholar 

  96. Vinikoor LC, Long MD, Keku TO, Martin CF, Galanko JA, Sandler RS. The association between diabetes, insulin use, and colorectal cancer among Whites and African Americans. Cancer Epidemiol Biomarkers Prev. 2009;18:1239–42.

    Article  PubMed  CAS  Google Scholar 

  97. Yang YX, Hennessy S, Lewis JD. Type 2 diabetes mellitus and the risk of colorectal cancer. Clin Gastroenterol Hepatol. 2005;3:587–94.

    Article  PubMed  Google Scholar 

  98. Limburg PJ, Anderson KE, Johnson TW, Jacobs Jr DR, Lazovich D, Hong CP, et al. Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women’s Health Study. Cancer Epidemiol Biomarkers Prev. 2005;14:133–7.

    PubMed  Google Scholar 

  99. Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients. Gastroenterology. 2004;127:1044–50.

    Article  PubMed  CAS  Google Scholar 

  100. Jin T. Why diabetes patients are more prone to the development of colon cancer? Med Hypotheses. 2008;71:241–4.

    Article  PubMed  CAS  Google Scholar 

  101. Berster JM, Goke B. Type 2 diabetes mellitus as risk factor for colorectal cancer. Arch Physiol Biochem. 2008;114:84–98.

    Article  PubMed  CAS  Google Scholar 

  102. Campbell PT, Deka A, Jacobs EJ, Newton CC, Hildebrand JS, McCullough ML, et al. Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. Gastroenterology. 2010;139:1138–46.

    Article  PubMed  Google Scholar 

  103. Hu FB, Manson JE, Liu S, Hunter D, Colditz GA, Michels KB, et al. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst. 1999;91:542–7.

    Article  PubMed  CAS  Google Scholar 

  104. Rinaldi S, Rohrmann S, Jenab M, Biessy C, Sieri S, Palli D, et al. Glycosylated hemoglobin and risk of colorectal cancer in men and women, the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev. 2008;17:3108–15.

    Article  PubMed  CAS  Google Scholar 

  105. Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N. Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev. 2004;13:915–9.

    PubMed  Google Scholar 

  106. Platz EA, Hankinson SE, Rifai N, Colditz GA, Speizer FE, Giovannucci E. Glycosylated hemoglobin and risk of colorectal cancer and adenoma (United States). Cancer Causes Control. 1999;10:379–86.

    Article  PubMed  CAS  Google Scholar 

  107. Murphy G, Devesa SS, Cross AJ, Inskip PD, McGlynn KA, Cook MB. Sex disparities in colorectal cancer incidence by anatomic subsite, race and age. Int J Cancer. 2011; 128:1668–75.

    Google Scholar 

  108. Wong RJ. Marked variations in proximal colon cancer survival by race/ethnicity within the United States. J Clin Gastroenterol. 2010;44:625–30.

    PubMed  Google Scholar 

  109. Alexander DD, Waterbor J, Hughes T, Funkhouser E, Grizzle W, Manne U. African-American and Caucasian disparities in colorectal cancer mortality and survival by data source: an epidemiologic review. Cancer Biomark. 2007;3:301–13.

    PubMed  Google Scholar 

  110. Laiyemo AO, Doubeni C, Pinsky PF, Doria-Rose VP, Bresalier R, Lamerato LE, et al. Race and colorectal cancer disparities: health-care utilization vs. different cancer susceptibilities. J Natl Cancer Inst. 2010;102:538–46.

    Article  PubMed  Google Scholar 

  111. Agrawal S, Bhupinderjit A, Bhutani MS, Boardman L, Nguyen C, Romero Y, et al. Colorectal cancer in African Americans. Am J Gastroenterol. 2005;100:515–23. discussion 514.

    Article  PubMed  Google Scholar 

  112. Anderson JC, Attam R, Alpern Z, Messina CR, Hubbard P, Grimson R, et al. Prevalence of colorectal neoplasia in smokers. Am J Gastroenterol. 2003;98:2777–83.

    Article  PubMed  Google Scholar 

  113. Cash B, Flood A, Weiss DG, Schatzkin A, Lieberman D, Schoenfeld P. Risk factors for advanced colorectal neoplasia in women: comparison of the CONCeRN and VA 380 populations (Abstract). Gastroenterology. 2006;130:A-186.

    Google Scholar 

  114. Lieberman DA, Prindiville S, Weiss DG, Willett W. Risk factors for advanced colonic ­neoplasia and hyperplastic polyps in asymptomatic individuals. JAMA. 2003;290:2959–67.

    Article  PubMed  Google Scholar 

  115. Anderson JC, Latreille M, Messina C, Alpern Z, Grimson R, Martin C, et al. Smokers as a high-risk group: data from a screening population. J Clin Gastroenterol. 2009;43:747–52.

    Article  PubMed  Google Scholar 

  116. Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels AB. Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology. 2008;134:388–95.

    Article  PubMed  Google Scholar 

  117. Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P. Smoking and colorectal cancer: a meta-analysis. JAMA. 2008;300:2765–78.

    Article  PubMed  CAS  Google Scholar 

  118. Stein B, Anderson JC, Rajapakse R, Alpern ZA, Messina CR, Walker G. Body mass index as a predictor of colorectal neoplasia in ethnically diverse screening population. Dig Dis Sci. 2010;55:2945–52.

    Article  PubMed  Google Scholar 

  119. Anderson JC, Messina CR, Dakhllalah F, Abraham B, Alpern Z, Martin C, et al. Body mass index: a marker for significant colorectal neoplasia in a screening population. J Clin Gastroenterol. 2007;41:285–90.

    Article  PubMed  Google Scholar 

  120. Anderson JC, Alpern Z, Messina CR, Lane B, Hubbard P, Grimson R, et al. Predictors of proximal neoplasia in patients without distal adenomatous pathology. Am J Gastroenterol. 2004;99:472–7.

    Article  PubMed  Google Scholar 

  121. Anderson JC, Stein B, Kahi CJ, Rajapakse R, Walker G, Alpern Z. Association of smoking and flat adenomas: results from an asymptomatic population screened with a high-definition colonoscope. Gastrointest Endosc. 2010;71:1234–40.

    Article  PubMed  Google Scholar 

  122. Rex DK, Lieberman DA. Feasibility of colonoscopy screening: discussion of issues and recommendations regarding implementation. Gastrointest Endosc. 2001;54:662–7.

    Article  PubMed  CAS  Google Scholar 

  123. Winawer SJ. A quarter century of colorectal cancer screening: progress and prospects. J Clin Oncol. 2001;19:6S–12.

    PubMed  CAS  Google Scholar 

  124. Betes M, Munoz-Navas MA, Duque JM, Angos R, Macias E, Subtil JC, et al. Use of colonoscopy as a primary screening test for colorectal cancer in average risk people. Am J Gastroenterol. 2003;98:2648–54.

    PubMed  Google Scholar 

  125. Colditz GA, Atwood KA, Emmons K, Monson RR, Willett WC, Trichopoulos D, et al. Harvard report on cancer prevention volume 4: Harvard Cancer Risk Index. Risk Index Working Group, Harvard Center for Cancer Prevention. Cancer Causes Control. 2000;11:477–88.

    Article  PubMed  CAS  Google Scholar 

  126. Kim DJ, Rockhill B, Colditz GA. Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk. J Clin Epidemiol. 2004;57:332–40.

    Article  PubMed  Google Scholar 

  127. Driver JA, Gaziano JM, Gelber RP, Lee IM, Buring JE, Kurth T. Development of a risk score for colorectal cancer in men. Am J Med. 2007;120:257–63.

    Article  PubMed  Google Scholar 

  128. Freedman AN, Slattery ML, Ballard-Barbash R, Willis G, Cann BJ, Pee D, et al. Colorectal cancer risk prediction tool for white men and women without known susceptibility. J Clin Oncol. 2009;27:686–93.

    Article  PubMed  Google Scholar 

  129. Colorectal Cancer Mortality Projections, National Cancer Institute. Bethesda, MD: NIH, DHHS, 2007.

    Google Scholar 

  130. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1–8.

    PubMed  Google Scholar 

  131. Brenner H, Hoffmeister M, Arndt V, Stegmaier C, Altenhofen L, Haug U. Protection from right- and left-sided colorectal neoplasms after colonoscopy: population-based study. J Natl Cancer Inst. 2010;102:89–95.

    Article  PubMed  Google Scholar 

  132. Arain MA, Sawhney M, Sheikh S, Anway R, Thyagarajan B, Bond JH, et al. CIMP status of interval colon cancers: another piece to the puzzle. Am J Gastroenterol. 2010;105:1189–95.

    Article  PubMed  Google Scholar 

  133. Shaukat A, Arain M, Thaygarajan B, Bond JH, Sawhney M. Is BRAF mutation associated with interval colorectal cancers? Dig Dis Sci. 2010;55:2352–6.

    Article  PubMed  CAS  Google Scholar 

  134. Li D, Jin C, McCulloch C, Kakar S, Berger BM, Imperiale TF, et al. Association of large serrated polyps with synchronous advanced colorectal neoplasia. Am J Gastroenterol. 2009;104:695–702.

    Article  PubMed  Google Scholar 

  135. Anderson JC, Pleau DC, Rajan TV, Protiva P, Swede H, Brenner B, et al. Increased frequency of serrated aberrant crypt foci among smokers. Am J Gastroenterol. 2010;105:1648–54.

    Article  PubMed  Google Scholar 

  136. Anderson JC, Rangasamy P, Rustagi T, Myers M, Sanders M, Vaziri H, et al. Risk factors for sessile serrated adenomas. J Clin Gastroenterol. (In Press)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph C. Anderson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Anderson, J.C. (2011). Risk Factors and Screening for Colorectal Cancer. In: Anderson, MD, J., Kahi, MD, C. (eds) Colorectal Cancer Screening. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-398-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-398-5_2

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-397-8

  • Online ISBN: 978-1-60761-398-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics