Heterogeneity of colorectal cancer risk by tumour characteristics: Large prospective study of <scp>UK</scp> women

  • Andrea Burón Pust
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Rupert Alison
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Roger Blanks
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Kirstin Pirie
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Kezia Gaitskell
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Isobel Barnes
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Toral Gathani
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Gillian Reeves
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Valerie Beral
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom
  • Jane Green
    Nuffield Department of Population Health Cancer Epidemiology Unit, University of Oxford United Kingdom

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<jats:p>Associations between behavioural and other personal factors and colorectal cancer risk have been reported to vary by tumour characteristics, but evidence is inconsistent. In a large UK‐based prospective study we examined associations of 14 postulated risk factors with colorectal cancer risk overall, and across three anatomical sites and four morphological subtypes. Among 1.3 million women, 18,518 incident colorectal cancers were identified during 13.8 (SD 3.4) years follow‐up <jats:italic>via</jats:italic> record linkage to national cancer registry data. Cox regression yielded adjusted relative risks. Statistical significance was assessed using correction for multiple testing. Overall, colorectal cancer risk was significantly associated with height, body mass index (BMI), smoking, alcohol intake, physical activity, parity and menopausal hormone therapy use. For smoking there was substantial heterogeneity across morphological types; relative risks around two or greater were seen in current smokers both for signet ring cell and for neuroendocrine tumours. Obese women were also at higher risk for signet ring cell tumours. For adenocarcinomas, the large majority of colorectal cancers in the cohort, all risk factor associations were weak. There was little or no heterogeneity in risk between tumours of the right colon, left colon and rectum for any of the 14 factors examined. These epidemiological findings complement an emerging picture from molecular studies of possible different developmental pathways for different tumour types.</jats:p>

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