Diseases of the Colon & Rectum · 2010 · 79 citations · 30 references
MedicineHealth SciencesOncologyCancer EpidemiologyEpidemiologic MethodsEpidemiologyCancer RiskColorectal CancerEnvironmental Cancer EpidemiologyEnvironmental EpidemiologyEnvironmental Health EpidemiologyEnvironmental RiskBreastfeeding-related RiskCancer Risk AssessmentColorectal Cancer EpidemiologyDietary Environmental ExposuresEnvironmental Exposure RiskLogistic RegressionPesticide Exposure EpidemiologyPesticide-related Cancer Risk
PURPOSE: Lifestyle factors and environmental exposures might help explain the risk of colorectal carcinoma in countries where the incidence is low, but unique patterns of young onset and a high proportion of rectal cancer exist. METHODS: We obtained detailed lifestyle information from 421 patients with colorectal cancer and 439 hospital-controls in Egypt. Logistic regression models were computed to evaluate the risk factors of colorectal carcinoma. RESULTS: A history of pesticide exposure and more frequently eating food directly from farms were significantly associated with a higher risk of colorectal carcinoma (odds ratio = 2.6; 95% CI = 1.1-5.9, and odds ratio = 4.6; 95% CI = 1.5-14.6, respectively). Parous women who reported 7 or more live births or breastfed for 19 months or longer per live birth had a significantly lower risk for colorectal carcinoma (odds ratio = 0.3; 95% CI = 0.2-0.7, and odds ratio = 0.2; 95% CI = 0.1-0.4, respectively). Compared with patients aged 40 years or older, industrial exposures were more common in younger patients (P = .05). CONCLUSIONS: Agricultural and industrial exposures were associated with increased risk of colorectal carcinoma, whereas prolonged lactation and increased parity were inversely associated with colorectal carcinoma in women. Further research to elucidate the biological role of intense environmental and industrial exposures and reproductive factors including lactation may further clarify the etiology of colorectal cancer.
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