A case-control study of risk factors for large bowel carcinoma

Abstract

Two hundred and seven large bowel cancer patients (93% of all cases diagnosed in a defined community between 1965 and 1976) were matched at random with non‐cancer subjects of same age, sex, and place of residence. Men with cancer, aged 75 years and younger than, had a more frequent history of work in a local factory handling synthetic fiber than controls (22 versus 10; P < 0.025). In this factory 45% of cancers occurred before age 60, while this was true in only 24% of cancer cases outside the factory (P < 0.05). There was a greater tendency for cancers in factory workers to occur in the colon than in the rectum. Heredity was not found to be a risk factor for large bowel cancer. The rate of prior appendectomy was higher in men with colon cancer (P < 0.05) and the rate of prior cholecystectomy was lower in females with colonic cancer (P < 0.05). A previous hemorroidectomy was also found more often in males with colonic cancer (P < 0.05). Long‐standing severe constipation was present more often in patients with cancer (P < 0.01). There was some evidence for a compounding influence of different risk factors, as studied by relative risk ratio. This study confirms the existence of a high risk of large bowel cancer in a group of workers in a synthetic fiber factory and suggests other factors antecedent to large bowel cancer.

Colorectal Cancer Incidence Among Female Textile Workers in Shanghai, China: A Case-cohort Analysis of Occupational Exposures

“…We also observed a trend of decreasing risk of rectum cancer by duration of employment in jobs with exposure to cotton dust or endotoxin, primarily when exposures were lagged by 20 years. Comparison of our results to previous studies is not straightforward in some respects because many previous studies combined diagnoses to examine the risk of colorectal cancer [1,2,6,12,16,30], whereas we estimated risk separately for the two cancers. Risk factors for the two cancers differ importantly, in demographics, geography, and lifestyle factors [31]; therefore, we would not necessarily expect similar associations with occupational exposures for the two cancer sites.…”

“…Several previous studies supported this hypothesis. Following the initial cluster of large-bowel cancers observed in the carpet factory in synthetic textile in the 1970s [1], a casecontrol study attributed the link to having ever worked at the synthetics plant [12], and increased colorectal cancer mortality was noted among workers in the polypropylene and cellulose triacetate extrusion unit of the factory [6]. Several other studies have found increases in colon or rectum cancer incidence in association with synthetic fibers [13], rayon textile fibers [14], and employment in an acrylic fiber factory [15].…”

Hay Fever and Asthma as Markers of Atopic Immune Response and Risk of Colorectal Cancer in Three Large Cohort Studies

“…Large European record linkage studies comparing colorectal cancer incidence in patients with asthma with that in the underlying general population reported lower risk (16), higher risk (19,20), and no association (21). Of 6 other studies (1 cohort and 5 case-control) that examined associations with allergic conditions and included at least 100 cases of incident colorectal cancer, 4 reported no association (22)(23)(24)(25), 1 reported significantly lower risk with a history of any allergic condition (defined as including asthma; ref. 17), and 1 reported a marginally statistically significant reduction in risk with a history of allergies (not including asthma; ref.…”

“…In the IWHS (15), having 2 or more allergic conditions was associated with approximately 40% lower colorectal cancer incidence. Although some studies of individual allergic conditions found associations with modestly lower risk of colorectal cancer (15)(16)(17)(18), others did not (19)(20)(21)(22)(23)(24)(25), or found lower risk of rectal cancer, but not colon cancer (26).…”

The relationship between smoking exposure and p53 overexpression in colorectal cancer

“…Results from epidemiological studies investigating its role in colorectal cancer have been inconsistent. Whereas some case -control studies have demonstrated an increased risk (Martinez et al, 1981;Dales et al, 1979;Vobecky et al, 1983;Kabat et al, 1986;Jarebinski et al, 1988Jarebinski et al, , 1989Slattery et al, 1990;Kune et al, 1992a), others find no association (Wynder et al, 1969;Haenszel et al, 1973;Williams and Horm, 1977;Graham et al, 1978;Jain et al, 1980;Tuyns et al, 1982;Ferraroni et al, 1989;Olsen and Kronberg, 1993), or a reduction in risk (Higginson, 1966;Wynder and Shigematsu, 1967;Stazewski, 1969;Haenszel et al, 1980;Papdimitriou et al, 1984;Tajima and Tominaga, 1985;Peters et al, 1989;Choi and Kahyo, 1991). In contrast, studies of the relationship between smoking and colorectal adenomas have consistently observed a positive relationship (Olsen and Kronberg, 1993;Zahm et al, 1991;Honjo et al, 1992;Kikendall et al, 1991;Hoff et al, 1987;Monnet et al, 1991;Lee et al, 1993;Sandler et al, 1993;Kune et al, 1992b;Demers et al, 1988;Cope et al, 1991;Martinez et al, 1995;Drexler, 1971).…”