Risk factors for adenocarcinoma of the small intestine

Negri, Eva; Bosetti, Cristina; Vecchia, Carlo La; Fioretti, Francesca; Conti, Ettore; Franceschi, Silvia

doi:10.1002/(sici)1097-0215(19990719)82:2<171::aid-ijc3>3.0.co;2-t

Cited by 94 publications

(101 citation statements)

References 17 publications

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“…Further, data from two Italian hospital-based case -control studies suggested an inverse relationship (Negri et al, 1999). However, only 23 cases were examined.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for small bowel cancer, however, include dietary factors, cigarette smoking, alcohol intake and different medical conditions (Neugut et al, 1998). Further, adenocarcinomas of the small and large bowel share several common features, and it has been shown that there is a strong similarity between the dietary correlates of risk of adenocarcinoma of the small intestine and colon cancer (Negri et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

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Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

2005

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The present study aimed at exploring the relations between body mass index (BMI, (weight in kilograms)/(height in meters) 2 ) and stature and cancer of the small intestine (1162 cases) in a large Norwegian cohort (of two million) with measured height and weight. Elevated BMI in males and increasing height in both sexes were associated with a moderately increased risk of cancer of the small intestine. Overweight or obesity has been linked to an increased risk of several site-specific cancers, including colorectal cancers (Engeland et al, 2005). A large cohort study of male US veterans found a significant excess risk of small intestine cancer, especially of the duodenum, among obese white veterans (Samanic et al, 2004). Also, a recent cohort study of obese individuals in Sweden reported a significantly elevated risk of cancer of the small intestine, but only among men (Wolk et al, 2001).The aim of the present study was to explore the associations between body mass index (BMI) and height and the risk of cancers of the small intestine in a very large Norwegian cohort of both men and women with a long follow-up. STUDY POPULATIONThe study population has been described in detail elsewhere, (Engeland et al, 2004).Briefly in a series of health surveys during 1963 -2001, height and weight were measured in a standardised way by a trained staff in 2 001 727 persons (963 709 men and 1 038 018 women) aged 20 -74 years. Deaths, emigrations and cases of cancer of the small intestine (International Classification of Diseases, seventh revision (ICD-7): 152) in this cohort were identified by linkage to the Death Registry at Statistics Norway (Statistics Norway, 2005) and to the Cancer Registry of Norway (The Cancer Registry of Norway, 2005). Both these registries are population based and are covering the entire Norwegian population. A unique 11-digit identification number assigned to all individuals living in Norway after 1960 simplified the linkages.In the present study, only histologically verified cancers of the small intestine were included. Persons with a diagnosis of cancer of the small intestine, prior to the height and weight measurements, were excluded. Consequently, 32 persons were excluded in the analyses. In the analyses, the persons in the cohort were followed up from the date of measurement until the date of cancer diagnosis, emigration, age 100 years, death or until 31 December 2003. Altogether, 2 001 695 persons were eligible for the study. A small number of these (39 men and 32 women) were lost to follow-up. STATISTICAL METHODSCox's proportional-hazards regression models (Cox and Oakes, 1984), with time since measurement as the time variable, were fitted to obtain relative risk (RR) estimates of cancer. In the analyses, categorised variables for age at measurement, year of birth, BMI ((weight in kilograms)/(height in meters) 2 ) and height were included. BMI was categorised using the WHO categorisation (World Health Organization Consultation on Obesity, 1998): BMI o18.5 (underweight), 18.5 -24.9 (normal), 25.0 -2...

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“…Further, data from two Italian hospital-based case -control studies suggested an inverse relationship (Negri et al, 1999). However, only 23 cases were examined.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

2005

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“…Small intestinal carcinomas share morphological characteristics and risk factors with other gastrointestinal carcinomas, especially with colorectal carcinomas (Negri et al, 1999;Neugut et al, 1998). Both tumour types may arise from pre-existing adenomas and both are reported to occur more frequently in patients with chronic in¯ammatory bowel diseases (Pohl et al, 2000;Logan et al, 1989;Lennard-Jones et al, 1977) and in patients with hereditary gastrointestinal cancer prone syndromes like familial adenomatous polyposis coli (FAP), hereditary non polyposis colorectal cancer syndrome (HNPCC), and Peutz-Jeghers syndrome (Neugut et al, 1998;Park et al, 1999;Spigelman et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Genetics of adenocarcinomas of the small intestine: frequent deletions at chromosome 18q and mutations of the SMAD4 gene

et al. 2002

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The small intestinal mucosa makes up about 90% of the total surface of the gastrointestinal tract. However, adenocarcinomas arise rarely in this location. To elucidate genetic alterations underlying tumour development in the small intestine we investigated 17 sporadic adenocarcinomas. By comparative genomic hybridization recurrent gains of chromosomal material were found at chromosomes 7, 8, 13q, and 20 (5/17, each), while non-random losses were seen at 8p, 17p (4/17, each), and 18 (8/17 cases). Deletions at 5q, the location of the APC tumour suppressor gene, were seen in three cases. Microsatellite analysis with markers on chromosomal arms 1p, 5q, 8p, 17p, 18q, 19p, and 22q revealed a microsatellite instable phenotype in two cases and a high frequency of loss at 18q21-q22 (80%). Given the high incidence of 18q21-q22 deletions, we performed sequencing analysis of SMAD4, a downstream component of the TGFb-pathway, located at 18q21. Four tumours displayed mutations in highly conserved domains of the gene indicating disruption of TGFb-signalling. Our data reveal complex genetic alterations in sporadic small intestinal carcinomas. However, most tumours share deletions of 18q21-q22, which frequently target SMAD4. This indicates that disruption of TGFb-signalling plays a critical role in small intestinal tumorigenesis.

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“…with de novo cancers that were found in 60-69-year-olds [15] . Tumors were found in the ileum at a rate of 75%.…”

Section: Discussionmentioning

confidence: 97%

A case of small bowel adenocarcinoma in a patient with Crohn’s disease detected by PET/CT and double-balloon enteroscopy

Kodaira¹,

Osawa²,

Mochizuki³

et al. 2009

WJG

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Small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) is quite rare, difficult to diagnose without surgery, and has a poor prognosis. Here, we report a 48-year-old man with SBA and a 21-year history of CD who was diagnosed by a combination of positron emission tomography/computed tomography (PET/CT) and double-balloon enteroscopy (DBE). Since the age of 27 years, the patient had been treated for ileal CD and was referred to our hospital with persistent melena. Multiple hepatic tumors were found by CT. PET/CT detected an accumulation spot in the small bowel. DBE revealed an ulcerative tumor in the ileum about 100 cm from the ileocecal valve. An endoscopic forceps biopsy specimen showed poorly differentiated adenocarcinoma. There were some longitudinal ulcer scars near the tumor, and the chronic inflammation in the small bowel appeared to be associated with the cancer development. Previous reports suggest the risk of SBA in patients with CD is higher than in the overall population. Since early diagnosis is extremely difficult in these cases, novel techniques, such as PET/CT and DBE, may be expected to help in making a preoperative diagnosis of the development of SBA in CD.

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Risk factors for adenocarcinoma of the small intestine

Cited by 94 publications

References 17 publications

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

Genetics of adenocarcinomas of the small intestine: frequent deletions at chromosome 18q and mutations of the SMAD4 gene

A case of small bowel adenocarcinoma in a patient with Crohn’s disease detected by PET/CT and double-balloon enteroscopy

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