The North–South and East–West Gradient in Colorectal Cancer Risk: A Look at the Distribution of Modifiable Risk Factors and Incidence across Canada

Abstract

Colorectal cancer (crc) is the 2nd most common cancer in Canada and the 2nd leading cause of cancer death. That heavy burden can be mitigated given the preventability of crc through lifestyle changes and screening. Here, we describe the extent of the variation in crc incidence rates across Canada and the disparities, by jurisdiction, in the prevalence of modifiable risk factors known to contribute to the crc burden. Findings suggest that there is a north-south and east-west gradient in crc modifiable risk factors, including excess weight, physical inactivity, excessive alcohol consumption, and low fruit and vegetable consumption, with the highest prevalence of risk factors typically found in the territories and Atlantic provinces. In general, that pattern reflects the crc incidence rates seen across Canada. Given the substantial interjurisdictional variation, more work is needed to increase prevention efforts, including promoting a healthier diet and lifestyle, especially in jurisdictions facing disproportionately higher burdens of crc. Based on current knowledge, the most effective approaches to reduce the burden of crc include adopting public policies that create healthier environments in which people live, work, learn, and play; making healthy choices easier; and continuing to emphasize screening and early detection. Strategic approaches to modifiable risk factors and mechanisms for early cancer detection have the potential to translate into positive effects for population health and fewer Canadians developing and dying from cancer.

Predictors of CRC Stage at Diagnosis among Male and Female Adults Participating in a Prospective Cohort Study: Findings from Alberta’s Tomorrow Project

“…Higher coffee consumption is associated with the male sex, along with alcohol consumption [60], smoking, and poorer dietary patterns [62,66]. Therefore, the association between caffeine intake and advanced CRC stage at diagnosis in males observed in this study may be due to residual confounding [67,68].…”

The Multifaceted Roles of Diet, Microbes, and Metabolites in Cancer

“…The link between inflammation and concomitant tumour development in cancers was first suggested by Virchow in 1863 [ 11 , 12 ], and today roughly 20% of cancers are thought to directly result from chronic inflammation [ 13 ]. Likely one of the most well studied examples to date is the link between inflammatory bowel diseases (IBD) and colorectal cancer (CRC) [ 14 , 15 , 16 , 17 ]. Notably, select dietary factors including saturated fats, red meat, and refined carbohydrates have been suggested to display pro-inflammatory properties and diet has been shown to play a key role in up to 40% of all cancers [ 18 , 19 , 20 , 21 ].…”