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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Approximately 34 million US adults were obese in 1980. Obesity is associated with increased risk of noninsulin-dependent diabetes mellitus (NIDDM), hypertension, cardiovascular disease, gallbladder disease and cholecystectomy, and colon and postmenopausal breast cancer. Using a prevalence-based approach to cost of illness, we estimated the economic costs in 1986 attributable to obesity for these medical conditions. Indirect costs due to morbidity and mortality were discounted at 4%. Overall, the costs attributable to obesity were $11.3 billion for NIDDM, $22.2 billion for cardiovascular disease, $2.4 billion for gall bladder disease, $1.5 billion for hypertension, and $1.9 billion for breast and colon cancer. Thus a conservative estimate of the economic costs of obesity was $39.3 billion, or 5.5% of the costs of illness in 1986. Addition of costs due to musculoskeletal disorders could raise this estimate to 7.8%. The costs of treatment for severe obesity must be weighed against the improved health status and quality of life.
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PMID:Economic costs of obesity. 173 19

Recent questions about the role of cholesterol (particularly blood cholesterol) in human cancer have assumed considerable scientific and public health importance. This paper has reviewed the evidence relating human cancer to cholesterol, in diet, blood, and feces. With respect to dietary cholesterol, there is moderately consistent evidence, both descriptive and analytic, of a small-to-medium increase in risk of cancers of the colon and female breast in association with increased dietary cholesterol. However, the close correlation of cholesterol with other foods and nutrients precludes causal inference. The association of fecal cholesterol with large bowel cancer, in both descriptive and analytic studies, is inconsistent. However, there is some evidence that individuals with reduced degradation of fecal cholesterol are at increased risk of colon cancer. Other bile-derived fecal components, particularly the acid sterols, show a somewhat more consistent relationship with large bowel cancer. It may be of relevance to the findings on blood cholesterol that bile is produced from hepatic cholesterol which derives, in part, from blood cholesterol. Studies of blood cholesterol and cancer have been either experimental (intervention) or observational (primarily follow-up). Deliberate lowering of blood cholesterol, by either drugs or diet, does not appear to alter the risk of cancer, either overall or of specific types. The findings from 20 published follow-up studies, each initiated as a cardiovascular disease study, have been more varied. In 12 studies, an inverse association was observed between blood cholesterol level and overall cancer risk. Eight of those 12 were mortality studies, and in six, the inverse association was confined to deaths that occurred early in follow-up; this observation is consistent with lowered blood cholesterol having occurred as a metabolic response to a preclinical cancer. However, the results of the other two mortality studies do not exclusively support this interpretation. Furthermore, in three of the four incidence studies that reported an inverse association, the inverse association persisted for 10 or more years. This relationship was most marked for colon cancer in men and showed some evidence of being maximal in the proximal colon. The biologic plausibility of these particular observations on colon cancer risk in relationship to an antecedent naturally occurring low blood cholesterol gains some support from a body of epidemiologic, clinical, and experimental evidence.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Dietary and endogenous cholesterol and human cancer. 638 2

A total of 3,868 urban policemen in Rome were investigated through a historical cohort study with emphasis on mortality from cardiovascular disease and cancer. Overall mortality from cardiovascular disease, respiratory conditions, digestive and genitourinary diseases, and accidents was lower than expected. An excess risk of ischemic heart disease was observed among subjects aged less than 50 years [14 deaths, standardized mortality ratio (SMR = 1.63), 95% CI = 0.89-2.73], corresponding to workers with a short duration of employment and a short latency since first employment. Overall cancer mortality was as expected and no excess was found for lung cancer (82 deaths, SMR = 1.05). Increased mortality was observed from colon cancer (16 deaths, SMR = 1.47), melanoma (four deaths, SMR = 2.34), bladder cancer (13 deaths, SMR = 1.27), renal cancer (seven deaths, SMR = 1.39), and non-Hodgkin's lymphoma (six deaths, SMR = 1.51), although none of the excesses were statistically significant. Two deaths from male breast cancer (SMR = 14.36) and three from cancer of endocrine glands were found (SMR = 3.44). Nested case-control studies were conducted to evaluate cancer mortality risk by job category. Bladder cancer was significantly increased among car drivers (OR = 4.17); for kidney cancer, an increased odds ratio (OR = 2.27) was found among motorcyclists; non-Hodgkin's lymphoma clustered among motorcyclists (OR = 5.14). In summary, excess risk for specific cancer sites (colon, male breast, and endocrine glands) might be linked to occupational exposures; professional drivers seem to be at higher risk of bladder cancer, kidney cancer, and non-Hodgkin's lymphoma.
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PMID:Mortality among urban policemen in Rome. 789 29

Heart disease and cancer, the major causes of mortality and morbidity in Western countries, have common risk factors. Exercise appears to reduce the risk of cardiovascular disease, but its role with respect to primary prevention of cancer has not been emphasized. Here we evaluate the epidemiological studies dealing with exercise and colon cancer. Despite the fact that different methods of assessing the amount of typical exercise of individuals and the different types of physical activity measured (occupational and recreational), there is remarkably consistent evidence that people who are highly physically active could be at a reduced risk of cancer of the colon. An analysis of case-control and cohort studies suggests that exercise might reduce the risk, at least in men, by up to one-third. We conclude that exercise has been overlooked as a potentially useful, effective, and acceptable method for reducing the risk of colon cancer.
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PMID:Physical activity and colon cancer. 800 Mar 7

The 10th edition of the RDA discusses carbohydrates in the context of dietary fiber and digestible carbohydrates, which provide energy, and recommends that more than half the energy requirement beyond infancy be provided by carbohydrates and that a desirable intake of fiber be achieved by consumption of fruits, vegetables, legumes, and whole-grain cereals. The recommendations on digestible carbohydrates are primarily based on the desirability of limiting the intake of fat. An additional consideration is the suggestion that excess calories from carbohydrate vs. fat are metabolized and stored with different efficiencies. The scientific basis for recommending an appropriate intake of dietary fiber is not clearly evident in the current RDA. The association between a high plant food, and thus fiber intake, and lower incidence of cardiovascular disease, colon cancer, and diabetes is of interest but difficult to use to form the basis of specific recommendations for an appropriate amount of fiber to include in the diet. The importance of fiber for normal gastrointestinal function provides the best scientific basis for developing recommended intake levels. Dietary fiber, as well as non-digested starch, are the only known dietary components that increase stool weight and are the primary substrates for the microflora in the large intestine. Metabolism of this microflora, including production of short chain fatty acids that are used by epithelial cells, appears to be important for intestinal health. However, the challenge we still face is to define the parameters of gastrointestinal function that are compatible with health.
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PMID:Carbohydrates: significance for energy balance and gastrointestinal function. 808 44

In the art glass industry workers run increased risks of dying from several types of cancer, cardiovascular diseases, and cerebrovascular diseases. This paper considers the diseases of glass workers in relation to exposure to particular elements, a high degree of correlation being found for some of them. Case-referent evaluations showed an association between stomach cancer and exposure to a mixture of elements, namely, arsenic, copper, nickel, and manganese, and to some extent also to lead and chromium. For colon cancer, a clearly increasing trend in risk was seen with increasing use of antimony, and to some extent also with increasing use of lead, the two elements being strongly correlated. For lung cancer no obvious correlation with any metal could be found. In addition, the risk for death from cardiovascular disease was fairly evenly distributed, although slightly more related to increasing consumption of the strongly correlated metals nickel and copper.
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PMID:Epidemiologic studies of occupational cancer as related to complex mixtures of trace elements in the art glass industry. 815 83

There is strong evidence that exercise reduces the risk of cardiovascular disease and that it reduces total mortality in men. This evidence comes from well-conducted, large prospective studies. These studies demonstrate a dose-response relationship and that beginning exercise later in life is beneficial, whereas stopping exercise is harmful. The data show that exercise is beneficial for those older than 65. Preliminary data also suggest that exercise may improve the health of women and that exercise may reduce the risk of malignancy (particularly colon cancer). The risks of a sedentary life-style dictate that physicians should routinely advise patients to engage in regular physical activity.
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PMID:Exercise and health: fact or hype? 817 13

Hypercoagulability with resultant thrombosis as a leading cause of death remains unproven due to the lack of a global screening coagulation test documenting antecedent hypercoagulability. To fill this need a modified recalcification time (MRT) test that incorporates the contribution of all the circulating cellular and chemical mediators, including the important but neglected tissue factor, to coagulation is described. Aliquots of blood are incubated with saline and with endotoxin, and the MRT is instrumentally determined. Values outside the normal ranges of 5.3 to 8.5 minutes (saline) and 4.5 to 7.5 minutes (endotoxin) in the coagulation spectrum of 0 to 10 minutes to infinity are abnormal. Shorter values are inversely related to the degree of hypercoagulability. To assess MRT in detecting hypercoagulability, MRT values in conditions with known thrombotic risk that were reported individually are presented by indicating the percentages of each in the abnormal ranges. The conditions, all with statistically significant hypercoagulability, included early breast cancer, diabetes, head, neck, and colon cancer, peripheral vascular disease, and pregnancy. Modified recalcification time meets the criteria of a global coagulation screening test because of: 1) age-related prevalence of asymptomatic cancer and thrombotic cardiovascular disease, 2) specificity and sensitivity, and 3) expected lower morbidity and mortality with early intervention.
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PMID:Modified recalcification time: a global coagulation screening test. 837 Dec 83

The US Public Health Service (USPHS) and the National Institutes of Health (NIH) have a major commitment to women's health issues and to women's health research. "To assess the problems of women's health in the context of the lives women in America lead today," the Assistant Secretary for Health, USPHS, appointed a task force whose report published in 1985 identified issues, listed 15 recommendations, and served as a guide for the establishment of groups within each agency to implement the recommendations according to their appropriate responsibilities. NIH established an Advisory Committee on Women's Health Issues which assessed NIH involvement in women's health research, made recommendations for implementation or expansion of this research, including a recommendation that women be included in clinical trails or their exclusion be justified. An Office of Research on Women's Health was created. The NIH announced a Women's Health Initiative (WHI) in the spring of 1991, which will address three of the leading health problems for women: cardiovascular disease, breast and colon cancer, and osteoporosis. The WHI will provide an integrated, multidisciplinary approach through clinical trials, observational studies, and community trials. Clinical trials will evaluate hormone replacement therapy, calcium/vitamin D, and dietary modification of fat/fiber. Community trials will implement known interventions for relevant risk factors. Presented here are USPHS response to the mandate to address women's health issues; data from the US National Center for Health Statistics about the incidence and prevalence of diseases and risk factors in women; details about the WHI clinical trial; and aspects of the WHI applicable to the field of nutrition.
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PMID:Women's health and nutrition research: US governmental concerns. 840 91

Chemoprevention refers to the use of specific natural or synthetic chemical agents to reverse, suppress, or prevent the progression to invasive cancer. The ideal chemopreventive agent is safe and nontoxic over the long term. It should be easy to take and demonstrated to be effective in randomized trials in humans. Aspirin and NSAIDs meet many of the criteria for an ideal agent. The literature on aspirin and NSAIDs makes it clear that these agents can prevent colorectal cancer and precursor adenomas. That does not mean that we should make general recommendations for their use. First, we do not know the proper dose or duration. More important, these medications are accompanied by adverse effects that can be considerable. Indeed, the Medical Letter, an authoritative, unbiased publication on drugs and therapeutics, concluded that "for primary prevention in low-risk patients, more studies are required to establish whether the beneficial effect of aspirin is great enough to compensate for the possible increased risk of hemorrhagic stroke." These recommendations were directed at the use of these medications for prevention of myocardial infarction, but the same conclusions apply to colorectal cancer: although aspirin may prevent the disease, it may increase the risk of hemorrhagic strokes or cause other adverse effects. We must accurately balance the benefits and risks of these drugs, based on the results of ongoing randomized studies, before recommending aspirin for prevention of colorectal cancer. Is there anything that we can recommend to our patients for prevention of colorectal cancer? Based on observational epidemiologic studies, it is clear that individuals who consume a diet high in vegetables and natural fibers and low in fat have a reduced risk of colon cancer and polyps. Optimal nutrient intakes for the prevention of cancer might be more readily achieved via food fortification or supplementation, but this requires more research. Regular physical exercise and maintenance of normal body weight are also protective. Until the results of definitive studies of chemopreventive agents are available, we can recommend that our patients eat a sensible diet, exercise, and avoid obesity. Such an approach should protect them from cardiovascular disease, an even deadlier condition than colorectal cancer. In the future, we need randomized prevention trials that, for logistic reasons, may need to focus on the occurrence and progression of colorectal adenomas rather than carcinoma itself. Studies that test more than one compound at a time, using factorial designs, will be more efficient. We will need better information about duration and dose, adverse side effects, molecular mechanisms, and cellular sites of NSAID activity. Ultimately, we will need to know more about the biology and molecular biology of colorectal cancer and its precursors. That information will, perhaps, permit us to design agents to interrupt the pathway to cancer and to use intermediate markers more intelligently.
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PMID:Aspirin and other nonsteroidal anti-inflammatory agents in the prevention of colorectal cancer. 879 Nov 32


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