ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2019
Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 8 of them syntheses that pooled it.
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Who cites it
87 citing papers in PubMed, 8 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- Genome-wide association studies and Mendelian randomization analyses provide insights into the causes of early-onset colorectal cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2024Pooled it
- Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies.British journal of sports medicine · 2023Pooled it
- Alcohol consumption, DNA methylation and colorectal cancer risk: Results from pooled cohort studies and Mendelian randomization analysis.International journal of cancer · 2022Pooled it
- Diabetes and Risks of Right-Sided and Left-Sided Colon Cancer: A Meta-Analysis of Prospective Cohorts.Frontiers in oncology · 2022Pooled it
- Pooled it
- Medication use and risk of proximal colon cancer: a systematic review of prospective studies with narrative synthesis and meta-analysis.Cancer causes & control : CCC · 2021Pooled it
- Proton pump inhibitors and the risk of colorectal cancer: a systematic review and meta-analysis of observational studies.International journal of colorectal disease · 2020Pooled it
- Non-genetic biomarkers and colorectal cancer risk: Umbrella review and evidence triangulation.Cancer medicine · 2020Pooled it
- Physical activity levels after low anterior resection for rectal cancer: one-year follow-up.BMC public health · 2021Trial
- A prospective investigation of early-onset colorectal cancer risk factors-pooled analysis of three large-scale European cohorts.British journal of cancer · 2026Article
- Genomic characterization of colorectal tumors: insights into significantly mutated genes, pathways, and survival outcomes.BMC cancer · 2025Article
- Differential expression of ferroptosis markers, circadian regulators, KLOTHO, and classical tumor suppressors in colorectal cancer according to tumor stage: Influence of age, anatomical location, and correlation patterns.Histology and histopathology · 2025Article
- Plasma metabolites, metabolic risk score and colorectal cancer risk: a prospective cohort study.European journal of epidemiology · 2025Article
- Accounting for Endoscopic Screening in Colorectal Cancer Risk Models.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Early-onset colorectal cancer as an emerging disease of metabolic dysregulation.Nature reviews. Endocrinology · 2025Review
- A Practical Guide to Developing and Troubleshooting Patient-Derived "Mini-Gut" Colorectal Organoids for Clinical Research.Methods and protocols · 2025Article
- Black-White disparities across the colorectal cancer care continuum in the USA.Nature reviews. Gastroenterology & hepatology · 2025Review
- Folate metabolism-associated CYP26A1 is a clinico-immune target in colorectal cancer.Genes and immunity · 2025Article
- Differences in the role of Gper1 in colorectal cancer progression depending on sex.Oncology letters · 2025Article
- Association between proteinuria changes and colorectal cancer incidence: evidence from a nationwide cohort study.BMC gastroenterology · 2025Article
27 more citing papers are in PubMed but not listed here.
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Authors and funding
45 authors at 20 institutions in 13 countries.
Funding
Abstract
BACKGROUND &
aimsColorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision.
methodsIn the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests.
resultsAfter a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors.
conclusionsThe relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.