Colon, Gastric, Gallbladder

Colon Cancer

Aspirin, NSAID Reduce Colorectal Cancer: After 6 month continuous treatment resulted in a 50% decrease RR 0.5 although the benefit disappeared after 1 year after off the anti-inflammatories. Would prevent a case per year per 1000 70-79 year-old people. Epidem 2001;12:88, Spain. Ed: With all of the side-effects from aspirin and NSAIDs, I would discourage their use unless really necessary or for victims of heart attacks in a single, small daily dose of aspirin.

Bananas Good: case-control study in Uruguay. Dietary patterns were assessed in detail (for cases before diagnosis or symptoms occurred) 61 food items, which allowed the calculation of total energy intake. Nutrient residuals were calculated through regression analysis. After adjustment for potential confounders (which included body mass index, total energy, and total alcohol intake), a reduction in risk for total vegetable intake, total fruit intake, and lettuce, apple, and banana consumption was observed. The strongest protection was observed for banana intake (odds ratio 0.28) for consumption in the third tertile. Nutr Cancer 1996;25(3):297-304

Bananas Good; Bacon, Butter Bad: Bangkok case control study found factors associated with colon cancer included a history of bowel polyps (OR = 14.69), parent's history of colon cancer (OR = 4.00), anal abscess (OR = 3.78), chronic colitis (OR = 3.61), chronic hemorrhoid (OR = 3.13) and the frequency of stools every three days or more (OR = 2.16). The results also indicated an increased risk for dietary factors; bacon (OR = 12.49) and butter (OR = 2.68). There was a protective effect provided by banana (OR = 0.54) and papaya (OR = 0.58). Asia Pac J Public Health 1995;8(2):118-22

Calcium: Low Intake Linked to Increased Colorectal Cancer Risk: In a 8.5 year follow-up study of 45,354 women from the Breast Cancer Detection Demonstration Project, women in the lowest fifth consumed less than 412.3 mg of calcium from diet each day. Compared to the low-consuming group, women in the four higher groups (412.4-528.9 mg/d; 529.0-656.2 mg/d; 656.3-830.9 mg/d; and greater than 830.9 mg/d) all showed reduced risk of developing colorectal cancer. Women in the highest group of dietary calcium intake, i.e. greater than 830 mg/d, had a 26 percent lower risk of developing colorectal cancer compared to women in the lowest group. Women who consumed more than 412.4 mg/d of calcium from diet and also consumed more than 800 mg/d from supplements had a 46% lower risk of colorectal cancer than women who consumed less than 412 mg/d from diet and less than 800 mg/d from supplements. Cancer Epidemiology, Biomarkers and Prevention, Andrew Flood, University of Minnesota 1/05.

Calcium and Vitamin D No Impact in Huge Study: In a 7-year DB PC study of 36,282 postmenopausal women, 1000 mg of elemental calcium and 400 IU of vitamin D3 had no impact on the number of cases of invasive colon cancer (168 vs. 154 for placebo). Calcium plus vitamin D supplementation and the risk of colorectal cancer. There was a non-significant 12% decrease in hip and 10% decrease in spinal fractures. Wactawski-Wende J, et al. University at Buffalo. . New Eng J Med 2006 Feb 16;354(7):684-96.

Calcium Minor Benefit in DB: In a 4 year 930-patient DB PC study of 60-year-old males treated with 1,200 mg/day of calcium in calcium carbonate, those on calcium had a 31% vs. 38% adenoma recurrence rate. Baron, JA, Beach, M, et al. N Engl J Med. 1999; 340:101-107. Ed: Calcium supplements considerably increase prostate cancer and Parkinson's disease in men.

Calcium & Vitamin D Decrease Colon Cancer: Dietary Calcium and Vitamin D inversely related to colon CA. Supplementary calcium inhibits epithelial cell proliferation and tumor formation. Treating subjects with colonic adenomas with low-fat dairy foods helpful. JAMA 9/23/98

Calcium from Lowfat Milk Products also Help: 70 with colon changes randomized and those getting 1200 mg calcium via lowfat milk products had fewer unfavorable colon changes. Holt, P.R. JAMA ‘98, Sep 30, Vol. 280(12):1074-1079

Cheese, Mammal, Butter Bad; Tomato, Poultry, Peppers, Lettuce Good: Familial colorectal cancer was associated with meal frequency, medical history of diabetes (relative risk, RR = 4.6) and cholelithiasis (RR = 5.2). Significant positive trends of increasing risk with more frequent consumption were observed for pasta (RR = 2.5, for the highest vs the lowest intake tertile), pastries (RR = 2.4), red meat (RR = 2.9), canned meat (RR = 1.9), cheese (RR = 3.5) and butter (RR = 1.9). Significant inverse associations and trends in risk were observed for consumption of poultry (RR = 0.4), tomatoes (RR = 0.2), peppers (RR = 0.3) and lettuce (RR = 0.3). Significant inverse trends in risk with increasing consumption for beta-carotene and ascorbic acid were observed (RR = 0.5 and 0.4), 1584 cases, 2874 controls. Br J Cancer 1997;75(9):1381-4

Cholecystectomy, Gallstone Increase Risk: Increased exposure of the colon lining to bile acids and undigested fat following cholecystectomy raises the risk of colon but not rectal cancer, which is consistent with the bile acid exposure theory. Data from 600,000 adults in the UK General Practice Research Database was analyzed. If 10,000 people who underwent the surgery, were followed for 10 years, 119 would develop colon cancer. By contrast, among subjects who did not undergo cholecystectomy, the number was lower -- 86. Simply having gallstones raised the risk of colon cancer to a similar degree as cholecystectomy, which also supports the bile acid exposure theory. Theresa Shao et al. University of Pennsylvania. Amer J Gastroenterology, August 2005.

Colonoscopy at Age 55 Most Cost-Effective: Colonoscopy every 10 years was less effective than the combination of annual FOBT plus sigmoidoscopy every 5 years. However, a single colonoscopy at age 55 years achieves nearly half of the reduction in CRC mortality obtainable with colonoscopy every 10 years. $22,000/yr of life saved. JAMA 10/2000

CRP Increase a Marker: Thomas P. Erlinger of Johns Hopkins in a 3.5 year prospective, nested case-control study of 22,887 adults with 172 developing colorectal cancer, found blood the highest CRP concentration was found in people who subsequently developed colon cancer (median, 2.69 vs. 1.97 mg/L for matched controls; p < 0.001). Among patients who developed rectal cancer, CRP levels did not differ. Compared with subjects in the lowest quartile of CRP, those in the highest quartile had an odds ratio of colon cancer of 2.55. In nonsmokers, the odds ratio was 3.51. JAMA 2/4/04

Estrogen Helps: Review of 18 studies women on estrogen up to 34% reduction colorectal CA vs women never on estrogen and 20% reduction vs women previously on estrogen. 50,000 American die annually about 50% female. Meir Stampfer, Harvard, North Amer Menopause Society Meeting, Toronto 3/14/99 Reuters Washington.

Exercise Lowers Colon Cancer in Men: As part of a 4-year DB PC study of 930 patients with one or more recently resected colorectal adenoma, researchers found no association between measures of physical activity or BMI and tubular adenomas or hyperplastic polyps. However, among men, there were strong inverse associations between physical activity and advanced neoplastic polyps. Compared with men whose total daily energy expenditure was in the lowest tertile, those in the highest tertile had a risk ratio of 0.35; there was no similar reduction observed among women. The association of physical activity and body mass index with the risk of large bowel polyps. Wallace K, et al. .. Cancer Epidemiol Biomarkers Prev. 2005 Sep;14(9):2082-6.

Fecal Blood Testing Every Two Years Decreases Colorectal 15-20%; Sigmoidoscopy Cost-effective, Not Colonoscopy: Lancet article argues against colonoscopy favored in U.S. Three randomized trials of fecal occult blood testing found them beneficial. Recommends single test at age 60 as most cost-effective. Study of 354,000 asked and 170,000 randomized. Of those tested, 5% were sent on to colonoscopy finding 12% with distal adenomas and 0.3% with distal cancer. Proximal adenomas were found in 1% (19% of those sent for colonoscopy and 0.02% proximal CA. Lancet 4/13/02. 1 perforation in 40,000. Diathermy snare for polyps. Carbon dioxide used for inflation. 3% severe pain.

Fecal Office Test Little Value; Home Test Better: In a study of 2,665 adults comparing the results of six-time at-home fecal occult blood sample testing vs. testing of a in-office sample found that in the office-testing detected only 5% of the tumors or precancerous polyps while the at-home testing detected 24%. Of patients who already had cancer, the at-home testing detected 43%. David Lieberman, Portland OR VA. Annal Int Med 1/18/05.

Fiber Not Help Preventing Colon Cancer: A 16 year follow-up of 89,000 nurses in a Harvard study found no evidence of benefit from higher fiber in diets in preventing colon cancer. Other research shows that fiber helps the heart and cancers of the stomach, esophagus, mouth, larynx, and pharynx. Sugar, total calories, and animal fats have been reported to increase colon CA. NEJM 1/21/99 & Chic Trib 1/21/99. Giovannucci, EL, et al. N Engl J Med. 1999; 340:169-176

Fiber and Fish Good; Mammal and Processed Meat Bad: The prospective EPIC cohort study in 23 centres from 10 European countries of 521,468 men and women ages 39-69 years with 24,185 developing cancer, one of the most important results is a protective effect of high fiber intake and fish consumption against colorectal cancer, while high red and processed meat intake increase the risk. Regarding lung cancer the first analyses found a protective effect of fruit intake but no association with vegetable consumption. No association was observed between vegetables and fruit intake and the risk of prostate cancer or breast cancer. According to the food diary a daily intake of 35 g of saturated fats doubles the risk of breast cancer compared to women with daily intake of 10 g or less. The European Prospective Investigation into Cancer and Nutrition (EPIC). Gonzalez CA. Institut Catala d'Oncologia (ICO), Barcelona, Spain. . Publ Health Nutr 2006 Feb;9(1A):124-6.

Fiber Helps Cut Colon CA in Largest Study: European study, half million people in 10 countries for an average of 4 1/2 years. 35 grams of daily fiber intake had a 25 percent lower risk of colorectal cancer, primarily colon cancer, compared with 15 grams. not statistically relevant for rectal cancer. more detailed dietary data for about 32,000 people in the European study showed that those who consumed 35 grams of fiber daily had a 40% lower vs. 15 grams daily, according to the study. Lancet 5/3/03

Fiber Helps in US Study, Too: U.S. study focused on 37,600 people, about 3,600 of whom had non-malignant polyps. Those who ate the most fiber, an average of 36.4 grams a day, had a 27 percent lower risk of the polyps than those who ate the least fiber, averaging 12.6 grams a day. Americans average about 16 grams of fiber a day. Lancet 5/3/03

Cakes, Sugar, Desserts, Refined Pasta & Bread Bad, Fruit & Veg Good: Italian study 1953 cases with 4100 controls found olive oil little impact on colon CA. Eur J Cancer Prev 1999 Dec;8 Suppl 1:S49-52

Fish, Fruit Good, Refined Grains & Sugar Bad for Colon CA: increasing risk of colorectal cancer with increasing intake emerged for bread and cereal dishes (odds ratio [OR] in highest vs. lowest quintile = 1.7), potatoes (OR = 1.2), cakes and desserts (OR = 1.1), and refined sugar (OR = 1.4). Intakes of fish (OR = 0.7), raw and cooked vegetables (OR = 0.6 for both) and fruit other than citrus fruit (OR = 0.7) showed a negative association. Int J Cancer 1997 Jul 3;72(1):56-61

Fish Decreased Colon Cancer: Italian study of 1125 colon cancer, 728 rectal cancer, and 4154 hospital controls asked about 79 food items. Bread and cereals (RR 1.11), but not wholemeal bread (RR .88) slightly increased colon cancer as did refined sugar (RR 1.11). Fish (RR .53), raw and cooked vegetables (RR .79 & .65), and fruits (RR .93) were associated with an inverse risk. Franceschi S, Eur J Cancer Prev 1998 May; 7 Suppl 2:S19-23.

Fish Oil Inhibits Colon Cancer: Rat given corn oil incr expression of farnesyl protein transferase which catalyses ras precursors during modification of ras oncoproteins enabling their anchorage to plasma membr. High fish oil reduces FPTase expression. Corn oil causes colon tumors and fish oil decr. Carcinogenesis 1998 Jun;19(6):985-9. Singh J, Amer Health Foundation. Study with rats also found fish oil to have inhib effect on colon CA. Paulson JE, Norway, Pharm Tox 1998 Jan;82:28-33

Fish Oil Not Incr Colon CA: Mice given human colon tumour growth cells incr with coconut oil, olive oil, safflower oil diets but not with fish oil vs. low faat control. Calder PC, Clin Sci (Colch) 1998 Mar; 94(3):303-11, U Southampton. Same finding with Korean study in Nutr Cancer 1998;30(2):118-23 by Kim DY with incr from high corn oil and lowest with fish oil and butter and beef tallow intermediate.

Fish Oil Increased Rat Colon CA: High fish oil and somewhat less with high safflower oil increased the number of liver metastasis of colon cancer cells injected into rats vs. a low fat diet. Griffini P, Univ. Amsterdam, Cancer Res 1998 Aug 1;58(15):3312-9.

Folic Acid Helps: 400 micrograms per day better tho optimal dose not determined. Dr. Joel Mason, Tufts University "We have 20 large epidemiologic studies, which included tens of thousands of people, that tell us this. But epidemiologic studies can only establish an association, not a cause-and-effect relationship. HealthScout Reporter 10/27/00. Nurses Health f/u study of 88,000 found folic supplement of 400/day erased negative effects of family history of colon CA. 3/14/02 Reuters

Magnesium Intake May Protect Against Colon and Rectal Cancers: Using data from the 14.8-year follow-up Swedish Mammography Cohort, a population-based prospective study of 61,433 women ages 40 to 75 and the 805 colorectal cancer cases diagnosed, there was a strong inverse association of magnesium intake with the risk of colorectal cancer (P= .006). Compared with women in the lowest fifth of magnesium intake, the multivariate rate ratio (RR) was 0.59 for those in the highest fifth or 41% lower. This was true for both colon (RR, 0.66) and rectal cancer (RR, 0.45). Magnesium intake in relation to risk of colorectal cancer in women. Larsson SC, Bergkvist L, Wolk A. Karolinska Institutet, Stockholm, Sweden. JAMA. 2005 Jan 5;293(1):86-9

Meat: Beef, Pork, Chicken Livers, Processed Meat Cause Colon Cancer: In a cohort of 148,610 adults ages 50-74 and followed for nine years as part of the Cancer Prevention Study II Nutrition Cohort, 1667 developed colorectal cancers. Being in the upper third in long-term consumption of beef and pork, including chicken livers and processed meats was associated with a 50% increased risk of distal colon cancer and a 71% increase in the risk of rectal cancer. Long-term consumption of poultry and fish was associated with 13% reduced risk of both proximal and distal colon cancer. Meat Consumption and Risk of Colorectal Cancer. Ann Chao, PhD; Michael J. Thun, et al. JAMA. 2005;293:172-182.

Meat: Red or White Increase; Peas, Nuts, & Beans Decrease Colon Cancer: Chicken & fish no better but peas and beans decreased (>BIW=RR .53) colon CA in prospective 6 yr study 32,051 7^th Day Adventists. QWk red meat increased colon ca 38% (RR 1.85), Qwk white meat incr 55% (RR 1.90). QIW meat incr 200%. Increased BMI>25.6 RR 2.63 vs. BMI<22.5. Aspirin over Qwk RR .83. Lower risk for women who have had at least one child RR .72. Nuts at least Qwk RR .67. Pramil Singh, Loma Linda, Am J Epid 10/98 148:761-74. Less than 20% variation in colon ca due to heredity. Antiox vitamins, Calcium, Vit D often found protective. Cruciferous, fruits and legumes reported beneficial. Physical activity, obesity, aspirin use (inverse effect?), cigs may contribute. Nurses’ Study found same with beef, pork, or lamb as a main dish every day was 2.49 (1.24 to 5.03) compared with women reporting consumption less than once a month. physical activity was associated inversely with the risk of large adenomas (= " src="/math/12pt/normal/ges.gif"1 cm) in the distal colon (relative risk 0.57 ). Of 19 published studies of hormonal replacement therapy and risk of colorectal cancer, 10 support an inverse association and a further five show a significant reduction in risk. The risk seems lowest among long term users.

Meat Bad, Esp Processed Meat; Fiber, Veg, Fruit Good: prospective study of 522 000 people in 10 European countries found a "modest" association between cancers of the bowel and stomach and a daily intake of more than 60 g of processed meat. Elio Riboli, WHO, 25 g of fibre a day were 40% less likely to develop bowel cancer than those eating less than 10 g a day. more than 250 g of fruit and vegetables daily had a modest reduction in digestive tract cancers. Prospective study of 38 917 people in Melbourne show that those who ate red meat or pork, or both, more than 10 times a week were 1.8 times more likely to develop bowel cancer during the first 10 years of follow up. Those who ate processed meat more than five times a week were 1.5 times more likely to develop bowel cancer than those eating it no more than once a week. Dallas English, Cancer Council Victoria. BMJ 6/28/02

Meat, Smoking, Heavy Beer, Sedentary Work Factors: Prospective study 20yr 35+yo white men found smoking RR 2.6, heavy beer (14/mo) RR 1.9, Meat (over 2/d) RR 1.8, white collar RR 1.7, craft trade in service and trade RR 2.6. Hsing, Int J Cancer 8/98;77:549

Olive Oil Lowers: An Oxford University study of 28 countries food statistics found olive oil consumption associated with lowest risk of colon CA. Red meat seven times per week increased cancer rates by 50%. J Epid Comm Health 2000;54:756-60

Pastries & Partially Hydrog Oils Incr: Partially hydrogenated vegetable oils were divided into four groups: sweetened baked goods, chocolate candy, oils and condiments, and french fries and chips. We observed no evidence of increased adenoma prevalence associated with consumption of fries and chips (200 vs 0 kcals/day: odds ratio (OR) = 0.70; 95% confidence limits (CL) = 0.27, 1.8) or chocolate candy (50 vs 0 kcals/day: OR = 0.49; 95% CL = 0.23, 1.1). We did, however, find evidence of increased adenoma prevalence associated with consumption of sweetened baked goods (400 vs < 100 kcals/day: OR = 1.9; 95% CL = 0.95, 3.8) and oils and condiments (200 vs < 100 kcals/day: OR = 2.4. Epidemiology 2000 Jul;11(4):469-73

Refined Grains, Butter, Pates, Pastries Increase: Burgundy France case control study odds ratios for the fourth vs. first quartile of intake (OR4) were 2.0 (1.1-3.6) for refined cereal products (rice, pasta and pastry), 2.4 (1.3-4.5) for delicatessen, 2.3 (1.2-4.2) for pates, 1.7 (1.1-2.8) for offal and 2.1 (1.1-4.0) for butter, lard and cream. There was no association with consumption of fresh meat (OR4 = 1.2), fish (OR4 = 1.5), egg (OR4 = 1.1) or dairy products (OR4 = 1.0). A protective effect of vegetables was only observed for left colon cancer (OR3 = 0.3; 0.1-0.6). The strong association with refined cereal products is consistent with the hypothesis of a role of hyperinsulinism in colorectal carcinogenesis. The association with processed but not fresh meat suggests the importance of exogenous carcinogenesis in that area. Eur J Cancer Prev 1999 Jul;8(3):229-35

Vegetables No Difference in Large Prospective Study: Intakes of beta-carotene, alpha-carotene, lycopene, lutein, and beta-cryptoxanthin and colorectal cancer risk in a large cohort study of Canadian 56,837 women in Canadian National Breast Screening Study. During follow-up, a total of 388 women developed colorectal cancer. A subcohort of 5,681 women was randomly selected. Analyses were based on 295 cases and 5,334 noncases. No clear association between intake of any of the studied carotenoids and colorectal cancer risk in the study population as a whole or in subgroups defined by smoking status, relative body weight (body mass index), intakes of total fat, energy, alcohol, and folic acid, or menopausal status. Dietary carotenoid intake and colorectal cancer risk. Terry P, Jain M, Miller AB, Howe GR, Rohan TE. Nutr Cancer 2002;42(2):167-72

Vegetarian Only Slight Advantage: In a cohort of 10 998 men and women, 95 incident cases of colorectal cancer were recorded after 17 years. Risk increased in association with smoking, alcohol, and white bread consumption, and decreased with frequent consumption of fruit. The relative risk in vegetarians compared with nonvegetarians was 0.85. Univ Oxford. Br J Cancer. 2004 Jan 12;90(1):118-21

Vitamin D Receptor Stops Bad Bile: Lithocholic acid breaks DNA strands. High doses cause animal colon cancer. Vitamin D receptor activated by lithocholic acid in colon turns on genes to make detoxifying enzyme CYP 3A4 destroying lithocholic acid. Science 5/17/02

Yogurt, Green Leafy Vegetables Lower Colorectal Cancer Risk: In a 9.9 year prospective study of 45,181 men and 62,643 women ages 40-79 in the Japan Collaborative Cohort Study. Between 1988 and 1990, 457 died of colon or rectal cancer. Eating green leafy vegetables was linked to a 40% decreased risk (HR = 0.6; p = 0.02]. Yogurt was linked to a 50% decrease in male rectal cancer mortality (HR = 0.5; p = 0.04). Egg consumption was associated with an increase male colon cancer mortality (P = 0.04). Women with high fruit consumption had increased colon cancer mortality (HR = 1.6; p = 0.04). Diet and colorectal cancer mortality: results from the Japan Collaborative Cohort Study. Kojima M, Wakai K, Nagoya City University Graduate School of Medical Sciences, Mizuho, Nagoya, Japan. Nutr Cancer. 2004;50(1):23-32.

Zinc Good, Heme Iron Bad: In a 15-year follow-up of 34,708 Iowa women ages 55-70, the risk of proximal colon cancer more than doubled across increasing categories of heme iron intake (meat), but risks for both proximal and distal colon cancer fell by more than 50% across categories on zinc intake. Heme iron, zinc, alcohol consumption, and colon cancer: Iowa Women's Health Study. Lee DH, Anderson KE, Harnack LJ, Folsom AR, Jacobs DR Jr. J Natl Cancer Inst. 2004 Mar 3;96(5):403-7.

Endometrial Cancer

Vitamin D and Calcium Lower Risk: In a case-control study of 85 cases of endometrial cancer and 629 controls, there was no association between EC risk and consumption of animal or vegetable proteins, saturated, monounsaturated, or polyunsaturated fat, although high intake of lactose (odds ratio [OR], 0.46, P = 0.004), vitamin D (OR, 0.38, P= 0.003), and calcium (OR, 0.39, P= 0.02) were inversely associated with EC. Dietary vitamin D and calcium may play an important role in the development of EC. Dietary factors and endometrial cancer risk. Results of a case-control study in Mexico. Salazar-Martinez E, et al. National Institute of Public Health, Cuernavaca, Mexico. Int J Gynecol Cancer. 2005 Sep-Oct;15(5):938-45.