Colorectal cancer a major public health problem
Article by: Zakir Hussain Mirzaie, MPH (Pune University, India). BPH (Kabul Medical University, Afghanistan)
World widely, colorectal cancer (CRC) is the third most common cancer in both sexes (1380602 cases, 9.7% of the total). In men, it is the third most common cancer after lung and prostate cancer (10.1% of the total) and the fourth leading cause of death among all cancer. In women, it is the 2nd most common cancer following breast cancer (9.2% cases of the total) and the third leading cause of death among all cancer. In Asia, it is the fourth most common cancer and the fourth leading cause of death due to cancer. Incidence of this cancer is decreasing in developed countries while it is increasing in developing countries adopting western lifestyle and dietary habits.
Studies of single food items or groups in relation to CRC may not be valid because they assume that every single food or nutrient has an isolated effect. The dietary pattern approach, which has been increasingly used in nutritional epidemiology, could capture and assess the overall dietary experience through considering simultaneous effects of dietary exposures potentially interacting with each other. This study can help to know the association between Indian dietary pattern and colon cancer.
Colon cancer is cancer that occurs in the colon or rectum. It is also called colorectal cancer. The risk of developing colon cancer increase with age and mostly occur in people age 50 or more.
In India, colorectal cancer was the fourth most common cancer in men and it was the cause of 7.8 % of total mortality of all cancers. In women, it was the third most frequent cancer and it was the cause of 6.4% of all death due to cancer. In both sexes, it was the fifth most frequent cancer and cause of 7.1% of all death due to cancer. Time trend population-based surveys carried out over the years in India, show an increasing trend in the incidence of colon cancer. The incidence rate for rectal cancer is higher than colon cancer throughout India, especially in the rural parts of India. The Kashmir valley has often been reported as a high incidence area for cancers of the gastrointestinal tract. The age-standardized incidence rate of 4.52 per 100,000 of the population and the age-specific rate for colorectal cancer to be highest in the age group 55–59 years (17.21/100,000), followed by 65–69 years (14.86/100,000).
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Modifiable risk factors for colorectal cancer include such as smoking, alcohol consumption, body fatness, dietary fat and meat as a risk for developing colon cancer. Increased BMI, red meat intake, low physical activity, cigarette smoking, low fruit consumption, and low vegetable consumption were associated with moderately increased risk of colon cancer. Among Asian populations, processed meats, red meats, preserved foods, saturated/animal fats, cholesterol, high sugar foods, spicy foods, tubers or refined carbohydrates as risk factors for developing colon cancer.
Dietary factors are the most important sources of modifiable risk for colon cancer. Among dietary factors that known to influence the risk are such as red meat, particularly processed meat, consumption is associated with increased risk. There are lower odds of disease related to plant-based compared to meat-based dietary patterns. Meat-diet/Sugary-diet patterns increased and Plant-based diet pattern decreased the risk of colon cancer.
There are several factors associated with decreased risk of colon cancer such as physical activity, hormone therapy in postmenopausal women, aspirin/NSAID use, fruit consumption, and vegetable consumption. High level of physical activity is consistently has been recognized as being associated with reduced risk of colon cancer. A Mediterranean diet (i.e. a diet which contains vegetables, fruits, poultry, and fish) significantly improve the quality of life as well as the prognosis of patients suffering from colon cancer. Consumption of milk, whole grains, vegetable, and fish will reduce the risk of colon cancer. Vegetarian dietary pattern is associated with a lower incidence of colon cancer. High consumption of dietary legumes and soya bean will decrease the risk of colon cancer.
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