Colon cancer in rapidly developing countries: review of the lifestyle, dietary, consanguinity and hereditary risk factor
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REVIEW
Colon cancer in rapidly developing countries: review of the lifestyle, dietary, consanguinity and hereditary risk factors Abdulbari Bener
Received: 29 October 2009 / Accepted: 5 August 2010 / Published online: 17 August 2010 Ó Springer-Verlag 2010
Abstract Colon cancer rates are rising dramatically in once low incidence nations. These nations are undergoing rapid economic development and are known as ‘‘nations in transition’’ (NIT). This review identifies some of the most common etiological risk factors of colon cancer in these nations and evaluates the existing epidemiological evidence. The main risk factors which were found to be prevalent in NIT include: lifestyle factors such as physical inactivity, obesity and abdominal adiposity, alcohol consumption and cigarette smoking; dietary factors such as fatty food and red meat consumption. Protective factors included white meat and fiber consumption. Several studies found to have significantly higher rates of colon cancer among the young population (\40 years old). There appears to be a quantitative and qualitative increase in risk to relatives of patients diagnosed at a young age compared with those diagnosed later in life, at least part of which is likely to be the result of a hereditary susceptibility. Close relatives of patients with colon cancer are at an increased risk of developing a colon cancer. Close relatives of early onset cases warrant more intensive endoscopic screening and at an earlier age than relatives of patients diagnosed at
A. Bener (&) Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, PO Box 3050, Doha, Qatar e-mail: [email protected]; [email protected] A. Bener Department of Public Health, Weill Cornell Medical College, PO Box 3050, Doha, Qatar A. Bener Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK
older ages. Furthermore, these suggest the existence of genetic predispositions in these nations which need to be investigated further and have implications for screening programs. In conclusion, public health awareness campaigns promoting prevention of modifiable risk factors and screening initiatives with guidelines suited to the age-specific incidence rates of NIT are needed very urgently. Keywords Epidemiology Colon cancer Life-style Dietary Consanguinity Hereditary
Background Colon cancer is strongly correlated with various environmental and genetic factors, which make primary prevention fundamental to public health initiatives [1]. While high colon cancer incidence rates were mainly found in developed nations, these are now increasing dramatically in rapidly developing nations [2] (Fig. 1). These rapidly developing countries are known as ‘‘nations in transition’’ (NIT). Although other reviews have noted these trends and documented the various screening programs around the globe [3], none have specifically looked at the common etiological factors in these nations, which are contributing to these r
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