Alcohol intake and colorectal cancer: a comparison of approaches for including repeated measures of alcohol consumption.
ABSTRACT In numerous studies, alcohol intake has been found to be positively associated with colorectal cancer risk. However, the majority of studies included only one exposure measurement, which may bias the results if long-term intake is relevant.
We compared different approaches for including repeated measures of alcohol intake among 47,432 US men enrolled in the Health Professionals Follow-up Study. Questionnaires including questions on alcohol intake had been completed in 1986, 1990, 1994, and 1998. The outcome was incident colorectal cancer during follow-up from 1986 to 2002.
During follow-up, 868 members of the cohort experienced colorectal cancer. Baseline, updated, and cumulative average alcohol intakes were positively associated with colorectal cancer, with only minor differences among the approaches. These results support moderately increased risk for intake >30 g/d and weaker increased risk for lower intake. The hazard ratio for baseline alcohol intake was 1.07 (95% confidence interval = 1.02-1.11) per 10 g/d increase, which was similar for updated and cumulative average alcohol intake. Consistent moderate and high alcohol intake showed increased risk, and the relative risk decreased slightly with longer latency time. Alcohol frequency was positively associated with cancer risk among men with alcohol intake above 15 g/d.
Alcohol intake was positively associated with colorectal cancer, with minor differences among analytic approaches (which may be attributable to low intraindividual variation during follow-up).
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Chapter: Removal of Difficult Colon Polyps[Show abstract] [Hide abstract]
ABSTRACT: Difficult colon polyps are not necessarily large, such as those over 2 cm in diameter, but may be relatively small but flat, or may be in a difficult or inaccessible area of the colon. These polyps include lesions that require special maneuvers for their removal. KeywordsSessile adenoma-Flat adenoma-Chromoendoscopy-Non-lifting sign04/2011: pages 151-176;
Chapter: Noninvasive Screening Tests[Show abstract] [Hide abstract]
ABSTRACT: During the past 2 decades, colorectal cancer (CRC) incidence and mortality rates in the United States have declined in part due to screening. The most recent Behavioral Risk Factor Surveillance System (BRFSS) survey data posted on the CDC website indicate that, in 2008, 52% of adults aged 50 years or older had a fecal occult blood test (FOBT) within the previous year or a lower endoscopy (sigmoidoscopy or colonoscopy) within the previous 5 years . In fact, the majority had either a sigmoidoscopy or colonoscopy (42.3% of respondents), while just 15.3% were screened with a stool test . In 2006, 60.8% of respondents to the same survey reported having had an FOBT within the year preceding the survey or a lower endoscopy within the preceding 10 years, an increase from 56.8% in 2004, 53.9% in 2002, and 53.1% in 2001 [2, 3]. These surveys show that while lower endoscopy screening has increased (43.4% in 2001, 44.8% in 2002, 50.1% in 2004, and 55.7% in 2006), FOBT screening has declined (23.5% in 2001, 21.6% in 2002, 18.5% in 2004, and 16.2% in 2006) [2, 3]. The 2000 National Health Interview Survey (NHIS) found that 49.7% of adults ≥50 years never had CRC testing; only 37.1% were current for their CRC screening . In 2003, the NHIS survey reported higher rates of colonoscopy screening (32.2% in men and 29.8% in women) than FOBT screening (16.1% in men and 15.3% in women) or sigmoidoscopy screening (7.6% in men and 5.9% in women) . In general, self-reported CRC screening rates from all national surveys, which are probably overestimates of actual screening, have increased from less than 25% in the late 1980s to about 60% in 2006, mainly due to increased use of screening colonoscopy . KeywordsFecal occult blood test-Immunochemical-Fecal DNA04/2011: pages 123-150;
Article: Alcohol and hypertension: a review[Show abstract] [Hide abstract]
ABSTRACT: In recent decades alcohol use has joined other correlates of hypertension (HTN), such as obesity and salt intake, as a major research focus about HTN risk factors. In cross-sectional and prospective epidemiologic studies, higher blood pressure (BP) has consistently been found among persons reporting usual daily intake of three standard-sized drinks or more. Although definitive mechanisms have not been established, several aspects of the data, including short and intermediate term experiments, suggest a causal relationship. Heavier drinking may, in fact, be the commonest cause of reversible HTN, and reduction of heavy alcohol intake plays an important public health role in HTN management. Additional to the mechanism, unresolved issues about the alcohol-BP relationship include whether there is a threshold dosage of alcohol for association with HTN, the sequelae of alcohol-associated HTN and the roles of interactions with gender, ethnicity, other lifestyle traits, drinking pattern, and choice of beverage. This article reviews these areas and includes new data about the beverage choice aspect.Journal of the American Society of Hypertension 09/2008; 2(5):307-17. DOI:10.1016/j.jash.2008.03.010 · 2.68 Impact Factor