Colorectal Cancer Risk Assessment; Awareness, Mediterranean Diet, and Early Detection

Year 2022, , 286 - 295, 27.01.2022

Özge Bayrak , Mehmet Emin Arayıcı , Nurçin Kayacık Selin İşidoğru Setenay Yeşil Hülya Ellidokuz , Ender Berat Ellidokuz

https://doi.org/10.30621/jbachs.1040841

Abstract

Objective: Colorectal cancer (CRC).is the second and third most common diagnosed cancer in women and men in worldwide, respectively. Nutrition, one of the modifiable risk factors, especially Mediterranean diet (MD) model, is an important place in the prevention of CRC. The aim of this study is to determine the frequency of risk factors in patients without CRC and to evaluate the relationship.between CRC risk factors and having knowledge about nutrition compatible with the MD, and early detection methods.
Meterials and Methods: In this study, the relationship between.MD and CRC risk was evaluated using CRC risk factors. A online survey consisting of 47 questions was prepared to collect the study data. Nutritional habits were evaluated using the “Mediterranean Diet Adherence Scale”. Statistical analyses was performed that calculating all scores of CRC risk, MD compatibility, knowledge level about CRC and the attitude towards early diagnosis methods. In data analysis, descriptive statistics, Chi-Square Test, Fisher Exact Test, Student’s t-test and Mann-Whitney U Test were used. The statistical significance was evaluated as p<.05.
Results: A total of 387 participant, 66.4% (n=257) female and 33.6% (n=130) male, were included.in this study. Mean age of research group was determined as 38±13 years. 85.8% of the research group had no family history of CRC. Mean score of Mediterranean Diet Adherence Scale of participants was calculated as 7.31±1.9. The knowledge level score mean about CRC was found to be 10.4+2.3. It was found that 71.8% of participants who have high knowledge level, display nutrition behaviour compatible with MD. 64.3% of participant those who are compatible with the MD want to have a stool occult blood test. The rate of having a stool occult blood test is significantly higher in those who have MD compared to those who do not (p=.004).
Conclusion: In this study, which was conducted to examine the CRC knowledge level, which is thought to be important about the risk and development of CRC, and the compatibility of the MD, there is a important relationship between the level of knowledge and the type of nutrition, but these data are not related to the risk of CRC. Further research in this area is recommended.

Keywords

colorectal cancer, mediterranean diet, nutrition, risk factors

References

• Globocan 2020, International Agency for Research on Cancer 2021, Estimated age-standardized incidence and mortality rates (World) in 2020 worlwide, both sexes, all age.
• Globocan 2020, International Agency for Research on Cancer 2021, Estimated number of new cases and deaths from 2020 to 2040 both sexes, age.
• Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014 Apr 26;383(9927):1490-1502. doi: 10.1016/S0140-6736(13)61649-9.
• R Siegel, C De Santis, K Virgo, et al. Cancer treatment and survivorship statistics, 2012 CA Cancer J Clin, 62 (2012), pp. 220-241
• B.W. Stewart, P. Kleihus (Eds.), World cancer report, IARC Press, Lyon (2003).
• Whitlock EP, Lin JS, Liles E, et al. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2008; 149:638–658.
• Simon K. (2016). Colorectal cancer development and advances in screening. Clinical interventions in aging, 11, 967–976. https://doi.org/10.2147/CIA.S109285
• Labianca, R., Beretta, G. D., Kildani, B., Milesi, L., Merlin, F., Mosconi, S., Wils, J. (2010). Colon cancer. Critical Reviews in Oncology/Hematology, 74(2), 106–133. doi:10.1016 j.critrevonc.2010.01.010.
• Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr (1995) 61:1402s–6s.
• da Silva R, Bach-Faig A, Raido Quintana B, Buckland G, Vaz de Almeida MD, Serra-Majem L. Worldwide variation of adherence to the Mediterranean diet, in 1961–1965 and 2000–2003. Public Health Nutr (2009) 12:1676–84.10.1017/S1368980009990541
• Simopoulos AP. The Mediterranean diets: what is so special about the diet of Greece? The scientific evidence. J Nutr (2001) 131:3065s–73s.
• Kastorini CM, Panagiotakos DB, Chrysohoou C, Georgousopoulou E, Pitaraki E, Puddu PE, et al. Metabolic syndrome, adherence to the Mediterranean diet and 10-year cardiovascular disease incidence: the ATTICA study. Atherosclerosis (2016) 246:87–93.10.1016/j.atherosclerosis.2015.12.025
• Yusof AS, Isa ZM, Shah SA. Dietary patterns and risk of colorectal cancer: a systematic review of cohort studies (2000–2011). Asian Pac J Cancer Prev (2012) 13:4713–7.10.7314/APJCP.2012.13.9.4713
• Özkan Pehlivanoğlu, E , Balcıoğlu, H , Ünlüoğlu, İ . (2020). Akdeniz Diyeti Bağlılık Ölçeği’nin Türkçe’ye Uyarlanması Geçerlilik ve Güvenilirliği . Osmangazi Tıp Dergisi , 42 (2) , 160-164 . DOI: 10.20515/otd.504188.
• https://decisionsupport1.shinyapps.io/CancerRiskAssessment/
• Lewandowski M, Lipiński P, Bednarski I, Mik M, Dziki A. Knowledge and Awareness of Colorectal Cancer. Pol Przegl Chir. 2020 Feb 12;92(2):34-41. doi: 10.5604/01.3001.0013.8160.
• Schulpen, M., & van den Brandt, P. A. (2020). Mediterranean diet adherence and risk of colorectal cancer: the prospective Netherlands Cohort Study. European journal of epidemiology, 35(1), 25–35. https://doi.org/10.1007/s10654-019-00549-8
• Mentella, M. C., Scaldaferri, F., Ricci, C., Gasbarrini, A., & Miggiano, G. (2019). Cancer and Mediterranean Diet: A Review. Nutrients, 11(9), 2059. https://doi.org/10.3390/nu11092059
• Seer.cancer.gov/Rate of New Cases per 100,000 Persons by Race/Ethnicity & Sex: Colorectal Cancer
• Bamia, C., Lagiou, P., Buckland, G., Grioni, S., Agnoli, C., Taylor, A. J., ... & Trichopoulou, A. (2013). Mediterranean diet and colorectal cancer risk: results from a European cohort. European journal of epidemiology, 28(4), 317-328.
• Park Y, Spiegelman D, Hunter DJ, et al. Intakesof vitamins A, C, and E and use of multiple vita-min supplements and risk of colon cancer: apooled analysis of prospective cohort studies.Cancer Causes Control2010;21:1745-57.
• Heine‐Bröring, R. C., Winkels, R. M., Renkema, J. M., Kragt, L., van Orten‐Luiten, A. C. B., Tigchelaar, E. F., ... & Kampman, E. (2015). Dietary supplement use and colorectal cancer risk: a systematic review and meta‐analyses of prospective cohort studies. International Journal of Cancer, 136(10), 2388-2401.
• Reedy J, Mitrou PN, Krebs-Smith SM, et al. Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol. 2008;168(1):38–48.
• Fung TT, Hu FB, Wu K, et al. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr. 2010;92(6):1429–35.
• Dixon LB, Subar AF, Peters U, et al. Adherence to the USDA Food Guide, DASH Eating Plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma. J Nutr. 2007;137(11):2443–50
• Norat T, Bingham S, Ferrari P, et al. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into Cancer and nutrition. J Natl Cancer Inst. 2005;97(12):906–16.
• Ferrari P, Jenab M, Norat T, et al. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and nutrition (EPIC). Int J Cancer. 2007;121(9):2065–72
• World Cancer Research Fund/American Institute for Cancer Research. Continuous update project interim report summary. Food, nutrition, physical activity, and the prevention of colorectal cancer; 2011. http://www.wcrf.org/PDFs/Colorectalcancerreportsummary 2011.pdf. Accessed 28 May 2012.
• Pauwels EK. The protective effect of the Mediterranean diet: focus on cancer and cardiovascular risk. Med Prince Pract. 2011;20(2):103–11.
• Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82(1):163–73.