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Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: closed (30 May 2023) | Viewed by 24857

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Special Issue Editors

Prof. Dr. Edoardo G. Giannini

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Guest Editor

Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, 16100 Genoa, Italy
Interests: hepatocellular carcinoma; liver disease; portal hypertension; platelets; liver function

Dr. Elisa Marabotto

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Guest Editor

Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Interests: functional gastrointestinal disorders; eosinophilic esophagitis; gastroesophageal reflux disease; neurogastroenterology; gastrointestinal motility disorders; liver disease; inflammatory bowel diseases

Dr. Stefano Kayali

E-Mail Website
Guest Editor

Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Interests: liver disease; inflammatory bowel diseases; gastrointestinal endoscopy; functional gastrointestinal disorders; colorectal cancer

Special Issue Information

Dear Colleagues,

Gastrointestinal tract cancers are responsible for over one-quarter of the cancer incidence (26%) and over one-third (35%) of all cancer-related deaths globally.

Malignancies of the digestive system, mainly represented by cancers of the esophagus, stomach, liver, pancreas and colorectum, share some risk factors but are each peculiar and distinct in their epidemiology and etiologic profiles. Several cancer-predisposing chronic conditions are often the basis for the development of the abovementioned neoplasia. This notwithstanding, most of them are caused by modifiable risk factors such as smoking, diet, lifestyle, alcohol consumption and infections.

The changing prevalence of these risk factors is responsible for gastrointestinal tract and liver neoplasia incidence variations, both in the present and in the future. The global number of new cases and mortality from gastrointestinal malignancies is predicted to increase by 58% and 73% to 7.5 million and 5.6 million, respectively, in the next 20 years. Therefore, the issue of patient-tailored risk assessment and prevention represents the main challenge of the coming years.

We are pleased to invite you to contribute to the advancement of knowledge in the field of gastrointestinal cancers epidemiology, risk and prevention.

This Special Issue aims to focus on the more recent developments in risk assessment and prevention modalities for gastrointestinal and liver cancers, including patients affected by predisposing conditions, dietary and lifestyle modifications and cancer risk, preventive medications, risk-reducing procedures in selected high-risk patients, and new techniques for diagnosis and screening.

In this Special Issue, reviews are welcome.

We look forward to receiving your contributions.

Prof. Dr. Edoardo G. Giannini
Dr. Elisa Marabotto
Dr. Stefano Kayali
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

hepatocellular carcinoma
cholangiocarcinoma
pancreatic cancer
colorectal cancer
gastric cancer
esophageal cancer
epidemiology
prevention
chemoprevention
surveillance
endoscopic surveillance
predisposing condition

Published Papers (13 papers)

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Editorial

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3 pages, 197 KiB

Open AccessEditorial

Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention

by Stefano Kayali, Elisa Marabotto and Edoardo Giannini

Cancers 2023, 15(18), 4634; https://doi.org/10.3390/cancers15184634 - 19 Sep 2023

Cited by 1 | Viewed by 668

Abstract

Gastrointestinal tract cancers, including oral, oesophageal, stomach, liver, pancreas, and colorectal cancers, represent a significant worldwide health concern [...] Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

Research

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12 pages, 3425 KiB

Open AccessArticle

Can High-Frequency Intraoral Ultrasound Predict Histological Risk Factors in Oral Squamous Cell Carcinoma? A Preliminary Experience

by Simone Caprioli, Giorgio-Gregory Giordano, Alessia Pennacchi, Valentina Campagnari, Andrea Iandelli, Giampiero Parrinello, Cristina Conforti, Riccardo Gili, Edoardo Giannini, Elisa Marabotto, Stefano Kayali, Bernardo Bianchi, Giorgio Peretti, Giuseppe Cittadini and Filippo Marchi

Cancers 2023, 15(17), 4413; https://doi.org/10.3390/cancers15174413 - 4 Sep 2023

Cited by 2 | Viewed by 981

Abstract

Despite advancements in multidisciplinary care, oncologic outcomes of oral cavity squamous cell carcinoma (OSCC) have not substantially improved: still, one-third of patients affected by stage I and II can develop locoregional recurrences. Imaging plays a pivotal role in preoperative staging of OSCC, providing depth of invasion (DOI) measurements. However, locoregional recurrences have a strong association with adverse histopathological factors not included in the staging system, and any imaging features linked to them have been lacking. In this study, the possibility to predict histological risk factors in OSCC with high-frequency intraoral ultrasonography (IOUS) was evaluated. Thirty-four patients were enrolled. The agreement between ultrasonographic and pathological DOI was evaluated, and ultrasonographic margins’ appearance was compared to the Brandwein-Gensler score and the worst pattern of invasion (WPOI). Excellent agreement between ultrasonographic and pathological DOI was found (mean difference: 0.2 mm). A significant relationship was found between ultrasonographic morphology of the front of infiltration and both Brandwein-Gensler score ≥ 3 (p < 0.0001) and WPOI ≥4 (p = 0.0001). Sensitivity, specificity, positive predictive value, and negative predictive value for the IOUS to predict a Brandwein-Gensler score ≥3 were 93.33%, 89.47%, 87.50%, and 94.44%, respectively. The present study demonstrated the promising role of IOUS in aiding risk stratification for OSCC patients. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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18 pages, 5536 KiB

Open AccessArticle

Folic Acid Supplementation Promotes Hypomethylation in Both the Inflamed Colonic Mucosa and Colitis-Associated Dysplasia

by Wen-Chi L. Chang, Jayashri Ghosh, Harry S. Cooper, Lisa Vanderveer, Bryant Schultz, Yan Zhou, Kristen N. Harvey, Esther Kaunga, Karthik Devarajan, Yuesheng Li, Jaroslav Jelinek, Mariana F. Fragoso, Carmen Sapienza and Margie L. Clapper

Cancers 2023, 15(11), 2949; https://doi.org/10.3390/cancers15112949 - 27 May 2023

Cited by 1 | Viewed by 1548

Abstract

Purpose: The purpose of this study was to assess the effect of folic acid (FA) supplementation on colitis-associated colorectal cancer (CRC) using the azoxymethane/dextran sulfate sodium (AOM/DSS) model. Methods: Mice were fed a chow containing 2 mg/kg FA at baseline and randomized after the first DSS treatment to receive 0, 2, or 8 mg/kg FA chow for 16 weeks. Colon tissue was collected for histopathological evaluation, genome-wide methylation analyses (Digital Restriction Enzyme Assay of Methylation), and gene expression profiling (RNA-Seq). Results: A dose-dependent increase in the multiplicity of colonic dysplasias was observed, with the multiplicity of total and polypoid dysplasias higher (64% and 225%, respectively) in the 8 mg FA vs. the 0 mg FA group (p < 0.001). Polypoid dysplasias were hypomethylated, as compared to the non-neoplastic colonic mucosa (p < 0.05), irrespective of FA treatment. The colonic mucosa of the 8 mg FA group was markedly hypomethylated as compared to the 0 mg FA group. Differential methylation of genes involved in Wnt/β-catenin and MAPK signaling resulted in corresponding alterations in gene expression within the colonic mucosa. Conclusions: High-dose FA created an altered epigenetic field effect within the non-neoplastic colonic mucosa. The observed decrease in site-specific DNA methylation altered oncogenic pathways and promoted colitis-associated CRC. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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14 pages, 1547 KiB

Open AccessArticle

Phase IIa Clinical Biomarker Trial of Dietary Arginine Restriction and Aspirin in Colorectal Cancer Patients

by Jason A. Zell, Thomas H. Taylor, C. Gregory Albers, Joseph C. Carmichael, Christine E. McLaren, Lari Wenzel and Michael J. Stamos

Cancers 2023, 15(7), 2103; https://doi.org/10.3390/cancers15072103 - 31 Mar 2023

Cited by 1 | Viewed by 1651

Abstract

After potentially curative treatment, colorectal cancer (CRC) patients remain at high risk for recurrence, second primary CRC, and high-risk adenomas. In combination with existing data, our previous findings provide a rationale for reducing tissue polyamines as tertiary prevention in non-metastatic CRC patients. The goal of this study was to demonstrate rectal tissue polyamine reduction in optimally treated stage I-III CRC patients after intervention with daily oral aspirin + dietary arginine restriction. A single-institution phase IIa clinical trial was conducted. Patients were treated with aspirin 325 mg/day and an individualized dietary regimen designed to reduce arginine intake by ≥30% over a 12-week study period. Dietary intake, endoscopy with rectal biopsies, and phlebotomy were performed pre- and post-intervention. The primary endpoint was to demonstrate ≥50% decrease in rectal tissue putrescine levels from baseline as a measure of polyamine reduction in the target tissue. Twenty eligible patients completed the study. After study intervention, mean dietary arginine intake decreased from 3.7 g/day ± 1.3 SD to 2.6 g/day ± 1.2 SD (29.7% decrease, p < 0.02 by Sign test). Mean plasma arginine levels decreased from 46.0 ng/mL ± 31.5 SD at baseline to 35 ng/mL ± 21.7 SD (p < 0.001). Rectal tissue putrescine levels were 0.90 nMol/mg-protein pre-intervention and 0.99 nMol/mg-protein post-intervention (p < 0.64, NS). No significant differences were observed for the other tissue polyamines investigated: spermidine (p < 0.13), spermine (p < 0.21), spermidine:spermine ratio (p < 0.71). Among CRC survivors, treatment with daily oral aspirin and an individualized dietary arginine restriction intervention resulted in lower calculated dietary arginine intake and plasma arginine levels but did not affect rectal tissue polyamine levels. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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10 pages, 2761 KiB

Open AccessArticle

Pancreatic Cancer Surveillance in Carriers of a Germline Pathogenic Variant in CDKN2A

by Joan Llach, Paula Aguilera, Ariadna Sánchez, Angels Ginès, Glòria Fernández-Esparrach, Guillem Soy, Oriol Sendino, Eva Vaquero, Sabela Carballal, Fabio Ausania, Juan Ramón Ayuso, Anna Darnell, María Pellisé, Sergi Castellví-Bel, Susana Puig, Francesc Balaguer and Leticia Moreira

Cancers 2023, 15(6), 1690; https://doi.org/10.3390/cancers15061690 - 9 Mar 2023

Cited by 5 | Viewed by 1828

Abstract

Three percent of patients with pancreatic ductal adenocarcinoma (PDAC) present a germline pathogenic variant (GPV) associated with an increased risk of this tumor, CDKN2A being one of the genes associated with the highest risk. There is no clear consensus on the recommendations for surveillance in CDKN2A GPV carriers, although the latest guidelines from the International Cancer of the Pancreas Screening Consortium recommend annual endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI) regardless of family history. Our aim is to describe the findings of the PDAC surveillance program in a cohort of healthy CDKN2A GPV heterozygotes. This is an observational analysis of prospectively collected data from all CDKN2A carriers who underwent screening for PDAC at the high-risk digestive cancer clinic of the “Hospital Clínic de Barcelona” between 2013 and 2021. A total of 78 subjects were included. EUS or MRI was performed annually with a median follow-up of 66 months. Up to 17 pancreatic findings were described in 16 (20.5%) individuals under surveillance, although most of them were benign. No significant precursor lesions were identified, but an early PDAC was detected and treated. While better preventive strategies are developed, we believe that annual surveillance with EUS and/or MRI in CDKN2A GPV heterozygotes may be beneficial. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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10 pages, 265 KiB

Open AccessArticle

Population-Based Analysis of National Comprehensive Cancer Network (NCCN) Guideline Adherence for Patients with Anal Squamous Cell Carcinoma in California

by Priyanka Kumar, Michael Del Rosario, Jenny Chang, Argyrios Ziogas, Mehraneh D. Jafari, Robert E. Bristow, Sora Park Tanjasiri and Jason A. Zell

Cancers 2023, 15(5), 1465; https://doi.org/10.3390/cancers15051465 - 25 Feb 2023

Cited by 3 | Viewed by 2113

Abstract

Purpose: We analyzed adherence to the National Comprehensive Cancer Network treatment guidelines for anal squamous cell carcinoma in California and the associated impacts on survival. Methods: This was a retrospective study of patients in the California Cancer Registry aged 18 to 79 years with recent diagnoses of anal squamous cell carcinoma. Predefined criteria were used to determine adherence. Adjusted odds ratios and 95% confidence intervals were estimated for those receiving adherent care. Disease-specific survival (DSS) and overall survival (OS) were examined with a Cox proportional hazards model. Results: 4740 patients were analyzed. Female sex was positively associated with adherent care. Medicaid status and low socioeconomic status were negatively associated with adherent care. Non-adherent care was associated with worse OS (Adjusted HR 1.87, 95% CI = 1.66, 2.12, p < 0.0001). DSS was worse in patients receiving non-adherent care (Adjusted HR 1.96, 95% CI = 1.56, 2.46, p < 0.0001). Female sex was associated with improved DSS and OS. Black race, Medicare/Medicaid, and low socioeconomic status were associated with worse OS. Conclusions: Male patients, those with Medicaid insurance, or those with low socioeconomic status are less likely to receive adherent care. Adherent care was associated with improved DSS and OS in anal carcinoma patients. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

13 pages, 303 KiB

Open AccessArticle

Metabolic Risk Factors for Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease: A Prospective Study

by Samuel O. Antwi, Emily C. Craver, Yvonne A. Nartey, Kurt Sartorius and Tushar Patel

Cancers 2022, 14(24), 6234; https://doi.org/10.3390/cancers14246234 - 17 Dec 2022

Cited by 12 | Viewed by 2375

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a fast-growing public health problem and predisposes to hepatocellular carcinoma (HCC) in a significant proportion of patients. Metabolic alterations might underlie the progression of NAFLD to HCC, but the magnitudes of risk and population-attributable risk fractions (PAFs) for various metabolic conditions that are associated with HCC risk in patients with NAFLD are unknown. We investigated the associations between metabolic conditions and HCC development in individuals with a prior history of NAFLD. The study included 11,245 participants in the SEER-Medicare database, comprising 1310 NAFLD-related HCC cases and 9835 NAFLD controls. We excluded individuals with competing liver diseases (e.g., alcoholic liver disease and chronic viral hepatitis). Baseline pre-existing diabetes mellitus, dyslipidemia, obesity, hypertension, hypothyroidism, and metabolic syndrome were assessed. Multivariable-adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). PAFs were also calculated for each metabolic condition. The results show that diabetes (OR = 2.39, 95% CI: 2.04–2.79), metabolic syndrome (OR = 1.73, 95% CI: 1.49–2.01), and obesity (OR = 1.62, 95% CI: 1.43–1.85) were associated with a higher HCC risk in individuals with NAFLD. The highest PAF for HCC was observed for pre-existing diabetes (42.1%, 95% CI: 35.7–48.5), followed by metabolic syndrome (28.8%, 95% CI: 21.7–35.9) and obesity (13.2%, 95% CI: 9.6–16.8). The major predisposing factors for HCC in individuals with NAFLD are diabetes mellitus, metabolic syndrome, and obesity, and their control would be critically important in mitigating the rising incidence of NAFLD-related HCC. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

12 pages, 924 KiB

Open AccessArticle

Use of Selective Serotonin Reuptake Inhibitors Is Associated with a Lower Risk of Colorectal Cancer among People with Family History

by Naiqi Zhang, Jan Sundquist, Kristina Sundquist and Jianguang Ji

Cancers 2022, 14(23), 5905; https://doi.org/10.3390/cancers14235905 - 29 Nov 2022

Cited by 3 | Viewed by 2567

Abstract

Individuals with a family history of colorectal cancer (CRC) are at a high risk of developing CRC. Preclinical and population-based evidence suggests that selective serotonin reuptake inhibitors (SSRIs) might play a role in preventing CRC. We performed a nationwide cohort study to explore whether the use of SSRIs could reduce CRC risk among individuals with family history. We identified individuals aged 50 and above who had one or more first-degree relatives diagnosed with CRC. A total of 38,617 incident SSRI users were identified and matched with 115,851 non-users, on a ratio of 1:3. The Cox regression model was used to calculate hazard ratios (HRs) and 95% CI confidence intervals (CIs). We found a significant negative association between SSRI use and the risk of CRC (adjusted HR, 0.77; 95% CI, 0.70–0.85). Restricted cubic spline regression showed a non-linear dose-responded relationship between SSRI use and CRC risk. The association was stronger in rectal cancer than colon cancer (adjusted HR, 0.73 vs. 0.79), and more pronounced in advanced-stage CRC than early-stage CRC (adjusted HR, 0.73 vs. 0.80). This population-based cohort study suggests that the use of SSRIs is associated with a reduced risk of CRC among individuals with a family history of CRC. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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14 pages, 2224 KiB

Open AccessArticle

Global, Regional, and National Burdens with Temporal Trends of Early-, Intermediate-, and Later-Onset Gastric Cancer from 1990 to 2019 and Predictions up to 2035

by Fei-Long Ning, Nan-Nan Zhang, Zhe-Ming Zhao, Wan-Ying Du, Yong-Ji Zeng, Masanobu Abe, Jun-Peng Pei and Chun-Dong Zhang

Cancers 2022, 14(21), 5417; https://doi.org/10.3390/cancers14215417 - 3 Nov 2022

Cited by 5 | Viewed by 1406

Abstract

Background: Evidence for estimating and predicting the temporal trends of gastric cancer in different age groups is lacking. Methods: Data of early-, intermediate-, and later-onset gastric cancer (EOGC, IOGC, LOGC) was from the Global Burden of Diseases Study 2019. The incidences and deaths due to EOGC, IOGC, and LOGC were analyzed by period, sex, geographic location, and sociodemographic incidence. Temporal trends were evaluated by estimated annual percentage changes (EAPCs). The incidences and temporal trends were predicted until 2035. Results: There were substantial differences in the incidence and death rates of the three populations at global, regional and national levels in 2019. From 1990 to 2019, EOGC (EAPC, −0.84) showed a slower decrease in incidence rate worldwide than IOGC (EAPC, −1.77) and LOGC (EAPC, −1.10), whereas EOGC and LOGC showed slower decreases in mortality than IOGC. The worldwide incidence rate of EOGC (EAPC, 1.44) was predicted to increase substantially from 2020 to 2035, while that for LOGC (EAPC, 0.43) was predicted to increase slightly and that for IOGC (EAPC, −0.01) was predicted to remain stable over the same period. Conclusions: This study revealed differences in the burdens and temporal trends of EOGC, IOGC, and LOGC, and highlighted the importance of tailored cancer-control measures in neglected subpopulations, especially in patients with EOGC. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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14 pages, 1563 KiB

Open AccessArticle

Structural and Socio-Spatial Determinants Influencing Care and Survival of Patients with a Pancreatic Adenocarcinoma: Results of the PANDAURA Cohort

by Gaël S. Roth, Yohan Fayet, Sakina Benmameche-Medjahed, Françoise Ducimetière, Amandine Charreton, Claire Cropet, Sylvie Chabaud, Anne-Marie Marion-Audibert, Olivier Berthelet, Thomas Walter, Mustapha Adham, Mathieu Baconnier, David Tavan, Nicolas Williet, Pascal Artru, Floriane Huet-Penz, Isabelle Ray-Coquard, Fadila Farsi, Hélène Labrosse and Christelle de la Fouchardière

Cancers 2022, 14(21), 5413; https://doi.org/10.3390/cancers14215413 - 3 Nov 2022

Cited by 2 | Viewed by 1352

Abstract

Background and aims: Pancreatic cancer is highly lethal and often diagnosed at an advanced stage. This cohort study analyzes the impact of care pathways, delays, and socio-spatial determinants on pancreatic cancer patients’ diagnosis, treatment, and prognosis. Method: Patients with pancreatic adenocarcinoma newly diagnosed at all stages between January and June 2016 in the AuRA French region were included. The influence on survival of delays of care, healthcare centers’ expertise, and socio-spatial determinants was evaluated. Results: Here, 538 patients were included in 76 centers including 116 patients (21.8%) with resectable, 64 (12.0%) borderline-resectable, 147 (27.6%) locally-advanced tumors, and 205 (38.5%) with metastatic disease. A delay between first symptoms and CT scans did not statistically influence overall survival (OS). In resected patients, OS was significantly higher in centers with more than 20 surgeries (HR_{<5 surgeries/year} = 2.236 and HR_{5-20 surgeries/year} = 1.215 versus centers with > 20 surgeries/year p = 0.0081). Regarding socio-spatial determinants, patients living in municipalities with greater access to a general practitioner (HR = 1.673, p = 0.0153) or with a population density below 795.1 people/km² (HR = 1.881, p = 0.0057) were significantly more often resectable. Conclusion: This cohort study supports the pivotal role of general practitioner in cancer care and the importance of the centralization of pancreatic surgery to optimize pancreatic cancer patients’ care and outcomes. However, delays of care did not impact patient survival. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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11 pages, 845 KiB

Open AccessArticle

Association of Non-Steroidal Anti-Inflammatory Drugs, Genetic Risk, and Environmental Risk Factors with Incidence of Colorectal Cancer

by Jiaojiao Ren, Peidong Zhang, Zhihao Li, Xiru Zhang, Wenfang Zhong, Weiqi Song, Xing Wang, Pingming Gao and Chen Mao

Cancers 2022, 14(20), 5138; https://doi.org/10.3390/cancers14205138 - 20 Oct 2022

Cited by 3 | Viewed by 1538

Abstract

Regular use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with the lower risk of colorectal cancer (CRC). However, whether regular use of NSAIDs could attenuate the effect of genetic risk and environmental risk factors on CRC is unknown. We aimed to evaluate the association of NSAID use, genetic risk, and environmental risk factors with CRC. Using data from a UK Biobank, a Cox proportional hazards model was performed to estimate the risk of CRC according to NSAID use, polygenic risk score, and environmental risk factors. Regular use of NSAIDs was associated with a 36.0% lower risk of CRC. No statistically significant interaction was observed between NSAID use and the genetic risk score (p = 0.190), and between NSAID use and the environmental risk score (p = 0.740). However, regular NSAID use was still associated with lower CRC incidence among subjects with either high environmental risk or high genetic risk. Furthermore, the genetic and environmental risk of CRC were additives. These findings appear to support the chemopreventive effect of regular NSAID use. Furthermore, controlling of modifiable environmental risk factors can reduce the CRC risk, especially among individuals with a moderate or high genetic risk of CRC. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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14 pages, 1315 KiB

Open AccessArticle

The Association between Peptic Ulcer Disease and Gastric Cancer: Results from the Stomach Cancer Pooling (StoP) Project Consortium

by Pedram Paragomi, Bashir Dabo, Claudio Pelucchi, Rossella Bonzi, Abdulaziz T. Bako, Nabila Muhammad Sanusi, Quan H. Nguyen, Zuo-Feng Zhang, Domenico Palli, Monica Ferraroni, Khanh Truong Vu, Guo-Pei Yu, Federica Turati, David Zaridze, Dmitry Maximovitch, Jinfu Hu, Lina Mu, Stefania Boccia, Roberta Pastorino, Shoichiro Tsugane, Akihisa Hidaka, Robert C. Kurtz, Areti Lagiou, Pagona Lagiou, M. Constanza Camargo, Maria Paula Curado, Nuno Lunet, Jesus Vioque, Paolo Boffetta, Eva Negri, Carlo La Vecchia and Hung N. Luu Show full author list Hide full author list

Cancers 2022, 14(19), 4905; https://doi.org/10.3390/cancers14194905 - 7 Oct 2022

Cited by 6 | Viewed by 3184

Abstract

Background. Gastric cancer (GC) is the fifth most common type of cancer and the fourth most common cause of cancer-related mortality. Although the risk of GC and peptic ulcer disease (PUD) is known to be increased by H. pylori infection, evidence regarding the direct relationship between PUD and GC across ethnicities is inconclusive. Therefore, we investigated the association between PUD and GC in the Stomach cancer Pooling (StoP) consortium. Methods. History of peptic ulcer disease was collected using a structured questionnaire in 11 studies in the StoP consortium, including 4106 GC cases and 6922 controls. The two-stage individual-participant data meta-analysis approach was adopted to generate a priori. Unconditional logistic regression and Firth’s penalized maximum likelihood estimator were used to calculate study-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between gastric ulcer (GU)/duodenal ulcer (DU) and risk of GC. Results. History of GU and DU was thoroughly reported and used in association analysis, respectively, by 487 cases (12.5%) and 276 controls (4.1%), and 253 cases (7.8%) and 318 controls (6.0%). We found that GU was associated with an increased risk of GC (OR = 3.04, 95% CI: 2.07–4.49). No association between DU and GC risk was observed (OR = 1.03, 95% CI: 0.77–1.39). Conclusions. In the pooled analysis of 11 case–control studies in a large consortium (i.e., the Stomach cancer Pooling (StoP) consortium), we found a positive association between GU and risk of GC and no association between DU and GC risk. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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Review

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17 pages, 363 KiB

Open AccessReview

Colorectal Cancer in Inflammatory Bowel Diseases: Epidemiology and Prevention: A Review

by Elisa Marabotto, Stefano Kayali, Silvia Buccilli, Francesca Levo, Giorgia Bodini, Edoardo G. Giannini, Vincenzo Savarino and Edoardo Vincenzo Savarino

Cancers 2022, 14(17), 4254; https://doi.org/10.3390/cancers14174254 - 31 Aug 2022

Cited by 15 | Viewed by 2412

Abstract

Colorectal cancer (CRC) is currently the third most frequent form of malignancy and the second in terms of mortality. Inflammatory bowel diseases (IBDs) are recognized risk factors for this type of cancer. Despite a worldwide increase in the incidence of CRC, the risk of CRC-related death in IBD patients has declined over time, probably because of successful surveillance strategies, the use of more effective drugs in the management of remission and improved indications to colectomy. This notwithstanding, CRC 5-year survival in patients with IBD is poorer than in the general population. This review provides a summary of the epidemiological features, risk factors and various prevention strategies proposed for CRC in IBD patients. Moreover, there is a special focus on reporting and highlighting the various prevention strategies proposed by the most important international scientific societies, both in terms of chemoprevention and endoscopic surveillance. Indeed, in conducting the analysis, we have given attention to the current primary, secondary and tertiary prevention guidelines, attempting to emphasize unresolved research and clinical problems related to this topic in order to improve diagnostic strategies and management. Full article

(This article belongs to the Special Issue Gastrointestinal Tract Cancers, an Increasing Burden of the Modern Era: Epidemiology and Prevention)

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