The Future Colorectal Cancer Burden Attributable to Modifiable Behaviors: A Pooled Cohort Study

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dc.contributor.authorVajdic, Claire M.
dc.contributor.authorMacInnis, Robert
dc.contributor.authorCanfell, Karen
dc.contributor.authorHull, Peter
dc.contributor.authorArriaga, Maria E.
dc.contributor.authorHirani, Vasant
dc.contributor.authorCumming, Robert
dc.contributor.authorMitchell, Paul
dc.contributor.authorByles, Julie
dc.contributor.authorGiles, Graham G.
dc.contributor.authorBanks, Emily
dc.contributor.authorTaylor, Anne
dc.contributor.authorShaw, Jonathan
dc.contributor.authorMagliano, Dianna
dc.contributor.authorMarker, Julie
dc.contributor.authorAdelstein, Barbara-Ann
dc.contributor.authorGill, Tiffany
dc.contributor.authorLaaksonen, Maarit A.
dc.date.accessioned2021-04-16T04:55:02Z
dc.date.available2021-04-16T04:55:02Z
dc.date.issued2018-08-28
dc.date.updated2020-11-23T11:57:21Z
dc.description.abstractBackground: Previous estimates of the colorectal cancer (CRC) burden attributed to behaviors have not considered joint effects, competing risk, or population subgroup differences. Methods: We pooled data from seven prospective Australian cohort studies (n ¼ 367 058) and linked them to national registries to identify CRCs and deaths. We estimated the strength of the associations between behaviors and CRC risk using a parametric piecewise constant hazards model, adjusting for age, sex, study, and other behaviors. Exposure prevalence was estimated from contemporary National Health Surveys. We calculated population attributable fractions for CRC preventable by changes to current behaviors, accounting for competing risk of death and risk factor interdependence. Statistical tests were two-sided. Results: During the first 10 years of follow-up, there were 3471 incident CRCs. Overweight or obesity explained 11.1%, ever smoking explained 10.7% (current smoking 3.9%), and drinking more than two compared with two or fewer alcoholic drinks per day explained 5.8% of the CRC burden. Jointly, these factors were responsible for 24.9% (95% confidence interval [CI] ¼ 19.7% to 29.9%) of the burden, higher for men (36.7%) than women (13.2%, Pdifference < .001). The burden attributed to these factors was also higher for those born in Australia (28.7%) than elsewhere (16.8%, Pdifference ¼ .047). We observed modification of the smoking-attributable burden by alcohol consumption and educational attainment, and modification of the obesity-attributable burden by age group and birthplace. Conclusions: We produced up-to-date estimates of the future CRC burden attributed to modifiable behaviors. We revealed novel differences between men and women, and other high–CRC burden subgroups that could potentially benefit most from programs that support behavioral change and early detection.en_AU
dc.description.sponsorshipThis work was supported by the Australian National Health and Medical Research Council (NHMRC; ID1060991). The Australian NHMRC also supported Dr. Laaksonen (ID1053642), Prof. Canfell (ID1082989), Prof. Banks (ID1042717), Prof. Shaw (ID1079438), and Prof. Magliano (ID1118161). Dr. Laaksonen was additionally supported by the Cancer Institute of New South Wales (ID13/ECF/1-07). Ms. Arriaga was supported by an Australian Postgraduate Award and a Translational Cancer Research Network PhD Scholarship Top-up Award.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn0027-8874en_AU
dc.identifier.urihttp://hdl.handle.net/1885/230319
dc.language.isoen_AUen_AU
dc.provenanceThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.comen_AU
dc.publisherOxford University Pressen_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1060991en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1053642en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1082989en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1042717en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1079438en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1118161en_AU
dc.rights© 2018 The Author(s)en_AU
dc.rights.licenseCreative Commons Attribution Non-Commercial Licenseen_AU
dc.rights.urihttp://creativecommons.org/ licenses/by-nc/4.0/en_AU
dc.sourceJournal of the National Cancer Instituteen_AU
dc.titleThe Future Colorectal Cancer Burden Attributable to Modifiable Behaviors: A Pooled Cohort Studyen_AU
dc.typeJournal articleen_AU
dcterms.accessRightsOpen Accessen_AU
dcterms.dateAccepted2018-06-08
local.bibliographicCitation.issue3en_AU
local.bibliographicCitation.lastpage9en_AU
local.bibliographicCitation.startpage1en_AU
local.contributor.affiliationVajdic, Claire M., University of New South Walesen_AU
local.contributor.affiliationMacInnis, Robert, Cancer Epidemiology Centre, Cancer Council Victoriaen_AU
local.contributor.affiliationCanfell, Karen, Cancer Counsil NSWen_AU
local.contributor.affiliationHull, Peter, University of New South Walesen_AU
local.contributor.affiliationArriaga, Maria E., Centre for Big Data Research in Health University of New South Walesen_AU
local.contributor.affiliationHirani, Vasant, The University of Sydneyen_AU
local.contributor.affiliationCumming, Robert, University of Sydneyen_AU
local.contributor.affiliationMitchell, Paul, University of Sydneyen_AU
local.contributor.affiliationByles, Julie, University of Newcastleen_AU
local.contributor.affiliationGiles, Graham G, Cancer Council Victoriaen_AU
local.contributor.affiliationBanks, Emily, College of Health and Medicine, ANUen_AU
local.contributor.affiliationTaylor, Anne, University of Adelaideen_AU
local.contributor.affiliationShaw, Jonathan, Baker IDI Heart and Diabetes Instituteen_AU
local.contributor.affiliationMagliano, Dianna, Baker IDI Heart and Diabetes Instituteen_AU
local.contributor.affiliationMarker, Julie, Cancer Voices South Australiaen_AU
local.contributor.affiliationAdelstein, Barbara-Ann, University of New South Walesen_AU
local.contributor.affiliationGill, Tiffany, University of Adelaideen_AU
local.contributor.affiliationLaaksonen, Maarit A., University of New South Walesen_AU
local.contributor.authoremailu4106314@anu.edu.auen_AU
local.contributor.authoruidBanks, Emily, u4106314en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor111706 - Epidemiologyen_AU
local.identifier.absfor111202 - Cancer Diagnosisen_AU
local.identifier.absseo920401 - Behaviour and Healthen_AU
local.identifier.absseo920102 - Cancer and Related Disordersen_AU
local.identifier.ariespublicationu1067127xPUB7en_AU
local.identifier.citationvolume2en_AU
local.identifier.doi10.1093/jncics/pky033en_AU
local.identifier.uidSubmittedByu1067127en_AU
local.publisher.urlhttps://academic.oup.com/en_AU
local.type.statusPublished Versionen_AU

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