Search

Background: Previous epidemiological studies have been suggestive but inconclusive in demonstrating inverse associations of calcium, vitamin D, dairy product intakes with risk of colorectal cancer (CRC). We conducted a large population-based comparison of such associations in Newfoundland and Labrador (NL) and Ontario (ON). Methods: A case control study design was used. Colorectal cancer cases were new CRC patients aged 20-74 years. Controls were a sex and age-group matched random sample of the population in each province. 1760 cases and 2481 controls from NL and ON were analyzed. Information on dietary intake and lifestyle was collected using self-administered food frequency and personal history questionnaires. Results: Controls reported higher mean daily intakes of total calcium and total vitamin D than cases in both provinces. In ON, significant reduced CRC risk was associated with intakes of total calcium (OR of highest vs. lowest quintiles was 0.57, 95% CI 0.42-0.77, [p.sub.trend]=0.03), total vitamin D (OR=0.73, 95% CI 0.54-1.00), dietary calcium (OR=0.76, 95% CI 0.60-0.97), dietary vitamin D (OR=0.77, 95% CI 0.61-0.99), total dairy products and milk (OR=0.78, 95% CI 0.60-1.00), calcium-containing supplements use (OR=0.76). In NL, the inverse associations of calcium, vitamin D with CRC risk were most pronounced among calcium- or vitamin D-containing supplement users (OR=0.67, 0.68, respectively). Conclusions: Results of this study add to the evidence that total calcium, dietary calcium, total vitamin D, dietary vitamin D, calcium- or vitamin D-containing supplement use may reduce the risk of CRC. The inverse associations of CRC risk with intakes of total dairy products and milk may be largely due to calcium and vitamin D. Key words: Calcium; vitamin D; dairy products; colorectal cancer Contexte : Des etudes epidemiologiques anterieures, bien que peu concluantes, donnent a penser que les apports en calcium, en vitamine D et en produits laitiers sont inversement associes au risque de cancer colorectal (CCR). Nous avons mene une vaste comparaison populationnelle de telles associations a Terre-Neuve-et-Labrador (T.-N.-L.) et en Ontario. Methode : Nous avons utilise un plan d'etude cas/temoins. Nos cas de cancer colorectal etaient des patients nouvellement atteints de CCR ages de 20 a 74 ans. Nos temoins etaient un echantillon aleatoire de la population de chaque province, assortis selon le sexe et le groupe d'age. Nous avons analyse 1 760 cas et 2 481 temoins de T.-N.-L. et de l'Ontario. Des renseignements sur leurs apports alimentaires et leurs modes de vie ont ete recueillis au moyen de questionnaires autoadministres sur la frequence de consommation des produits alimentaires et les antecedents personnels. Resultats : Dans les deux provinces, les temoins ont declare des apports moyens quotidiens plus eleves en calcium total et en vitamine D totale. En Ontario, un risque de CCR significativement reduit etait associe aux apports en calcium total (RC des quintiles superieur et inferieur = 0,57, IC de 95% = 0,42-0,77, P=0,03), en vitamine D totale (RC=0,73, IC de 95% = 0,541,00), en calcium alimentaire (RC=0,76, IC de 95% = 0,60-0,97), en vitamine D alimentaire (RC=0,77, IC de 95% = 0,61-0,99), en lait et produits laitiers totaux (RC=0,78, IC de 95% = 0,60-1,00) et a la consommation de supplements contenant du calcium (RC=0,76). A T.-N.-L., les associations inverses entre le calcium, la vitamine D et le risque de CCR etaient plus prononcees chez les consommateurs de supplements contenant du calcium ou de la vitamine D (RC=0,67, 0,68, respectivement). Conclusion : Les resultats de cette etude tendent a confirmer que le calcium total, le calcium alimentaire, la vitamine D totale, la vitamine D alimentaire et la consommation de supplements contenant du calcium ou de la vitamine D peuvent reduire le risque de CCR. Les associations inverses entre le risque de CCR et les apports en lait et produits laitiers totaux pourraient s'expliquer dans une large mesure par le calcium et la vitamine D. Mots cles : calcium; vitamine D; produits laitiers; tumeurs colorectales, Diet has long been regarded as one of the most important environmental factors associated with colorectal cancer (CRC). (1) Since 1980 when Garland and Garland proposed that the inverse association [...]

Objective: Newfoundland and Labrador (NL) has the highest incidence rate of both colorectal cancer (CRC) and smoking prevalence in Canada. The objective of this study was to examine if CRC is associated with smoking in this population. Methods: Newly diagnosed cases identified between 1999 and 2003 were frequency-matched by 5-year age group and sex with controls selected from the residents of NL through random digit dialing. A total of 702 cases and 717 controls consented to participate in the study and completed a set of self-administered questionnaires. Measures of tobacco use included type of tobacco, age of initiation of smoking, years of smoking, years since started smoking, number of cigarettes smoked daily, pack years, and years since abstention from smoking. Odds ratios were estimated using multivariate logistic regression. Results: In comparison with non-smokers, former and current smokers were at a significantly elevated risk of CRC with corresponding odds ratios of 1.36 and 1.96. The risk significantly increased with cigarette smoking years, the amount of cigarettes smoked daily, and cigarette pack years. The risk significantly decreased with years of abstention from smoking cigarettes. This association was stronger among drinkers and in men. In addition, this effect was observed to be slightly stronger for rectum than colon cancer. Discussion: In summary, cigarette smoking increased the risk of CRC in the NL population. The risk of CRC associated with cigarette smoking varies by sex, drinking status, and site of CRC. Key words: Colorectal cancer; smoking; odds ratio; case-control study Objectif : C'est a Terre-Neuve-et-Labrador (T.-N.-L.) que l'on observe les plus hauts taux d'incidence du cancer colorectal (CCR) et de prevalence du tabagisme au Canada. Nous avons cherche a determiner si le CCR etait associe au tabagisme dans cette population. Methode : Les cas nouvellement diagnostiques declares entre 1999 et 2003 ont ete assortis par frequence selon le groupe d'age (intervalles de cinq ans) et le sexe; les temoins ont ete selectionnes par composition aleatoire parmi les residents de T.-N.-L. En tout, 702 cas et 717 temoins ont consenti a participer a l'etude et ont repondu a un ensemble de questionnaires a remplir soi-meme. Les indicateurs de tabagisme etaient le genre de tabac, l'age d'initiation au tabac, les annees de tabagisme, les annees ecoulees depuis l'initiation au tabac, le nombre de cigarettes fumees par jour, le nombre de paquets par annee et le nombre d'annees d'abstention du tabagisme. Nous avons estime les rapports de cotes par regression logistique multivariee. Resultats : Par comparaison avec les non-fumeurs, les anciens fumeurs et les fumeurs actuels presentaient un risque significativement eleve de CCR avec des rapports de cotes de 1,36 et de 1,96, respectivement. Le risque augmentait de facon significative avec les annees de tabagisme, le nombre de cigarettes fumees par jour et le nombre de paquets de cigarette par annee. Le risque diminuait de facon significative avec les annees d'abstention du tabagisme. Cette association etait plus prononcee chez les consommateurs d'alcool et les hommes. De plus, cet effet etait legerement plus prononce pour le cancer du rectum que pour le cancer du colon. Discussion : Pour resumer, l'usage de la cigarette accroit le risque de CCR dans la population de T.-N.-L. Le risque de CCR associe a l'usage de la cigarette varie selon le sexe, la consommation d'alcool et le site de CCR. Mots cles : tumeurs colorectales; tabagisme; rapport de cotes; etudes cas-temoins, Globally, colorectal cancer (CRC) is the third leading cause of death from cancer in males and the fourth leading cause of death from cancer in females. (1) In 2002, an [...]

Background: This study aims to characterize the heterogeneity in BMI trajectories and evaluate how different BMI trajectories predict mortality risk in Canadian seniors.Methods: Data came from the Canadian National Population Health Survey (NPHS, 1994-2011) and 1480 individuals aged 65-79 years with at least four BMI records were included in this study. Group-based trajectory model was used to identify distinct subgroups of longitudinal trajectories of BMI measured over 19 years for men and women. Cox proportional hazards models were used to examine the association between BMI trajectories and mortality risks.Results: Distinct trajectory patterns were found for men and women: 'Normal Weight-Down'(N-D), 'Overweight-Normal weight' (OV-N), 'Obese I-Down' (OB I-D), and 'Obese II- Down' (OB II-D) for women; and 'Normal Weight-Down' (N-D), 'Overweight-Normal weight' (OV-N), 'Overweight-Stable' (OV-S), and 'Obese-Stable' (OB-S) for men. Comparing with OV-N, men in the OV-S group had the lowest mortality risk followed by the N-D (HR = 1.66) and OB-S (HR = 1.98) groups, after adjusting for covariates. Compared with OV-N, women in the OB II-D group with three or more chronic health conditions had higher mortality risk (HR = 1.61); however, women in OB II-D had lower risk (HR = 0.56) if they had less than three conditions.Conclusion: The course of BMI over time in Canadian seniors appears to follow one of four different patterns depending on gender. The findings suggest that men who were overweight at age 65 and lost weight over time had the lowest mortality risk. Interestingly, obese women with decreasing BMI have different mortality risks, depending on their chronic health conditions. The findings provide new insights concerning the associations between BMI and mortality risk. [ABSTRACT FROM AUTHOR]

Background. Whether there is heterogeneity in the development of BMI from middle-age onward is still unknown. The primary aim of this study is to analyze long-term obesity and how BMI trajectories are associated with health outcomes in midlife. Methods. Latent Class Growth Modelling was used to capture the changes in BMI over time. In this study, 3070 individuals from the National Population Health Survey (NPHS), aged 40–55 years at baseline, were included. Results. Four BMI trajectory groups, “Normal-Stable” (N-S), “Overweight-Stable” (OV-S), “Obese I-Stable” (OB I-S), and “Obese II-Stable” (OB II-S), were identified. Men, persons of White ancestry, and individuals who had no postsecondary education had higher odds of being in the latter three groups. Moreover, members of the OV-S, OB I-S, and OB II-S groups experienced more asthma, arthritis, hypertension, diabetes, heart disease, cognitive impairment, and reduced self-rated overall health. Individuals in the OB II-S group were at greater risk for back problems, chronic bronchitis or emphysema, and emotional issues when compared to the N-S group. Conclusion. Understanding different BMI trajectories is important in order to identify people who are at the highest risk of developing comorbidities due to obesity and to establish programs to intervene appropriately. [ABSTRACT FROM AUTHOR]

To investigate the health burden of diabetes and determine its impact on health-related quality of life (HRQOL) in a population with a high prevalence of chronic conditions. A representative sample of the Canadian province of Newfoundland and Labrador (NL) was used to estimate prevalence of diabetes and mean health utility index (HUI), a utility-based measure of HRQOL. Diabetes-deleted life expectancy (LE) and health-adjusted life expectancy (HALE) were derived to measure HRQOL. Diabetic individuals comprised 6.8% of the sample and accounted for 14% of total deaths from 2001 to 2005. Life Expectancy at age 15 was 61.3 years for men and 66.7 years for women, of which 53.0 and 57.0 years, respectively, were spent with perfect health (86.4 and 85.5%). Eliminating diabetes would extend both the overall LE and HALE for men by 1.3 and 1.4 years, and women by 2.0 and 1.7 years, respectively. People with diabetes had a significantly lower HRQOL than people without diabetes (mean HUI: 0.78 vs. 0.88, P < 0.01). The burden of illness from diabetes in NL is considerable. Using cause-eliminated LE and HALE provides a robust approach for assessing HRQOL that may have important implications for diabetes surveillance, prevention, and management strategies. [ABSTRACT FROM AUTHOR]