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Original article
Interaction between vitamin E intake and a COMT gene variant on colorectal cancer risk: a case-control study
Shinyoung Jun, Madhawa Gunathilake, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
Epidemiol Health. 2023;e2023100.   Published online November 14, 2023
DOI: https://doi.org/10.4178/epih.e2023100    [Accepted]
  • 359 View
  • 22 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
Previous human trials have not supported the anticarcinogenic effect of vitamin E despite biological plausibility and considerable epidemiological evidence. A possible explanation for this inconsistency is the interactive effect of the catechol-O-methyltransferase (COMT) gene and supplemental vitamin E on cancer. We examined whether a COMT gene variant modulates the effect of dietary vitamin E intake on colorectal cancer (CRC) risk.
METHODS
In this case-control study of Korean adults (975 cases and 975 age- and sex-matched controls), dietary vitamin E density (mg/1,000 kcal) was measured using a semiquantitative food frequency questionnaire, COMT SNP rs740603 (A>G) was genotyped, and CRC was verified histologically. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models with adjustments for potential confounders.
RESULTS
Higher vitamin E density was associated with a lower risk of CRC (highest vs. lowest quartiles; OR, 0.72; 95% CI, 0.55 to 0.96; p-for-trend=0.0018). When stratified by COMT SNP rs740603 genotype, the inverse association between vitamin E density and CRC risk was confined to those with at least 1 A allele (≥median vs. <median; OR, 0.63; 95% CI, 0.51 to 0.78). The interaction between rs740603 and vitamin E density was significant (p-for-interaction=0.0204). No direct association was observed between COMT SNP rs740603 and CRC risk (OR, 0.92; 95% CI, 0.71 to 1.20).
CONCLUSIONS
Our findings support a role for a genetic polymorphism in COMT modifies the association between dietary vitamin E intake and CRC.
Summary
Original Articles
Association of the inflammatory balance of diet and lifestyle with colorectal cancer among Korean adults: a case-control study
Shinyoung Jun, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
Epidemiol Health. 2022;44:e2022084.   Published online September 30, 2022
DOI: https://doi.org/10.4178/epih.e2022084
  • 2,831 View
  • 176 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Dietary and lifestyle exposures may affect the risk of colorectal cancer (CRC) by promoting chronic inflammation. Therefore, we assessed the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with CRC.
METHODS
Data from 919 pathologically confirmed CRC cases and 1,846 age- and sex-matched controls recruited at the National Cancer Center Korea were analyzed. We calculated the DIS and LIS, which characterize the collective contributions of 19 dietary and 4 lifestyle factors, respectively, to systemic inflammation by applying weights based on high-sensitivity C-reactive protein. A higher score represented a higher balance of pro- to anti-inflammatory exposures. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for CRC risk compared across the DIS and LIS tertile categories, with the lowest tertile as the reference group.
RESULTS
The highest DIS tertile had significantly increased odds of having CRC (OR, 2.65; 95% CI, 2.10 to 3.36), and the odds increased with increasing DIS. The highest LIS tertile group had 1.28-fold higher odds of having CRC (95% CI, 1.03 to 1.58). In the cross-classification analysis, the odds of having CRC increased as the DIS and LIS jointly increased until the DIS reached the highest tertile, where the risk was very high (3-fold or more) regardless of the LIS.
CONCLUSIONS
In conclusion, a higher balance of pro-inflammatory relative to anti-inflammatory dietary and lifestyle factors, especially dietary factors, was associated with higher CRC risk among Korean adults.
Summary
Korean summary
본 연구는 국립암센터에서 수집한 대장암 환자-대조군 데이터를 활용하여, 새롭게 개발된 식이 염증 지수(Dietary Inflammation Score, DIS) 및 생활습관 염증 지수(Lifestyle Inflammation Score, LIS)와 대장암 발생 위험 간의 연관성을 탐색하였다. 분석 결과, 식이 염증 지수 혹은 생활습관 염증 지수가 높은 집단에서 대장암 위험이 더 높아, 식이와 생활습관이 체내 염증 수준을 높여 대장암 발생 위험을 높일 가능성이 제기되었다
Key Message
Dietary inflammation score (DIS) and lifestyle inflammation score (LIS) quantify the collective effect of dietary and lifestyle factors, respectively, on systemic inflammation. In this case-control study, we assessed the associations of DIS and LIS with colorectal cancer risk among Korean adults. Our results suggest that a higher balance of pro-to anti-inflammatory dietary and lifestyle factors may be associated with higher risk for colorectal cancer. The findings from our study support that reducing inflammation through dietary or lifestyle changes could potentially reduce the risk for colorectal cancer.

Citations

Citations to this article as recorded by  
  • The association of diet-dependent acid load with colorectal cancer risk: a case–control study in Korea
    Tao Thi Tran, Madhawa Gunathilake, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
    British Journal of Nutrition.2023; : 1.     CrossRef
  • Gout and Colorectal Cancer Likelihood: Insights from a Nested Case-Control Study of the Korean Population Utilizing the Korean National Health Insurance Service-National Sample Cohort
    Mi Jung Kwon, Kyeong Min Han, Joo-Hee Kim, Ji Hee Kim, Min-Jeong Kim, Nan Young Kim, Hyo Geun Choi, Ho Suk Kang
    Cancers.2023; 15(23): 5602.     CrossRef
The classification capability of the Asia Pacific Colorectal Screening score in Korea: an analysis of the Cancer Screenee Cohort
Xuan Quy Luu, Kyeongmin Lee, Jeongseon Kim, Dae Kyung Sohn, Aesun Shin, Kui Son Choi
Epidemiol Health. 2021;43:e2021069.   Published online September 16, 2021
DOI: https://doi.org/10.4178/epih.e2021069
  • 6,577 View
  • 215 Download
  • 3 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screenings and potential factors relevant for implementing this tool in the Korean population.
METHODS
Our study analyzed data from the Cancer Screenee Cohort Study conducted by the National Cancer Center in Korea. The risk level was assessed using the Asia Pacific Colorectal Screening (APCS) score developed by the Asia-Pacific Working Group on Colorectal Cancer. Logistic regression models were used to examine the associations between colorectal-related outcomes and the risk level by APCS score. The discriminatory performance of the APCS score for various colorectal-related outcomes was assessed using C-statistics.
RESULTS
In 12,520 individuals, 317 ACN cases and 4,528 adenoma cases were found. The APCS tool successfully classified the study population into different risk groups, and significant differences in the ACN rate and other outcomes were observed. The APCS score demonstrated acceptable discrimination capability with area under the curve values ranging from 0.62 to 0.65 for various outcomes. The results of the multivariate logistic regression model revealed that the high-risk group had a 3.1-fold higher risk of ACN (95% confidence interval, 2.08 to 4.67) than the average-risk group. Body mass index (BMI) was identified as a significant predictor of ACN in both multivariate and subgroup analyses.
CONCLUSIONS
Our study highlighted significant differences in colorectal-related screening outcomes by colorectal risk level measured using the APCS score, and BMI could be used to improve the discriminatory capability of the APCS score.
Summary
Korean summary
검진의 위해성을 줄이면서 동시에 이득을 최대화할 수 있는 최적의 검진 프로그램은 암 발생 위험도를 고려하는 것이다. 이 연구는 Asia-Pacific Working Group on Colorectal Cancer에서 제안한 “Asia Pacific Colorectal Screening Score (APCS)”가 한국인에서 대장암 발생 위험도를 선별적으로 잘 구분해 낼 수 있음을 보여주었다. 나아가 대장암의 위험도 점수를 산출하는데 체질량지수가 중요한 예측 변수라는 것을 확인하였고, 한국인에서 대장암 발생 위험도의 변별력을 향상시키기 위해 기존의 APCS에 체질량지수를 추가할 것을 제안하였다.
Key Message
This study highlighted that the Asia Pacific Colorectal Screening Score by the Asia-Pacific Working Group on Colorectal Cancer could successfully classify Korean screenees into different risk groups with acceptable discriminatory capability. Furthermore, our study results also suggest that BMI is a significant predictor of colorectal-related health outcomes, which could be potentially added to the original APCS score for improving its discriminatory power.

Citations

Citations to this article as recorded by  
  • A Comparison of Single and Combined Schemes of Asia-Pacific Colorectal Screening, Faecal Immunochemical and Stool Deoxyribonucleic Acid Testing for Community Colorectal Cancer Screening
    Yuan Ze, Huiming Tu, Lin Zhang, Yu Bai, Yilin Ren, Xin Chen, Yuzheng Xue, Renjuan Sun, Yuling Yang, Jie Yang, Xuan Zhou, Li Liu
    Journal of Multidisciplinary Healthcare.2023; Volume 16: 571.     CrossRef
  • Advances in Screening Methods for Colorectal Cancer
    碗宜 张
    Advances in Clinical Medicine.2023; 13(03): 2995.     CrossRef
  • A scoping review of risk-stratified bowel screening: current evidence, future directions
    J. M. Cairns, S. Greenley, O. Bamidele, D. Weller
    Cancer Causes & Control.2022; 33(5): 653.     CrossRef
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