Archives

  • 2018-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • 2024-04

    • Colorectal cancer CRC is the third most common cancer

    2021-09-13

    Colorectal cancer (CRC) is the third most common cancer in men and the second in women worldwide and almost 55% of the cases occur in more developed areas of the world. In the 2012, more than 1.3 million new cases were reported, which accounts for about 10% of the total cancers worldwide (GLOBOCAN, 2013, O'Keefe, 2016). The wide geographical variation in CRC incidence is remarkable, as illustrated by the World Health Organization (GLOBOCAN, 2013). There is increasing awareness that lifestyle and dietary choices have a profound impact on the pathophysiology of many diseases. This is especially true in Western countries, where the excessive consumption of Western food is on a constant rise. Western diet is generally low in monounsaturated and polyunsaturated fatty acids, plant-derived proteins, and fiber and mostly characterized by food with high content of saturated fat and large amount of processed carbohydrates, as well as high intakes of red meat, processed meat products, unprocessed food additioned with artificial preservatives, refined grains, starch, and high-fat dairy products. At first, this dietary pattern was largely present in North America and Europe, but now is almost an ubiquitous phenomenon since worldwide consensus indicates that it strongly correlates with increasing incidence of several diseases such as obesity, cardiovascular complications, chronic kidney disease and metabolic syndrome (Cordain et al., 2005, Heidemann et al., 2008, Kant, 2004, Odermatt, 2011). CRC presents with the highest incidence rates in Australia/New Zealand, North America and Western Europe. In contrast, incidence tends to be low in rural Africa and Asia (GLOBOCAN, 2013, O'Keefe, 2016, Parkin et al., 2002). CRC is a long multistep process that arises from a combination of genetic and environmental causes. Only 20% of all CRC cases are inherited, as in the Familial Adenomatous Polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC), while vast majority (80%) is sporadic. Most of sporadic and hereditary forms of CRC harbor point mutations or whole allele atp gamma s of the tumor suppressor adenomatous polyposis coli (APC) gene (Kinzler and Vogelstein, 1996). Supporting the idea that diet is a key driver in the geographical variation of CRC incidence, experimental studies in genetic and carcinogen-induced rodent models of CRC have shown that a Western-like diet increases the incidence and aggressiveness of intestinal tumorigenesis (Newmark et al., 2001, Newmark et al., 2009, Wasan et al., 1997, Yang et al., 2001). Already in the 1970s, Burkitt proposed that dietary fibers are able to reduce the risk of colorectal tumorigenesis, based on the observation of low incidence rate of CRC in rural African areas consuming a diet rich in fibers (Burkitt, 1971). In the same decade, Berg assessed that CRC risk is higher among descendants of low-risk populations upon moving to developed-westernized countries and converting to a new, more western, dietary pattern (Berg, 1973). Similarly, Le Marchand observed that Japanese individuals moving to the Hawaii increased their risk of CRC occurrence in only one generation (Le and Kolonel, 1992). Consistently, human prospective and case control studies reported evidence that a high intake of animal fat and cholesterol increases CRC risk (Howe et al., 1997, Jarvinen et al., 2001, Willett et al., 1990). Furthermore, although the exact mechanisms are currently unclear, excess calories introduced as carbohydrates are stored as triglycerides, therefore dietary carbohydrates are associated with a higher systemic insulin concentration and weight gain, contributing to a dysfunctional metabolic system likely leading to obesity, metabolic syndrome, and diabetes mellitus (Giovannucci et al., 2010, Ishino et al., 2013). Many studies have reported diabetes mellitus to be related with the increasing incidence of CRC (Giovannucci et al., 2010, De Bruijn et al., 2013, Deng et al., 2012, Larsson et al., 2005, Shin et al., 2014). Taken together, these studies all indicates that the etiology of CRC is strongly influenced by nutrition, and despite the fact that no single dietary factor shows a strong and consistent enough effect to unequivocally formalize it as a carcinogen or anti-carcinogen, it strongly point out that high fat/high carb Western-style diet increases susceptibility to CRC, while low fat/high fiber diets highly reduces the risk of developing it (Willett, 2001).