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      Association of Survival With Adherence to the American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors After Colon Cancer Diagnosis : The CALGB 89803/Alliance Trial

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          Abstract

          The American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors (ACS guidelines) include maintaining (1) a healthy body weight; (2) physical activity; and (3) a diet that includes vegetables, fruits, and whole grains. It is not known whether patients with colon cancer who follow these guidelines have improved survival.

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          Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study).

          Bette Caan, Jeffrey A. Meyerhardt, Candyce Kroenke … (2017)
          Background: Body composition may partially explain the U-shaped association between body mass index (BMI) and colorectal cancer survival.Methods: Muscle and adiposity at colorectal cancer diagnosis and survival were examined in a retrospective cohort using Kaplan-Meier curves, multivariable Cox regression, and restricted cubic splines in 3,262 early-stage (I-III) male (50%) and female (50%) patients. Sarcopenia was defined using optimal stratification and sex- and BMI-specific cut points. High adiposity was defined as the highest tertile of sex-specific total adipose tissue (TAT). Primary outcomes were overall mortality and colorectal cancer-specific mortality (CRCsM).Results: Slightly over 42% patients were sarcopenic. During 5.8 years of follow-up, 788 deaths occurred, including 433 from colorectal cancer. Sarcopenic patients had a 27% [HR, 1.27; 95% confidence interval (CI), 1.09-1.48] higher risk of overall mortality than those who were not sarcopenic. Females with both low muscle and high adiposity had a 64% higher risk of overall mortality (HR, 1.64; 95% CI, 1.05-2.57) than females with adequate muscle and lower adiposity. The lowest risk of overall mortality was seen in patients with a BMI between 25 and <30 kg/m(2), a range associated with the greatest number of patients (58.6%) who were not at increased risk of overall mortality due to either low muscle or high adiposity.Conclusions: Sarcopenia is prevalent among patients with non-metastatic colorectal cancer, and should, along with adiposity be a standard oncological marker.Impact: Our findings suggest a biologic explanation for the obesity paradox in colorectal cancer and refute the notion that the association between overweight and lower mortality is due solely to methodologic biases. Cancer Epidemiol Biomarkers Prev; 1-8. ©2017 AACR.
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            Point and interval estimates of partial population attributable risks in cohort studies: examples and software.

            E Hertzmark, D Spiegelman, H Wand (2007)
            The concept of the population attributable risk (PAR) percent has found widespread application in public health research. This quantity describes the proportion of a disease which could be prevented if a specific exposure were to be eliminated from a target population. We present methods for obtaining point and interval estimates of partial PARs, where the impact on disease burden for some presumably modifiable determinants is estimated in, and applied to, a cohort study. When the disease is multifactorial, the partial PAR must, in general, be used to quantify the proportion of disease which can be prevented if a specific exposure or group of exposures is eliminated from a target population, while the distribution of other modifiable and non-modifiable risk factors is unchanged. The methods are illustrated in a study of risk factors for bladder cancer incidence (Michaud DS et al., New England J Med 340 (1999) 1390). A user-friendly SAS macro implementing the methods described in this paper is available via the worldwide web.
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              Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices

              C L Rock, B. Grant, W Demark-Wahnefried … (2006)
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                Author and article information

                Journal
                Title: JAMA Oncology
                Abbreviated Title: JAMA Oncol
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2374-2437
                Publication date Created: June 01 2018
                Publication date (Print): June 01 2018
                Volume: 4
                Issue: 6
                Page: 783
                Affiliations
                [1 ]Department of Epidemiology and Biostatistics, University of California, San Francisco
                [2 ]Department of Urology, University of California, San Francisco
                [3 ]Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
                [4 ]Alliance Statistics and Data Center, Duke University, Durham, North Carolina
                [5 ]Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
                [6 ]Memorial Sloan Kettering Cancer Center, New York, New York
                [7 ]Toledo Community Hospital Oncology Program, Toledo, Ohio
                [8 ]Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
                [9 ]Loyola University, Stritch School of Medicine, Naperville, Illinois
                [10 ]Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
                [11 ]Virginia Oncology Associates, Norfolk, Virginia
                [12 ]Southeast Clinical Oncology Research Consortium, Mission Hospitals Inc, Asheville, North Carolina
                [13 ]University of Chicago Comprehensive Cancer Center, Chicago, Illinois
                [14 ]Helen Diller Family Comprehensive Cancer Center, San Francisco, California
                [15 ]Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco
                [16 ]Program in Molecular Pathology Epidemiology (MPE), Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
                [17 ]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
                [18 ]Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
                [19 ]Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
                Article
                DOI: 10.1001/jamaoncol.2018.0126
                PMC ID: 6145685
                PubMed ID: 29710284
                SO-VID: 0be8628f-6e64-4efa-92ce-dd03744baa5a
                Copyright © © 2018
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