Lifestyle factors and risk of sporadic colorectal cancer by microsatellite instability status: A systematic review and meta-analyses
A partir d'une revue systématique de la littérature (31 études), cette méta-analyse évalue l'association entre des facteurs liés au mode de vie (consommation d'alcool, alimentation, utilisation d'un traitement hormonal substitutif de la ménopause, activité physique, tabagisme, etc.) et le risque de cancer sporadique du côlon-rectum, en fonction du statut MSI
Introduction : The association of lifestyle factors with molecular pathological subtypes of colorectal cancer (CRC), such as microsatellite instability (MSI), could provide further knowledge about the colorectal carcinogenic process. The aim of this review was to evaluate possible associations between lifestyle factors and risk of sporadic CRC by MSI status. Methods : PubMed and Web of Science were searched for studies investigating the association between alcohol, body mass index (BMI), dietary fiber, hormone replacement therapy (HRT), non-steroidal anti-inflammatory drugs (NSAIDs), physical activity, red meat, smoking, or statin use, with MSI-high (MSI-H) and microsatellite stable (MSS) CRC. Meta-analyses were performed to calculate summary relative risks (sRR). Results : Overall, 31 studies reporting on the association between lifestyle factors and CRC according to MSI status were included in this review. Ever smoking was associated with MSI-H (sRR=1.62; 95%CI: 1.40-1.88) and MSS/MSI-Low CRC (sRR=1.10; 95%CI: 1.01-1.20), but the association was significantly stronger for MSI-H CRC. The use of HRT was associated with a 20% decrease (sRR=0.80; 95%CI: 0.73-0.89) in the risk of MSS CRC, but was not associated with MSI-H CRC. An increase in BMI per 5 kg/m2 was equally associated with MSS and MSI-H CRC (sRR=1.22, in both cases), but was statistically significant for MSS CRC only (95%CI: 1.11-1.34 and 0.94-1.58, respectively). Limited evidence for associations between other lifestyle factors and CRC by MSI status exists. Conclusions : Lifestyle factors, such as HRT and smoking are differentially associated with the risk of MSI-H and MSS CRC. Further research on associations of lifestyle factors and CRC subtypes is necessary to provide a better understanding of the CRC disease pathway.
Annals of Oncology 2018