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.
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).
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.
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.
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 November 2018.
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#5,142,991
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Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,859 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.6. This one has gotten more attention than average, scoring higher than 62% of its peers.
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We're also able to compare this research output to 147 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.
