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  1. [Note: this was a discussion that Rodney started in response to a post on another thread. After talking about it with Rodney, we thought it worthwhile on this new "General Health and Longevity" forum to start a new thread on colon cancer screening. So I've moved the discussion to its own thread here. While our good diets make colon cancer less of an issue for CR practitioners than the general population, it is a serious enough health risk (3rd leading cause of cancer deaths) that it is worth serious consideration, and screening for. -Dean] Despite having no known family history of colon problems of any kind in previous generations, my brother and I both seem to acquire a new polyp about every two years. So, of course, we need to have occasional colonoscopies. My last colonoscopy was two weeks ago, and prior to that the previous one had been in 2009. You can guess how many new polyps they found this time: three of course: One of moderate size, one smaller, and one tiny one ...... likely to have appeared, respectively, in 2010, 2012 and 2014. All of them were quickly and painlessly removed and sent to pathology. Polyps of course, start off benign, but if left long enough, are likely to turn into cancer. Now the relevence of this to Dean's post is that none of the nine polyps I have had removed over the years have shown even the very earliest suggestions of turning cancerous - even the one just removed, for example, that probably had been sitting there for five years since 2010. (But what would the current status of the one found in 1998 be, had it not been found and removed?) It seems likely the explanation of the benign nature of my polyps might be that I have gone a long way out of my way to avoid eating stuff that, while no doubt devastatingly tasty, might also be devastatingly carcinogenic (incinerated fat, for example, in particular). Anyway, SFSG. I have noted to have another colonoscopy in 2019 and expect them to find another two then. Six years is a bit too long to go between checks for someone who regularly seems to sprout new ones. Anyone approaching the age of 60, who is aiming to live to be 100, and has never had one, probably ought to get a baseline colonoscopy and then follow the gastroenterologist's advice. Having them reduces the chance of getting colon cancer - a rather common form of the disease - by not far short of 100%. Not only that, the health systems have finally figured out that doing colonoscopies at appropriate intervals - which will vary from patient to patient - is less expensive than the cost of treating the cancer when it appears if colonoscopies are not done. Incidentally, all my polyps have been found in the ASCENDING colon or at the very start of the transverse colon. They would never have been found by any other investigative technique until far too late. It may also be worth mentioning that it is surprising to me how often, even when cancer is found in a polyp, if it is found early, the cancer can be surgically cured. And I do mean *genuinely* cured - not the five-year supposed cure so often talked about in cancer treatments. But changes in diet are of course necessary if cancerous polyps are not to recur. Rodney. "The unverified conventional wisdom is almost invariably mistaken."
  2. Diet & Colon Cancer Prevention While researching the Adventists diet study for prostate cancer prevention, Al Pater kindly pointed me to a similar study [1] of diet and colon cancer risk among the Adventists in the AHS-2 study by the same authors (thanks Al!). It followed 96,000 Adventists of both genders for an average follow-up time of 7.3 years to see which diets were associated with a reduced risk of colon cancer. As expected, all vegetarians combined were 22% less likely than omnivores to develop any form of colon cancer during the follow-up (HR 0.78: 95% CI, 0.64-0.95). Here is the breakdown of colon cancer risk by various types of vegetarian diets, again relative to omnivores: Vegans 0.84 (95% CI, 0.59-1.19); lacto-ovo vegetarians 0.82 (95% CI, 0.65-1.02); pescovegetarians, 0.57 (95% CI, 0.40-0.82) semivegetarians, 0.92 (95% CI, 0.62-1.37) For colon cancer, it appears to be the pesky pesco-vegetarians who have the lowest risk of colon cancer. But vegans win overall, at least among this healthy Adventist population relative to all cancers (not just prostate or colon cancer), according to [2]. From the abstract: ... vegan diets showed statistically significant protection for overall cancer incidence (HR, 0.84; 95% CI, 0.72-0.99) in both genders combined. Here is the diagram from [2] comparing the overall cancer risk for different forms of vegetarian diets, relative to omnivores: If we look at the male & female line (first highlight) or the male-only line (second highlight) in the fully adjusted model (including adjusting for BMI), it is only the vegan dietary pattern that reaches the level of 0.05 significance, and is P < 0.05 for the combined gender group. The other vegetarian subgroups failed to show a statistically significant lower overall risk of cancer relative to omnivores. Go ahead - call my Dr. Greger. But thems the data... --Dean ----------- [1] JAMA Intern Med. 2015 May;175(5):767-76. doi: 10.1001/jamainternmed.2015.59. Vegetarian dietary patterns and the risk of colorectal cancers. Orlich MJ(1), Singh PN(2), Sabaté J(1), Fan J(2), Sveen L(2), Bennett H(2), Knutsen SF(1), Beeson WL(2), Jaceldo-Siegl K(1), Butler TL(2), Herring RP(2), Fraser GE(1). IMPORTANCE: Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established. OBJECTIVE: To evaluate the association between vegetarian dietary patterns and incident colorectal cancers. DESIGN, SETTING, AND PARTICIPANTS: The Adventist Health Study 2 (AHS-2) is a large, prospective, North American cohort trial including 96,354 Seventh-Day Adventist men and women recruited between January 1, 2002, and December 31, 2007. Follow-up varied by state and was indicated by the cancer registry linkage dates. Of these participants, an analytic sample of 77,659 remained after exclusions. Analysis was conducted using Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. The analysis was conducted between June 1, 2014, and October 20, 2014. EXPOSURES: Diet was assessed at baseline by a validated quantitative food frequency questionnaire and categorized into 4 vegetarian dietary patterns (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a nonvegetarian dietary pattern. MAIN OUTCOMES AND MEASURES: The relationship between dietary patterns and incident cancers of the colon and rectum; colorectal cancer cases were identified primarily by state cancer registry linkages. RESULTS: During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64-0.95) for all colorectal cancers, 0.81 (95% CI, 0.65-1.00) for colon cancer, and 0.71 (95% CI, 0.47-1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was 0.84 (95% CI, 0.59-1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65-1.02); in pescovegetarians, 0.57 (95% CI, 0.40-0.82); and in semivegetarians, 0.92 (95% CI, 0.62-1.37) compared with nonvegetarians. Effect estimates were similar for men and women and for black and nonblack individuals. CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with an overall lower incidence of colorectal cancers. Pescovegetarians in particular have a much lower risk compared with nonvegetarians. If such associations are causal, they may be important for primary prevention of colorectal cancers. PMCID: PMC4420687 PMID: 25751512 ------------ [2] Cancer Epidemiol Biomarkers Prev. 2013 Feb;22(2):286-94. doi: 10.1158/1055-9965.EPI-12-1060. Epub 2012 Nov 20. Vegetarian diets and the incidence of cancer in a low-risk population. Tantamango-Bartley Y(1), Jaceldo-Siegl K, Fan J, Fraser G. Author information: (1)Department of Epidemiology and Biostatistics, Loma Linda University, School of Public Health, Loma Linda, CA 92350, USA. ytantamango@hotmail.com BACKGROUND: Cancer is the second leading cause of death in the United States. Dietary factors account for at least 30% of all cancers in Western countries. As people do not consume individual foods but rather combinations of them, the assessment of dietary patterns may offer valuable information when determining associations between diet and cancer risk. METHODS: We examined the association between dietary patterns (non-vegetarians, lacto, pesco, vegan, and semi-vegetarian) and the overall cancer incidence among 69,120 participants of the Adventist Health Study-2. Cancer cases were identified by matching to cancer registries. Cox proportional hazard regression analysis was conducted to estimate hazard ratios, with "attained age" as the time variable. RESULTS: A total of 2,939 incident cancer cases were identified. The multivariate HR of overall cancer risk among vegetarians compared with non-vegetarians was statistically significant [hr, 0.92; 95% confidence interval (CI), 0.85-0.99] for both genders combined. Also, a statistically significant association was found between vegetarian diet and cancers of the gastrointestinal tract (HR, 0.76; 95% CI, 0.63-0.90). When analyzing the association of specific vegetarian dietary patterns, vegan diets showed statistically significant protection for overall cancer incidence (HR, 0.84; 95% CI, 0.72-0.99) in both genders combined and for female-specific cancers (HR, 0.66; 95% CI, 0.47-0.92). Lacto-ovo-vegetarians appeared to be associated with decreased risk of cancers of the gastrointestinal system (HR, 0.75; 95% CI, 0.60-0.92). CONCLUSION: Vegetarian diets seem to confer protection against cancer. IMPACT: Vegan diet seems to confer lower risk for overall and female-specific cancer than other dietary patterns. The lacto-ovo-vegetarian diets seem to confer protection from cancers of the gastrointestinal tract. PMCID: PMC3565018 PMID: 23169929
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