Abstrak: Most epidemiologic studies on folate intake suggest that folate may be protective against colorectal cancer, but the results on circulating (plasma or serum) folate are mostly inconclusive. We conducted a meta-analysis of case-control studies nested within prospective studies on circulating folate and colorectal cancer risk by using flexible meta-regression models to test the linear and nonlinear dose-response relationships. A total of 8 publications (10 cohorts, representing 3,477 cases and 7,039 controls) were included in the meta-analysis. The linear and nonlinear models corresponded to relative risks of 0.96 (95% confidence interval (CI): 0.91, 1.02) and 0.99 (95% CI: 0.96, 1.02), respectively, per 10 nmol/L of circulating folate in contrast to the reference value. The pooled relative risks when comparing the highest with the lowest category were 0.80 (95% CI: 0.61, 0.99) for radioimmunoassay and 1.03 (95% CI: 0.83, 1.22) for microbiological assay. Overall, our analyses suggest a null association between circulating folate and colorectal cancer risk. The stronger association for the radioimmunoassay-based studies could reflect differences in cohorts and study designs rather than assay performance. Further investigations need to integrate more accurate measurements and flexible modeling to explore the effects of folate in the presence of genetic, lifestyle, dietary, and hormone-related factors.

Abstrak: Adenomatous polyposis coli gene (APC) polymorphisms may influence the risk for colorectal neoplasia. However, results thus far have been inconclusive. We performed a systematic literature search of the Medline, Embase, Cochrane Collaboration, and HuGE databases and reviewed the references of pertinent articles through May 2012. Odds ratios with 95% confidence intervals were used to estimate the association between 3 APC polymorphisms (D1822V, E1317Q, and I1307K) and colorectal neoplasia. In total, 40 studies from 1997 to 2010 were included in this meta-analysis, and individuals with the D1822V variant homozygote VV genotype had a slight decrease in the risk for colorectal neoplasia compared with the wild-type homozygote DD genotype (pooled odds ratio = 0.87, 95% confidence interval: 0.77, 0.99). There was a small association between the APC E1317Q polymorphism and a risk for colorectal neoplasia (variant vs. wild-type: pooled odds ratio = 1.41, 95% confidence interval: 1.14, 1.76), particularly for colorectal adenomas (variant vs. wild-type: odds ratio = 2.89, 95% confidence interval: 1.83, 4.56). Compared with those who carried the wild-type I1307K, Ashkenazi Jews who carried the I1307K variant were at a significantly increased risk for colorectal neoplasia, with a pooled odds ratio of 2.17 (95% confidence interval: 1.64, 2.86). Our study suggests that APC is a candidate gene for colorectal neoplasia susceptibility.

Abstrak: Penyakit kanker kolorektal merupakan kanker usus besar dan rektum yang saat ini masih menjadi masalah kesehatan didunia termasuk di Indonesia. Penelitian ini bertujuan untuk mengetahui faktor risiko dan dominan dari kanker kolorektal. Desain studi yang digunakan adalah matched case control dengan matching umur menggunakan data rekam medis, kasus adalah pasien kanker kolorektal dan kontrol adalah pasien trauma dan patah tulang. Sampel berjumlah 122 orang dengan 61 pasangan kasus dan kontrol. Hasil analisis bivariat mc nemar chi square menunjukkan faktor risiko yang berhubungan adalah pola makan daging merah dengan OR=27 (95% CI 4,45-1105,4), asupan lemak tinggi dengan OR=2,2 (95% CI 0,967-5,542), dan asupan serat rendah OR=44 (95% CI 7,49-1776,9). Analisis multivariat conditional regresi logistic menunjukkan faktor paling dominan adalah asupan serat rendah dengan OR=26,8 (95% CI 3,44-209,5). Adapun faktor risiko yang tidak berhubungan adalah jenis kelamin, tingkat pendidikan, riwayat keluarga, pendapatan keluarga, aktifitas fisik, obesitas, merokok dan alkohol. Diperlukan upaya pencegahan penyakit kanker kolorektal dengan cara memperbanyak asupan serat, mengurangi asupan lemak tinggi dan pola konsumsi daging merah.
Kata kunci : Kanker kolorektal, Matched case control, Faktor risiko

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Colectal cancer disease is colon cancer and rectum until now is a health problem in the word, including in Indonesia yet. The purpose of this study is to investigate the risk factor and dominant factor of colorectal cancer. The design of study used was matched case control with age matching using the medical record data, the data of case were colorectal cancer patients and control were trauma and fracture patients. The calculate sample is 122 people were 61 pairs of cases and controls. The result of bivariate analysis of mc nemar chi square showed related risk factor was red meat diet with OR=27 (95% CI 4,45-1105,4), high fat intake with OR=2,2 (95% CI 0,967-5,542), and low fiber intake with OR=44 (95% CI 7,49- 1776,9). Multivariate analysis of conditional logistic regression showed the most important factor was low fiber intake with OR=26,8 (95% CI 3,448-209,5). The unrelated risk factors are gender, education level, family history, family income, physical activity, obesity, smoking and alcohol. It is necessary to prevent the prevention of colorectal cancer by increasing fiber intake, reducing fat intake and concumption pattern of read meat.
Keywords : Colorectal cancer, Matched case control, Risk factor