ENVIRONMENTAL AND FAMILIAL RISK-FACTORS IN RELATION TO THE COLORECTALADENOMA-CARCINOMA SEQUENCE - RESULTS OF A CASE-CONTROL STUDY IN BURGUNDY (FRANCE)

A case-control study in the Cote-d'Or area (Burgundy, France) investig ated the relationship between environmental and familial risk factors and the different steps off the adenoma-carcinoma sequence. Two adenom a groups (<10mm and greater than or equal to 10mm), a polyp-free contr ol group, a colorectal cancer group and a general population control g roup were recruited. Tobacco was associated,vith the risk of adenomas, and alcohol with the risk of large adenomas. They proved to be indepe ndently related to large adenoma formation when compared with controls . There was no association with cancer risk. Refined cereals, delicate ssen, offal and fats appear to be risk factors along the adenoma-carci noma sequence. This data does not support an increased risk with high consumption of fresh meat, or a protective effect of dairy products an d calcium. A high consumption of vegetables was a protective factor fo r cancer, mainly in men. Excess weight and body mass index influenced the earlier step of the adenoma carcinoma sequence and excess calorie intake was risk factor for cancer. The decision to study precancerous lesions as well as cancer appears fruitful. Results suggest that the t hree stages of large bowel carcinogenesis are partly related to diet i n different ways. They are concordant with risk factors recorded for c olorectal cancer, but suggest some local specificities.