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The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 27180

Special Issue Editors

Dr. Vincenza Gianfredi

E-Mail Website
Guest Editor
School of Medicine Vita-Salute San Raffaele University, Milan, Italy
Interests: epidemiology; cancer prevention; public health; health promotion; lifestyle behavior; health education
Special Issues, Collections and Topics in MDPI journals
Dr. Daniele Nucci

E-Mail Website
Guest Editor
Research Dietitian-Nutritionist, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
Interests: human nutrition; cancer prevention; culinary nutrition; colon cancer; esophageal cancer; Barrett’s esophagus; nutrition education; mental health; health promotion

Special Issue Information

Dear Colleagues,

On behalf of the International Journal of Environmental Research and Public Health (IJERPH), we are organizing a Special Issue on the role of lifestyle in gastrointestinal cancers: prevention, treatment and survival. IJERPH is a peer-reviewed scientific journal that publishes manuscripts in the interdisciplinary area of environmental health sciences and public health.

Gastrointestinal (GI) cancers include five major types of cancers (stomach, liver, esophagus, pancreas, and colorectum) with approximately 5 million new cases and 4 million deaths worldwide in 2018. GI cancers are predicted to increase by 2040. These data highlight the continuing challenge that GI cancers present to public health.

In most cases, these five types of cancers share the same modifiable risk factors, including alcohol consumption, smoking, infection, diet, and obesity, showing a large margin for intervention in prevention, treatment, and survival. In fact, with the exception of colorectal cancer, the prognosis tends to be poor, mostly due to the late-stage diagnoses and reduced treatment options. Considering that the incidence of GI cancers is forecast to increase (from 58% to 73%, in the next decades), and taking into account that most of the risk factors are modifiable and attributable to lifestyle, new studies are needed in order to assess their role in the prevention, treatment, and survival of GI cancers.

This Special Issue of IJERPH focuses on the current state of knowledge on the links between a broad range of lifestyle factors (including but not limited to diet, physical activity, smoking, alcohol consumption) and GI cancers. New research papers, reviews, case reports, and protocol studies are welcome to this Issue. Special attention will be paid to original research (including systematic reviews). Studies do not necessarily have to offer “positive results” (i.e., results confirming previous literature).

Dr. Vincenza Gianfredi
Dr. Daniele Nucci
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal cancer
  • lifestyle
  • diet
  • cancer prevention
  • cancer treatment
  • cancer survivors

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Published Papers (5 papers)

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Research

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13 pages, 656 KiB  
Article
Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory
by Wenshuang Wei, Miao Zhang, Dan Zuo, Qinmei Li, Min Zhang, Xinguang Chen, Bin Yu and Qing Liu
Int. J. Environ. Res. Public Health 2022, 19(7), 4203; https://doi.org/10.3390/ijerph19074203 - 1 Apr 2022
Cited by 6 | Viewed by 2404
Abstract
Colorectal cancer poses a serious threat worldwide. Although early screening has been proved to be the most effective way to prevent and control colorectal cancer, the current situation of colorectal cancer screening remains not optimistic. The aim of this article is to apply [...] Read more.
Colorectal cancer poses a serious threat worldwide. Although early screening has been proved to be the most effective way to prevent and control colorectal cancer, the current situation of colorectal cancer screening remains not optimistic. The aim of this article is to apply the protection motivation theory (PMT) to examine the influencing factors on screening intention of colorectal cancer (CRC). This cross-sectional survey was launched in five communities in Wuhan, China. All the eligible urban Chinese were recruited and interviewed using paper-and-pencil questionnaires. The intention of colorectal cancer screening (CRCS) was measured using six PMT subconstructs, including perceived risk, perceived severity, fear arousal, response efficacy, response cost, and self-efficacy. Data on sociodemographic variables and knowledge of CRC were also collected. The structural equation modeling (SEM) method was used for data analysis. Among all the 569 respondents, 83.66% expressed willingness to participate in CRCS. Data of the research fit the proposed SEM model well (Chi-square/df = 2.04, GFI = 0.93, AGFI = 0.91, CFI = 0.91, IFI = 0.91, RMSEA = 0.04). Two subconstructs of PMT (response efficacy and self-efficacy) and CRC knowledge were directly and positively associated with screening intention. Age, social status, medical history, physical activity, and CRC knowledge were indirectly related to the screening intention through at least one of the two PMT subconstructs (response efficacy and self-efficacy). The findings of this study suggest the significance of enhancing response efficacy and self-efficacy in motivating urban Chinese adults to participate in CRC screening. Knowledge of CRC is significantly associated with screening intention. This study can provide useful information for the formulation and improvement of colorectal cancer screening strategies and plans. Full article
(This article belongs to the Special Issue The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival)
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17 pages, 712 KiB  
Article
Cost-Effectiveness of Colorectal Cancer Genetic Testing
by Abdul Rahman Ramdzan, Mohd Rizal Abdul Manaf, Azimatun Noor Aizuddin, Zarina A. Latiff, Keng Wee Teik, Gaik-Siew Ch'ng, Kurubaran Ganasegeran and Syed Mohamed Aljunid
Int. J. Environ. Res. Public Health 2021, 18(16), 8330; https://doi.org/10.3390/ijerph18168330 - 6 Aug 2021
Cited by 5 | Viewed by 3270
Abstract
Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3–5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic [...] Read more.
Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3–5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic testing can identify genes that cause these syndromes. Early detection could facilitate the initiation of targeted prevention strategies and surveillance for CRC patients and their families. The aim of this study was to determine the cost-effectiveness of CRC genetic testing. We utilized a cross-sectional design to determine the cost-effectiveness of CRC genetic testing as compared to the usual screening method (iFOBT) from the provider’s perspective. Data on costs and health-related quality of life (HRQoL) of 200 CRC patients from three specialist general hospitals were collected. A mixed-methods approach of activity-based costing, top-down costing, and extracted information from a clinical pathway was used to estimate provider costs. Patients and family members’ HRQoL were measured using the EQ-5D-5L questionnaire. Data from the Malaysian Study on Cancer Survival (MySCan) were used to calculate patient survival. Cost-effectiveness was measured as cost per life-year (LY) and cost per quality-adjusted life-year (QALY). The provider cost for CRC genetic testing was high as compared to that for the current screening method. The current practice for screening is cost-saving as compared to genetic testing. Using a 10-year survival analysis, the estimated number of LYs gained for CRC patients through genetic testing was 0.92 years, and the number of QALYs gained was 1.53 years. The cost per LY gained and cost per QALY gained were calculated. The incremental cost-effectiveness ratio (ICER) showed that genetic testing dominates iFOBT testing. CRC genetic testing is cost-effective and could be considered as routine CRC screening for clinical practice. Full article
(This article belongs to the Special Issue The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival)
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Review

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23 pages, 493 KiB  
Review
The Rise of Gastrointestinal Cancers as a Global Phenomenon: Unhealthy Behavior or Progress?
by Silvia Rodrigues Jardim, Lucila Marieta Perrotta de Souza and Heitor Siffert Pereira de Souza
Int. J. Environ. Res. Public Health 2023, 20(4), 3640; https://doi.org/10.3390/ijerph20043640 - 18 Feb 2023
Cited by 32 | Viewed by 5036
Abstract
The overall burden of cancer is rapidly increasing worldwide, reflecting not only population growth and aging, but also the prevalence and spread of risk factors. Gastrointestinal (GI) cancers, including stomach, liver, esophageal, pancreatic, and colorectal cancers, represent more than a quarter of all [...] Read more.
The overall burden of cancer is rapidly increasing worldwide, reflecting not only population growth and aging, but also the prevalence and spread of risk factors. Gastrointestinal (GI) cancers, including stomach, liver, esophageal, pancreatic, and colorectal cancers, represent more than a quarter of all cancers. While smoking and alcohol use are the risk factors most commonly associated with cancer development, a growing consensus also includes dietary habits as relevant risk factors for GI cancers. Current evidence suggests that socioeconomic development results in several lifestyle modifications, including shifts in dietary habits from local traditional diets to less-healthy Western diets. Moreover, recent data indicate that increased production and consumption of processed foods underlies the current pandemics of obesity and related metabolic disorders, which are directly or indirectly associated with the emergence of various chronic noncommunicable conditions and GI cancers. However, environmental changes are not restricted to dietary patterns, and unhealthy behavioral features should be analyzed with a holistic view of lifestyle. In this review, we discussed the epidemiological aspects, gut dysbiosis, and cellular and molecular characteristics of GI cancers and explored the impact of unhealthy behaviors, diet, and physical activity on developing GI cancers in the context of progressive societal changes. Full article
(This article belongs to the Special Issue The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival)
21 pages, 3350 KiB  
Review
Early Gastric Cancer: Update on Prevention, Diagnosis and Treatment
by Clara Benedetta Conti, Stefano Agnesi, Miki Scaravaglio, Pietro Masseria, Marco Emilio Dinelli, Massimo Oldani and Fabio Uggeri
Int. J. Environ. Res. Public Health 2023, 20(3), 2149; https://doi.org/10.3390/ijerph20032149 - 25 Jan 2023
Cited by 46 | Viewed by 7533
Abstract
Gastric cancer (GC) is a relevant public health issue as its incidence and mortality rates are growing worldwide. There are recognized carcinogen agents, such as obesity, tobacco, meat, alcohol consumption and some dietary protective factors. Strategies of early diagnosis through population-based surveillance programs [...] Read more.
Gastric cancer (GC) is a relevant public health issue as its incidence and mortality rates are growing worldwide. There are recognized carcinogen agents, such as obesity, tobacco, meat, alcohol consumption and some dietary protective factors. Strategies of early diagnosis through population-based surveillance programs have been demonstrated to be effective in lowering the morbidity and mortality related to GC in some countries. Indeed, the detection of early lesions is very important in order to offer minimally invasive treatments. Endoscopic resection is the gold standard for lesions with a low risk of lymph node metastasis, whereas surgical mini-invasive approaches can be considered in early lesions when endoscopy is not curative. This review outlines the role of lifestyle and prevention strategies for GC, in order to reduce the patients’ risk factors, implement the surveillance of precancerous conditions and, therefore, improve the diagnosis of early lesions. Furthermore, we summarize the available treatments for early gastric cancer. Full article
(This article belongs to the Special Issue The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival)
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23 pages, 2075 KiB  
Review
Association between Dietary Fibre Intake and Colorectal Adenoma: A Systematic Review and Meta-Analysis
by Daniele Nucci, Cristina Fatigoni, Tania Salvatori, Mariateresa Nardi, Stefano Realdon and Vincenza Gianfredi
Int. J. Environ. Res. Public Health 2021, 18(8), 4168; https://doi.org/10.3390/ijerph18084168 - 15 Apr 2021
Cited by 28 | Viewed by 7220
Abstract
PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus were searched in January 2021 in order to retrieve evidence assessing the association between dietary fibre intake and the risk of colorectal adenoma in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were [...] Read more.
PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus were searched in January 2021 in order to retrieve evidence assessing the association between dietary fibre intake and the risk of colorectal adenoma in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the reporting of results. Only primary observational studies were included. Publication bias was estimated through the Egger’s test and the visual inspection of the funnel plot. Heterogeneity between studies was calculated with I2 statistics. The search strategy identified 683 papers, 21 of which were included in our meta-analysis. Having evaluated a total of 157,725 subjects, the results suggest a protective effect of dietary fibre intake against colorectal adenoma. Effect Size (ES) was [0.71 (95% CI = 0.68–0.75), p = 0.000)]. Moderate statistical heterogeneity (Chi2 = 61.68, df = 23, I2 = 62.71%, p = 0.000) was found. Findings show a statistically significant (p = 0.000) and robust association between a higher intake of dietary fibre and a lower risk of colorectal adenoma, considering both the prevalent and incident risk. Moreover, the meta-regression analysis showed a borderline significant negative linear correlation between the amount of dietary fibre intake and colorectal adenoma. Lastly, we performed a subgroup analysis by sex, showing a higher protective effect for men. Full article
(This article belongs to the Special Issue The Role of Lifestyle in Gastrointestinal Cancer: Prevention, Treatment and Survival)
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