Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 12, 2019
Open Peer Review Period: Mar 15, 2019 - Mar 29, 2019
Date Accepted: Jul 19, 2019
(closed for review but you can still tweet)
Behavioural, nutritional and genetic risk factors of colorectal cancers in Morocco: Protocol for a multi-centre case-control study
ABSTRACT
Background:
Colorectal cancer (CRC) has been reported as the third most commonly diagnosed cancer worldwide and is currently considered as a major public health concern. In Morocco, the incidence of CRC increased significantly in the last years. At the same time data (e.g. food balance sheets) demonstrate a change of the typical traditional Moroccan diet to a Westernized diet among the Moroccan population.
Objective:
we present the protocol of a large-scale Moroccan case-control study that aims at investigating associations of diets, other lifestyle factors and genetic factors with CRC risk in Morocco.
Methods:
A case-control study conducted between 2009 and 2017 and including 3032 case-control pairs (1516 cases/1516 controls) matched on sex, age and centre in five major public health hospitals in Morocco. Questionnaires on socio-demographic data, lifestyle, family history of CRC and non-steroidal anti-inflammatory drugs were completed by trained investigators during face-to-face interviews. In addition, participants completed a semi-quantitative food-frequency questionnaire, developed to assess food intake in the Moroccan population. Information regarding genetic factors was recorded for cases; and paraffin blocks (with embedded tumour tissues) are available in 3 collaborating hospitals. Conditional logistic regression analysis are planned to assess the association between diet and CRC risk. Binary logistic regression is considered to predict the association between mutations and nutritional risk factors including only CRC case series.
Results:
All together, 2906 cases and controls (1453 cases and 1453 controls) were considered eligible and included in our study. Both cases and controls did not differ significantly with respect to sex (p=0.51), centre (p=1.00) marital status (p=0.36), alcohol intake (p=0.12), and NSAID use (p=0.95). However, participants in the control group were significantly more physically active and more likely to be never smokers and to have a higher education level than cases.
Conclusions:
This is the first study investigating potential risk factors of CRC risk such as nutrition, lifestyle and genetic factors, originating from a southern Mediterranean country with low but increasing CRC prevalence. Identified risk factors will allow the establishment of evidence based preventive actions regarding nutrition and other lifestyle habits adapted to the Moroccan context. In brief, this study will promote cancer research and prevention in Morocco. Clinical Trial: Our study is not clinical trial
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