title: Evaluating the impact of population changes in diet, physical activity, and weight status on population risk for colon cancer (United States).
abstract: OBJECTIVE
  To estimate the effects of observed population-level changes in risk factors on population risk and incidence of disease.
  
  
  METHODS
  Trends in a set of risk factors for colon cancer (vegetable intake, red meat intake, alcohol consumption, physical activity levels, and weight status) were modeled for the US adult population over the years 1975-1995 and combined with relative risk estimates from epidemiologic studies and a probability distribution for the induction period to estimate the percentage change in incidence rates from 1985 to 1995 due to the five risk factors. A sensitivity analysis was performed to account for imprecision related to estimates of trends in behavior and epidemiologic risk.
  
  
  RESULTS
  Increased vegetable intake and decreased intakes of red meat and alcohol reduced risk, while reduced physical activity and increased body mass index increased risk for colon cancer. When all five factors were considered together, change in the average population relative risk was small and the risk factors accounted for little of the recently observed decline in incidence.
  
  
  CONCLUSIONS
  Although these factors have the potential to greatly affect risk of colon cancer and incidence rates, little of that potential was realized since adverse trends neutralized what progress had been made in the areas of vegetables, red meat, and alcohol consumption.
authors.affiliation: Statistical Research and Applications Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7344, USA. cronink@dcpcenp.nci.nih.gov
authors.forename: K A
authors.initials: KA
authors.lastname: Cronin
authors.forename: S M
authors.initials: SM
authors.lastname: Krebs-Smith
authors.forename: E J
authors.initials: EJ
authors.lastname: Feuer
authors.forename: R P
authors.initials: RP
authors.lastname: Troiano
authors.forename: R
authors.initials: R
authors.lastname: Ballard-Barbash
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D001835:Body Weight; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D015986:Confounding Factors, Epidemiologic; D004034:Diet Surveys; D016021:Epidemiologic Studies; D005069:Evaluation Studies as Topic; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008460:Meat / Q000009:adverse effects; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables