Physical fitness reduces the risk of colon cancer in people with family adenomatous polyposis

Physical movement to reduce the risk of sporadic and genetically induced CRC is an effective treatment that goes beyond its effectiveness.

Since FAP is an inherited illness, the study included 10 cases in which 2 members of the same family took part, and 7 cases in which 3 members of the same family took part. The researchers carried out preliminary analyzes according to family lines, but found no observable differences in the results.

study parameters evaluated

All participants were subjected twice between September 2000 and August 2007, first at the time of the setting, followed by another test 2 years later. The participants led the stress test in the form of a postprandial level test at least 2 hours after the last meal and after confirming lactic acid levels (LA) in the blood in the rest of the state by < 1.5 mmol/l. The heart rate (HR) was measured immediately after the step test and the predicted maximum oxygen recording (VO 2 max) was increased based on the increase in the HF, since the training intensity is also increasing. The intensity levels were adapted to age, with participants aged 50 and over the test with a little fewer steps per minute.

primary result measurements

The authors examined 2 primary endpoints: the development of CRC and the maximum polyp diameter, measured during colonoscopies that were carried out up to 3 years ago up to 2 years after the step test. The authors compared these two results with the VO of the participants 2 Max during the stress test, the surrogate marker for physical fitness.

important knowledge

Even after adjustments to age, gender, surgical history, alcohol consumption and smoking status, the risk of CRC was significantly higher _{2 max compared to those with high VO 2 max (or: 3,32; 95 % KI: 1.00–11,02). In other words, the risk of developing CRC decreased with increasing physical fitness.}

In the 40 participants without a colectomy in the history, the maximum polyp diameter was similarly significantly negative with the VO maximum ( r = - 0.44, p <0.01).

practice implications

The researchers found that although more and more epidemiological evidence show the positive effect of physical activity on the prevention of sporadic CRC, 1–3 There are only a few studies on the effects of physical activity on people with FAP. This represents an urgently needed study area, since almost 100 % of people with FAP, if they remain untreated, finally develop CRC. ⁴ In view of this dramatically increased malignancy risk and the resulting drastic directive on the prophylactic colectomy as common practice, chemofeating treatments represent a decisive area of ​​care for this population group. have proven to be effective when reducing the polyp load and the progression of intestinal patients in patients with FAP. Quercetin. 11 The present publication provides mandatory evidence for the inclusion of exercises in this list. This simple recommendation for lifestyle can enable more patients with FAP to avoid larger surgical interventions and at the same time reduce the risk of CRC development.

Although the mechanism of action of movement in CRC prevention remains unclear, possibly due to the large number of biological signal paths that are influenced by physical activity, a number of potential mechanisms were proposed. Movement can reduce the inflammation of the colon, a crucial factor for the progression of the tumor; A higher degree of physical activity at the beginning of the study is associated with lower concentrations of prostaglandin e 2 (PG 2 ) in the rectal mucosa, as identified by biopsy up to 26 months later. ^{12 Another possibility of how sport can influence the CRC risk from its role in insulin regulation. It is now generally known that movement increases insulin sensitivity and reduces the obvious insulin production. High insulin levels related to a seated way of life, a high body mass and an increase in abdominal obesity are a mitogean for both normal and neoplastic thick -intestine.}

As the results of this study show, the effects of regular exercise and adequate physical conditioning can also extend to other forms of CRC in which genetic mutations play a role. This latter-mentioned effect of physical activity on insulin metabolism can provide an indication of the potential effect of physical activity on hereditary non-polyped colorectal carcinoma (HNPCC). Zecevic et al. (2006) found a possible connection between a mutation in the insulin-like growth factor (IGF) and an increased risk of CRC in patients with HNPCC. They showed that variants of the IGF-1 genotype with shorter cytosine adenades (CA) reimbursement promoter lengths were strongly associated with the development of malignancy at HNPCC. In fact, the time until the inserting of CRC decreased with every acceptance of the CA reimbursement number (HR = 1.17; 95 % KI: 1.05–1.31; p = 0.006) and patients with a CA < 17 repetition allelele had a statistically higher risk risk (HR = 2.36; 95 % KI: 1,28–4,36; But one of the main interactions between these related hormones is the stimulating effect of insulin on IGF-1 synthesis. ^{18 Therefore, movement as a modulator of insulin level as treatment for the treatment of increased IF-1 production in HNPCC can be promising. This theory is promising, since Kim et al. (2005) Research carried out that moderate training reduces the circulating mirror of insulin and IGF-1 over a long period of time.}

physical activity to reduce the risk of a sporadic and genetically conditioned CRC is an effective treatment that goes beyond its effectiveness, as has been repeatedly explained - it is free of charge and easily accessible to all patients. In the field of medicine, especially in the area of ​​oncology, the seduction of innovation and technology can often lead to simple but effective strategies for both doctors and patients. Nakamura et al. remind us of the crucial importance of primary prevention and illustrate how nature, here a genetic predisposition for CRC, can be influenced by suitable care.