EP275 - Colorectal Cancer Risk and Constipation: a case-control analysis

Purpose/Background: Colorectal cancer is the second leading cause of cancer related death in the United States and the incidence in younger adults is rising. Addressing modifiable risk factors for colon cancer remains of great interest to public health. Constipation is a common condition that has been hypothesized to be a risk factor for colorectal cancer due to prolonged contact of carcinogens in stool with the colonic mucosa. The data regarding the relationship between colon cancer risk and constipation is not well established within the available literature. Here, we present a case-control analysis examining the relationship between constipation, laxative use and colorectal cancer.

Methods/Interventions: This is a prospective, ongoing case-control analysis of patients who presented for colorectal care at a tertiary care hospital system who had undergone colonoscopy within the past year. Enrolled patients completed a survey containing demographic information, personal and family history of colon or rectal cancer, bowel habits, laxative use over the past 2 years, and dietary history. Patients with a prior diagnosis of colon or rectal cancer were compared to a non-colorectal cancer control group. Statistical analysis was performed using t-test for continuous variables and chi-squared test for categorical variables.

Results/Outcomes: 201 patients were enrolled; 58 with colorectal cancer cases and 143 controls. Study groups were notable for colorectal cancer patients being older (mean age 59.9 vs 53.1 years) with a higher percentage of white (95 vs 80%) and male (57 vs 38%) patients. Colorectal cancer patients had a higher rate of previous polyps (74 vs 41%). Demographics are further described in table 1. There was no difference in the frequency of constipation or laxative use between the colorectal cancer and control groups. In both groups, 17% of patients reported constipation (p=0.97). Patients reported using laxatives one time per month or less 74% of the time in the control group and 76% of the time in the colorectal cancer group (p = 0.57).

Conclusion/Discussion: This study found no significant difference in the rate of constipation or laxative use in colorectal cancer patients as compared to controls. Though this study is limited due to a smaller sample size, the strength of the study lies in the prospective nature with real-time data capture thus reducing the risk of recall bias. Future directions are to continue to examine the effects of diet, lifestyle, and other novel, modifiable risk factors for colon cancer.

Table 1
Characteristics of participants with reported constipation status by case-control status.