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. Author manuscript; available in PMC: 2012 Mar 1.
Published in final edited form as: Gut. 2010 Oct 29;60(3):397–411. doi: 10.1136/gut.2010.217182

Table 1.

Molecular pathologic epidemiology studies on possible etiologic factors and molecular changes in colorectal neoplasia

Ref. First author Year Study design Tissue specimens Study cohort, sample sizes (N)* and notes Exposure variables Potential modifiable factors Outcome variables Main findings on modifiable (or genetic) factors and tumoral molecular changes
Case-case studies
[17] Arain 2010 Case-case CC 194 CC (63 interval CC), 0 non-cancer controls Colonoscopy within 5 years prior to diagnosis of CC (interval cancer) CIMP, MSI in CC Colonoscopy within 5 years prior to diagnosis of CC is associated with CIMP and MSI in CC.
[18] Baba 2009 Case-case (in PCS) CRC NHS, HPFS. 621 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC CDX2 expression in CRC BMI or family history of CRC is not significantly associated with loss of CDX2 expression in CRC.
[19] Baba 2009 Case-case (in PCS) CRC NHS, HPFS. 517 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC AURKA expression in CRC BMI or family history of CRC is not significantly associated with AURKA expression in CRC.
[20] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 516 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC HIF1A, EPAS1 (HIF-2A) expression in CRC BMI or family history of CRC is not significantly associated with HIF1A or EPAS1 expression in CRC.
[21] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 731 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC PTGER2 (prostaglandin EP2 receptor) expression in CRC BMI or family history of CRC is not significantly associated with PTGER2 expression in CRC.
[22] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 869 CRC, 0 non-cancer controls BMI (prediagnosis), family hisotry of CRC, smoking LINE-1 methylation in CRC Family history of CRC may be associated with LINE-1 hypomethylation in CRC. LINE-1 extreme hypomethylators are associated with young age of onset.
[23] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 1105 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC IGF2 differentially methylated region-0 (DMR0) hypomethylation in CRC Family history of CRC is associated with IGF2 DMR0 hypomethylation.
[24] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 718 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC phospho-PRKA (AMPK) expression in CRC Family history of CRC or BMI is not associated with phospho-PRKA (AMPK) expression in CRC.
[25] Baba 2010 Case-case (in PCS) CRC NHS, HPFS. 717 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC phospho-AKT expression in CRC Family history of CRC or BMI is not associated with phospho-AKT expression in CRC.
[26] Bapat 2009 Case-case CRC CCFR.3143 CRC Family history of CRC and endometrial cancer MSI in CRC Family history of CRC and endometrial cancer is associated with MSI-high in CRC. Familial risk associated with MSI-high CRC is primarily driven by the Amsterdam criteria patients.
[30] Brink 2003 Case-case (in PCS) CRC NLCS.737 CRC, 0 non-cancer controls Family history of CRC KRAS mutation in CRC Family history of CRC is not associtade with KRAS mutation in CRC
[37] Chang 2007 Case-case CRC 195 CRC MTHFR codon 222 SNP, plasma folate MSI, aneuploidy in CRC MTHFR codon 222 variant is associated with MSI-H CRC. Plasma folate is lower in aneuploid MSS CRC than in diploid MSS CRC.
[38] Chen 2007 Case-case CRC 387 CRC MLH1 SNPs MLH1 methylation in CRC MLH1 rs1800734 (−93G>A) SNP is associated with MLH1 methylation in CRC.
[40] Clarizia 2006 Case-case CRC 105 CRC, 0 non-cancer controls MTHFR codon 222 SNP MSI, methylation in MLH1, CDKN2A, MGMT, DAPK1, p14 in CRC MTHFR codon 222 SNP variant is associated with MSI-H in CRC.
[52] Eaton 2005 Case-case CC NCCCS.486 CC, 0 non-cancer controls MTHFR SNPs Dietary and supplement folate MSI in CRC Among high folate intake group (≥400 ug/day), the presence of either MTHFR SNP variant is associated with MSS.
[54] Fernandez-Peralta 2010 Case-case CRC 143 CRC MTHFR SNPs MSI, LOH at APC, DCC, TP53, MLH1, MSH2, mutation in KRAS, BAX, TGFBR2 in CRC None of molecular feature in CRC is differentially related to MTHFR SNP with certainty.
[55] Ferraz 2004 Case-case CRC 165 CRC, 0 non-cancer controls GSTM1, GSTT1, GSTP1, NAT2 genotypes KRAS, TP53 mutations in CRC GSTT1 or GSTP1 SNPs may be associated with KRAS or TP53 mutations in CRC.
[57] Firestein 2010 Case-case(in PCS) CRC 470 CRC, 0 non-cancer controls BMI (prediagnosis) CDK8 expression in CRC Female sex is associated with CDK8 expression in CRC. BMI (prediagnosis) is not associated with CDK8 expression in CRC.
[58] Gonzalo 2010 Case-case CRC 82 CRC patients (37 synchronous CRC patients, 4 metachronous CRC patients) Tumor synchronicity/metachronicity Methylation in MGMT, CDKN2A, SFRP1, TMEFF2, HS3ST2, RASSF1, GATA4 in CRC Tumor synchronicity/metachronicity is associated with methylation in MGMT and RASSF1 in CRC.
[59] Gruber 2007 Case-case CRC MECCS (northern Israel). 133 CRC SNP rs10505477 in 8q24 mRNA expression of genes in 8q24 in CRC SNP rs10505477 is not associated with any difference in expression of examined genes in 8q24.
[60] Hansen 2010 Case-case CRC 109 CRC, 0 non-cancer controls KDR SNPs Microvessel density (assessed by immunohisto-chemistry for ENG and CD34) in CRC KDR rs2305948 SNP T variant is associated with high microvessel density.
[61] Hazra 2010 Case-case (in PCS) CRC NHS, HPFS.182 CRC, 0 non-cancer controls SNPs in one-carbon metabolism genes CIMP, LINE-1 methylation in CRC MTHFR rs1801131 (codon 429) and TCN2 rs1801198 SNP variants are associated with CIMP-high in CRC.
[62] Huang 2009 Case-case CRC 151 CRC, 0 non-cancer controls NAT2 genotypes KRAS mutation in CRC NAT2 genotype may be associated with KRAS mutation in CRC in female.
[65] Irahara 2010 Case-case (in PCS) CRC NHS, HPFS. 225 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC NRAS mutation in CRC There is no association between BMI or family history of CRC and NRAS mutation in CRC.
[67] Jensen 2008 Case-case CRC 130 CRC, 0 non-cancer controls Plasma homocysteine MSI in CRC MSI-H cases show higher plasma homocysteine level than MSS cases.
[68] Kang 2008 Case-case CRC 188 CRC p14 (CDKN2A/ARF) SNPs p14 methylation in CRC p14 promoter SNP haplotype is associated with p14 methylation in CRC.
[70] Kawakami 2003 Case-case CRC 103 CRC, 0 non-cancer controls TYMS, MTHFR, MTR, CBS genotypes 5, 10-methylene-tetrahydrofolate, tetrahydrofolate, methylation in MLH1, TIMP3, p14 (CDKN2A/ARF), CDKN2A, MINT-2, DAPK, APC in CRC MTHFR rs1801133 SNP (codon 222) with decreased 5,10-methylene-tetrahydrofolate and tetrahydrofolate contents in CRC. homozygous variant is associated
[71] Konishi 2009 Case-case CRC 97 CRC patients (28 synchronous CRC patients) Tumor synchronicity Methylation in MINT-1, MINT-2, MINT-31, MLH1, CDKN2A, p14, MGMT, ESR1 in CRC Synchronous CRC is associated with higher methylation levels at p14 methylation level at MINT-31 in CRC. (CDKN2A/ARF) and MGMT and lower
[72] Kure 2009 Case-case (in PCS) CRC NHS, HPFS. 619 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC VDR expression in CRC BMI or family history of CRC is not significantly associated with VDR expression in CRC.
[74] Langerod 2002 Case-case CRC 162 CRC, 0 controls TP53 codon 72 SNP TP53 mutation in CRC TP53 codon 72 SNP is not related to TP53 mutation in CRC, but to TP53 mutation in breast cancer (N=390).
[79] Lindor 2010 Case-case CRC CCFR. 789 CRC Parent of origin family history of CRC MSI in CRC Among overall CRC cases, HNPCC, or MSS cancer cases, family history of CRC in father is associated with lower age of onset of CRC in daughters than in family history of CRC in mother, but no such difference in age of onset is present among affected sons.
[81] Lubbe 2009 Case-case CRC NSCCG. 488 CRC Family history of CRC in first degree relatives MSI in CRC Family history of CRC in first degree relatives is associated with MSI-H CRC.
[84] Luchtenborg 2005 Case-case (in PCS) CRC NLCS. 656 CRC Family history of CRC APC, KRAS mutation, MLH1 loss in CRC APC, KRAS or MLH1 alteration is not associated with family history of CRC.
[85] Martinez 1999 Case-case CRA WBFT. 678 CRA, 0 non-cancer controls Various nutrients, alcohol, family history, aspirin use, smoking, BMI, physical activity, hormone use KRAS mutation in CRA Folate intake is inversely associated with KRAS mutation in CRA.
[86] Mas 2007 Case-case CRC 120 CRC, 0 con-cancer controls Various nutrients CDKN2A (p16), p14, MLH1 methylation in CRC Patents with CDKN2A methylation consumed less folate, vitamin A, vitamin B1, potassium and iron.
Patients with p14 or MLH1 methylation consumed less vitamin A.
[87] Mokarram 2008 Case-case CC 151 CC, 0 non-cancer controls Folate, vitamin B12 in serum MTHFR rs1801133 SNP Methylation in MLH1, MSH2, CDKN2A (p16) in CC Relation between folate/B12 and methylation in CC may be modified by MTHFR rs1801133 (codon 222) SNP.
[89] Naguib 2010 Case-case (in PCS) CRC EPIC-Norfolk Study. 186 CRC, 0 non-cancer controls BMI, smoking, physical activity, HRT, alcohol, dietary factors KRAS and BRAF mutations in CRC KRAS-mutated tumors are associated with higher white meat consumption, compared to KRAS-wild-type tumors.
[91] Nosho 2009 Case-case (in PCS) CRC NHS, HPFS. 863 CRC, 0 non-cancer controls Tumor synchronicity BMI, family history of CRC MSI, CIMP, LINE-1 methylation, 18q LOH, KRAS, BRAF, PIK3CA mutation, expression of TP53, CTNNB1, CDKN1A (p21), CDKN1B (p27), CCND1, FASN, PTGS2 (COX-2) in CRC Tumor synchronicity is associated with CIMP-high, MSI-H, and BRAF mutation. There is no significant modifying effect by BMI or family history of CRC.
[92] Nosho 2009 Case-case (in PCS) CRC NHS, HPFS. 485 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC SIRT1 expression in CRC BMI or family history of CRC is not significantly associated with SIRT1 expression in CRC.
[93] Nosho 2009 Case-case (in PCS) CRC NHS, HPFS. 766 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC JC virus T antigen expression in CRC Family history of CRC may be inversely associated with JC virus T antigen expression in CRC.
[94] Ogino 2007 Case-case (in PCS) CRC NHS, HPFS. 182 CRC, 0 non-cancer controls MGMT SNPs MGMT methylation, CIMP, MSI, 18q LOH, KRAS, BRAF mutation in CRC MGMT rs16906252 SNP variant is associated with MGMT methylation (adjusted OR=18; 95% CI, 6.2–52) and loss of expression.
[2] Ogino 2008 Case-case (in PCS) CC NHS, HPFS. 623 CC, 0 non-cancer controls BMI (prediagnosis) FASN expression in CRC There is an inverse relation between BMI and FASN expression in CRC.
[95] Ogino 2009 Case-case (in PCS) CRC NHS, HPFS. 470 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC PPARG expression in CRC There is no relation between BMI or family history of CRC and PPARG expression in CRC.
[96] Ogino 2009 Case-case (in PCS) CRC NHS, HPFS. 546 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC STMN1 expression in CRC There is no relation between BMI or family history of CRC and STMN1 expression in CRC.
[97] Ogino 2009 Case-case (in PCS) CC NHS, HPFS. 450 CC, 0 non-cancer controls BMI (prediagnosis) PIK3CA mutation in CC There is no relation between BMI and PIK3CA mutation in CC.
[98] Ogino 2009 Case-case (in PCS) CC NHS, HPFS. 630 CC, 0 non-cancer controls BMI (prediagnosis), family history of CRC CDKN1B (p27) localization in CC There is no relation between BMI or family history of CRC and CDKN1B (p27) localization in CC.
[99] Ogino 2009 Case-case (in PCS) CC NHS, HPFS. 647 CC, 0 non-cancer controls BMI (prediagnosis), family history of CRC CDKN1A (p21) expression in CC There is no relation between BMI or family history of CRC and CDKN1A (p21) expression in CC.
[100] Ogino 2009 Case-case (in PCS) CC NHS, HPFS. 602 CC, 0 non-cancer controls BMI (prediagnosis), family history of CRC CCND1 (cyclin D1) expression in CC There is no relation between BMI or family history of CRC and CCND1 expression in CC.
[101] Ogino 2009 Case-case (in PCS) CRC NHS, HPFS. 555 CRC, 0 non-cancer controls BMI (prediagnosis), family history of CRC 18q LOH in CRC Obesity (prediagnosis) is associated with 18q LOH in CRC.
[102] Oyama 2004 Case-case CRC 194 CRC, 0 non-cancer controls MTHFR SNPs Methylation in CDKN2A, MLH1, TIMP3, p14 in CRC MTHFR codon 429 SNP variant is associated with CDKN2A methylation in CRC.
[103] Park 2010 Case-case (in PCS) CRC EPIC-Norfolk Study. 185 CRC, 0 non-cancer controls Dietary factors, family history, BMI, physical activity, smoking TP53 mutation in CRC There is a positive relation between meat intake and TP53 mutation in Duke’s stage C and D cases, while there is a positive relation between meat intake and wild-type TP53 in Duke’s stage A and B cases.
[104] Paz 2002 Case-case CRC 118 CRC, 0 non-cancer controls Genotypes of one-carbon metabolism genes Methylation in CDKN2A, p14, MLH1, MGMT, APC, STK11, DAPK1, GSTP1, BRCA1, RARB, CDH1, RASSF1 in CRC Results on all cancers (CRC, breast presented, and CRC-specific results are not presented. cancers, and lung cancers) are
[109] Ricciardiello 2003 Case-case CRA 70 CRA Family history of CC MSI, MLH1 methylation, expression of MLH1 and MSH2 in CRA Family history of CC is associated with MLH1 methylation and loss of MLH1 in CRA.
[110] Rozek 2008 Case-case CRC MECCS (northern Isreal). 82 CRC CDX2 SNPs and haplotypes CDX2 mRNA expression in CRC CDX2 SNPs or haplotypes are not associated with CDX2 mRNA expression in CRC.
[112] Samowitz 1995 Case-case CC 188 CC Family history of CRC, GSTM1 genotype MSI in CC Family history of CRC or GSTM1 genotype is not associated with MSI in CC.
[121] Shima 2010 Case-case (in PCS) CRC HPFS, NHS. 902 CRC, 0 non-cancer controls BMI, family history of CRC CDKN2A (p16) promoter methylation, loss of CDKN2A in CRC There is no relation between BMI or family history of CRC and CDKN2A methylation (or loss of expression) in CRC.
[122] Sinicrope 2010 Case-case CC 7 colon cancer adjuvant therapy trials. 2222 CC, 0 non-cancer controls BMI Mismatch repair protein loss (or MSI-H) in CC High BMI is inversely associated with MSI in CC.
[141] van Engeland 2003 Case-case CRC NLCS. 121 CRCs,0 non-cancer controls. Various nutrients, alcohol Methylation in APC, CDKN2A (p16), p14, MLH1, MGMT, RASSF1A in CRC Folate and alcohol intake may be associated with promoter hypermethylation in CRC.
[143] Ward 2004 Case-case CRC 547 CRC Family history of CRC, family history of any cancer CIMP in CRC CIMP in CRC is not associated with family history of CRC or any cancer.
[149] Wu 2001 Case-case CC Los Angeles County Cancer Surveillance Program (a part of SEER). 276 CC, 0 non-cancer controls Smoking, red meat cooking practice MSI in CC Certain red meat cooking (well-doing) and heterocyclic amine score are associated with MSI-H CC. Smoking is associated with MSI-H CC.
[150] Wu 2010 Case-case CC Los Angeles County Cancer Surveillance Program (a part of SEER). 280 CC Hormone therapy ESR1, ESR2, PGR, CDKN2A, MGMT, MYOD1, MLH1 methylation in CC There may be an inverse association between hormone therapy and ESR1 methylation in CC.
Case-cohort studies
[28] Bongaerts 2006 Case-cohort study CRC NLCS. 4076 subcohort, 578 CRC Alcohol intake KRAS mutation in CRC Alcohol intake does not influence KRAS mutation in CRC.
[29] Bongaerts 2007 Case-cohort study CRC NLCS. 4076 subcohort, 573 CRC Alcohol intake KRAS, APC mutation, TP53 expression, MLH1 loss in CRC Alcohol intake does not influence KRAS, APC mutation, TP53 or MLH1 alteration in CRC.
[31] Brink 2004 Case-cohort study CRC NLCS. 2948 subcohort, 608 CRC Various fat components KRAS mutation in CRC High intake of polyunsaturated fat is associated with risk of KRAS-mutated CC.
[32] Brink 2005 Case-cohort study CRC NLCS. 2948 subcohort, 608 CRC Meat consumption KRAS mutation in CRC There may be an inverse association between pork consumption and KRAS wild-type CRC.
[33] Brink 2005 Case-cohort study CRC NLCS. 3048 subcohort, 330 CRC Various nutrients KRAS mutation in CRC Folate intake is associated with lower risk of KRAS-mutated CRC in men, but not in women.
[46] de Vogel 2006 Case-cohort study CRC NLCS. 4343 subcohort. 547 CRC with APC data Various nutrients APC mutation in CRC Folate may influence the occurrence of APC mutation in CRC.
[47] de Vogel 2008 Case-cohort study CRC NLCS. 4059 subcohort. 648 CRC Various nutrients MLH1 methylation, MLH1 expression, MSI, BRAF mutation in CRC Among men, folate intake may increase risk of BRAF-mutated CRC, and vitamin B6 may increase risk of MLH1 methylated CRC.
[48] de Vogel 2009 Case-cohort study CRC NLCS. 4774 subcohort. 373 CRC SNPs in folate enzyme genes metabolizing CIMP, MLH1 methylation, MSI in CRC MTR rs1805087 (A2756G) SNP is inversely associated with CIMP in men.
[64] Hughes 2009 Case-cohort study CRC NLCS. 4650 subcohort, 662 CRC Hunger in adolescence and young adulthood CIMP, MSI in CRC Exposure to hunger in young age is associated with decreased risk of CIMP+ CRC, but not associated with CIMP-negative CRC.
[82] Luchtenborg 2005 Case-cohort study CRC NLCS. Subcohort 2948. 588 CRC Meat and fish consumption APC mutation, MLH1 loss in CRC Beef consumption is associated with risk of CC without APC mutation.
[83] Luchtenborg 2005 Case-cohort study CRC NLCS. Subcohort 2948. 650 CRC Smoking GSTM1, GSTT1 genotypes APC mutation, MLH1 loss in CRC Smoking increases risk of APC-WT CRC, and there is no modifying effect of GSTM1 or GSTT1 genotypes.
[144] Wark 2005 Case-cohort study CRC NLCS. 3048 subcohort, 441 CC Fruits, vegetable consumption MLH1 loss in CC Fruits consumption decrease risk of MLH1-lost CC, but not that of MLH1-expressing CC.
[146] Weijenberg 2007 Case-cohort study CRC NLCS. 2948 subcohort, 531 CRC Various fat components APC, KRAS mutation, MLH1 loss in CRC High intakes of polyunsaturated fatty acid and linoleic acid increase risk of KRAS-mutated CC.
[147] Weijenberg 2008 Case-cohort study CRC NLCS. 4083 subcohort, 428 CRC Smoking KRAS mutation in CRC Effect of smoking on CRC risk is not different according to KRAS mutational status.
Case-control studies (CCS)
[27] Bautista 1997 CCS CRC 106 CRC, 295 controls Various nutrients KRAS mutation in CRC Monounsaturated fat is inversely associated with KRAS wild-type CRC compared to controls, but no such association is present for KRAS-mutated CRC.
[34] Campbell 2009 CCS CC KPMCP-UT-MN. 1211 CC, 1972 controls SNPs in MLH1, MSH6 Smoking, dietary pattern MSI in CC Smoking does not modify MSI-H CC risk that is conferred by MLH1 rs1800734 (−93G>A) SNP.
[35] Campbell 2010 CCS CRC CCFR. 1250 CRC, 1880 controls (unaffected siblings) BMI, BMI at age 20, weight gain MSI in CRC Obesity is associated with MSS CRC risk, but not with MSI-H CRC risk.
[39] Chia 2006 CCS CRC CCFR. 1792 CRC, 1501 controls. Smoking, NSAIDs MSI in CRC Smoking is associated with increased risk of MSI-H CRC, but not strongly with that of MSI-L/MSS CRC.
[41] Curtin 2007 CCS CC KPMCP-UT-MN. 916 CC, 1972 controls SNPs in one-carbon metabolism genes One-carbon nutrients, alcohol, dietary pattern CIMP in CC MTHFR rs1801131 (codon 429) SNP may interact with alcohol intake and dietary pattern to modify CIMP+ CC risk.
[42] Curtin 2007 CCS CC KPMCP-UT-MN. 1206 CC, 1962 controls TYMS SNPs MSI, TP53, KRAS mutations in CC TYMS SNPs are not differentially associated with CC by MSI, TP53 or KRAS status.
[43] Curtin 2009 CCS CC KPMCP-UT-MN. 1604 CC, 1969 controls SNPs in base excision repair genes Smoking MSI, CIMP, mutations in BRAF, KRAS, TP53 in CC There is no significant effect modification by smoking status.
[44] Curtin 2009 CCS CC KPMCP-UT-MN. 1048 CC, 1964 controls MSH6 rs1042821 SNP Alcohol intake, age, family history CIMP, MSI, BRAF mutation in CC MSH6 rs1042821 SNP is associated with CIMP+ CC, and this relation is not modified by alcohol intake, age at diagnosis or family history.
[45] Curtin 2009 CCS Rectal cancer KPMCP-UT-MN. 750 rectal cancers, 1201 controls GSTM1, NAT2 genotypes Smoking MSI, CIMP, TP53, KRAS, BRAF mutation in rectal cancers Smoking is associated with CIMP, TP53, BRAF mutation in rectal cancer.
[49] Diergaarde 2003 CCS CC Population-based case-control study in The Netherlands. 176 CC, 249 controls Smoking KRAS, TP53, APC mutations, MSI in CC Smoking may be associated with transversion mutations and with TP53-negative CC.
[50] Diergaarde 2003 CCS CC Population-based case-control study in The Netherlands. 184 CC, 259 controls Various food and nutrients MSI, MLH1 methylation, expression of MLH1 and MSH2 in CC Red meat intake may differentially modify CC risk stratified by MSI status.
[51] Diergaarde 2003 CCS CC Population-based case-control study in The Netherlands. 184 CC, 259 controls Various food and nutrients APC mutation in CC Alcohol intake may differentially modify CC risk stratified by APC mutation status.
[56] Figueiredo 2010 CCS CRC CCFR. 1200 CRC, 1880 matched unaffected sibling controls. FOLR1, FPGS, GGH, SLC19A1 SNPs Dietary one-carbon nutrients MSI in CRC CRC risks associated with any SNP do not significantly differ by MSI status.
[63] Hubner 2007 CCS CRC NSCCG. 1649 CRC, 2692 non-cancer controls MTHFR rs1801133 SNP MSI in CRC MTHFR rs1801133 SNP (codon 222) variant is associated with MSI-H CRC compared to controls, but not with MSS CRC.
[66] Jacobs 2010 CCS CRC CCFR. 1182 CRC, 1880 matched unaffected sibling controls. SNPs in RXRA, CASR MSI in CRC RXRA SNP rs12004589 is associated with MSI-high cancer, but not with MSS/MSI-low cancer.
[69] Karpinski 2010 CCS CRC 186 CRC, 140 con-cancer controls MTHFR, TYMS, DNMT3B genotypes CIMP in CRC Compared to controls, DNMT3B - 283T>C SNP is associated inversely with CIMP+ CRC, but not with CIMP− CRC.
[73] Lafuente 2000 CCS CRC 117 CRC, 296 controls NQO1 SNP KRAS mutation in CRC KRAS codon 12 mutations are associated with NQO C609T SNP.
[75] Laso 2004 CCS CRC 117 CRC, 296 controls Micro-nutrients KRAS mutation in CRC KRAS codon 12 mutations are associated with lower intake of vitamin A, B1, D and iron than controls.
[76] Levine 2010 CCS CRC CCFR. 1133 CRC, 1787 controls (unaffected siblings) MTHFR SNPs MSI in CRC MTHFR rs1801133 (codon 222) SNP variant is associated with a decreased risk of MSI-L/MSS CRC.
[77] Levine 2010 CCS CRC CCFR. 1185 CRC, 1787? controls (unaffected siblings) SNPs of one-carbon metabolism genes Folate and multi-vitamin supplement use, dietary folate, family history of CRC MSI in CRC SNPs of one-carbon metabolism genes are not associated with CRC differently by MSI status.
[80] Lindor 2010 CCS CRC CCFR. 940 CRC, 940 controls Smoking, SERPINA1 SNP MSI in CRC Smoking is associated with MSI-H CRC in patients ≥age 50.
[88] Naghibalhos saini 2010 CCS CRC 151 CRC, 231 controls MTHFR SNPs (rs1801133, rs1801131) MSI in CRC There is no significant difference in risks associated with MTHFR SNPs between MSI and MSS cancers.
[90] Newcomb 2007 CCS CRC Cancer Surveillance System (a part of SEER). 311 CRC, 1062 controls Exogenous hormone use MSI in CRC The relation between hormone use and CRC risk does not differ by MSI status.
[105] Plaschke 2003 CCS CRC 287 CRC, 346 controls MTHFR SNPs MSI in CRC MTHFR SNPs are not associated with MSI-H CRC.
[106] Poynter 2009 CCS CRC CCFR. Case-unaffected sibling design. 1564 CRC, 4486 controls Smoking, alcohol MSI in CRC Smoking is associated with increased risk of MSI-H CRC (OR, 1.94; 95% CI, 1.09–3.46). Alcohol intake is associated with increased risk of MSI-L CRC (OR, 1.85; 95% CI, 1.06–3.24).
[107] Poynter 2010 CCS CRC CCFR. Case-unaffected sibling design. 1200 CRC, 1880 controls VDR, GC SNPs MSI in CRC GC rs222029, rs222016 and rs16847039 SNPs are associated with lower risk of MSI-H CRC, but not associated with MSS CRC.
[108] Raptis 2007 CCS CRC 766 CRC, 1098 controls MLH1, MSH2 SNPs MSI in CRC MLH1 rs1800734 (−93G>A) SNP is associated with MSI-H CRC.
[111] Rozek 2010 CCS CRC MECCS (northern Isreal). 1297 CRC, 2019 matched controls Ethnicity, smoking, family history of CRC BRAF mutation in CRC Men who smoked are more likely to have BRAF-mutated tumor than women who never smoked.
[113] Samowitz 2006 CCS CC KPMCP-UT-MN. 1510 CC, 1981 controls IRS1, IRS2, IGF1, IGFBP3 SNPs MSI, KRAS, TP53 mutations in CC IRS1 G972R SNP is associated with MSI CC.
[114] Samowitz 2006 CCS CC KPMCP-UT-MN. 1315 CC, 2392 controls Smoking CIMP, BRAF mutation in CC Smoking ≥20 cigarettes/day is associated with CIMP+ (OR, 2.06; 95% CI, 1.43–2.97) and BRAF mutation (OR, 3.16; 95% CI, 1.80–5.54) compared to controls, but smoking is not associated with CIMP-negative or BRAF-WT.
[115] Samowitz 2008 CCS CC KPMCP-UT-MN. 795 CC, 1968 controls MLH1 rs1800734 SNP MSI, CIMP, BRAF mutation in CC MLH1 rs1800734 (−93G>A) SNP is associated with CIMP, MLH1 methylation and BRAF mutation in MSI-H CC.
[116] Satia 2005 CCS CC NCCCS. 486 CC, 1048 controls Various food and nutriens, BMI, smoking, physical activity, family history, NSAIDs, vitamin mineral supplements MSI in CC No dietary factor is differentially related to MSI-H compared to MSI-L/MSS CC.
[120] Shannon 2002 CCS CRC 456 CRC, 1207 controls MTHFR SNP, CBS polymorphisms MSI in CRC CBS 844ins68 variant is inversely associated with MSI in proximal CRC.
[123] Slattery 2000 CCS CC KPMCP-UT-MN. 1510 CC, 2410 controls BMI, physical activity, smoking, aspirin, NSAIDs MSI in CC Among both men and women, cigarette smoking is associated with MSI but not with MSS.
[124] Slattery 2000 CCS CC KPMCP-UT-MN. 1428 CC, 2410 controls Various food and nutrients KRAS mutation in CC Low cruciferous vegetable intake may be differentially associated with KRAS mutation vs. WT (p=0.01).
[125] Slattery 2001 CCS CC KPMCP-UT-MN. 1428 CC, 2410 controls BMI, dietary pattern, physical activity, smoking, aspirin, NSAIDs KRAS mutation in CC Among men, but not women, low physical activity is associated with KRAS mutation but not with KRAS-WT.
[126] Slattery 2001 CCS CC KPMCP-UT-MN. 1510 CC, 2410 controls Various food and nutrients MSI in CC Alcohol intake may increase MSI cancer risk.
[127] Slattery 2001 CCS CC KPMCP-UT-MN. 1510 CC, 2410 controls Oral contraceptive use, Estrogen replacement, number of pregnancies, BMI, physical activity MSI in CC Estrogen exposure in women may decrease MSI cancer risk.
[128] Slattery 2002 CCS CC KPMCP-UT-MN. 1457 CC, 2410 controls Family history of CRC MSI, KRAS, TP53 mutations in CC Family history of CRC is not differentially associated with CC risk by MSI, KRAS or TP53 status.
[129] Slattery 2002 CCS CC KPMCP-UT-MN. 1458 CC, 2410 controls Diet, physical activity, BMI, smoking, aspirin/NSAIDs use, TP53 mutation in CC Western dietary pattern, red meat, and high glycemic load are associated with TP53 mutation in CC.
[130] Slattery 2002 CCS CC KPMCP-UT-MN. 1344 CC, 1958 controls GSTM1, NAT2 genotypes Smoking MSI, TP53, KRAS mutation in CC GSTM1 genotype and smoking may interact to influence occurrence of KRAS mutation in CC.
[131] Slattery 2006 CCS CRC KPMCP-UT-MN. 1577 CC (unknown number for molecular data), 1971 controls PPARG P12A SNP MSI, TP53, KRAS mutations in CC It is unknown whether PPARG SNP differentially relates to CC risk by MSI, TP53 or KRAS status.
[132] Slattery 2007 CCS CC KPMCP-UT-MN. 1154 CC, 2410 controls BMI, nutrients, physical activity, smoking, aspirin, NSAIDs MSI, CIMP, BRAF mutation in CC Obesity is associated with CIMP-negative, but not CIMP+ (OR, 2.0; 95% CI, 1.5–2.6). Among MSI-high tumors, high alcohol intake is associated with BRAF-WT (OR 2.2; 95% CI, 1.2–3.7), but not among MSS tumors.
[133] Slattery 2009 CCS CC KPMCP-UT-MN. 1375 CC, 2014 controls Polymorphisms in various genes MSI, CIMP, KRAS, TP53 mutations in CC Variants of insulin-related genes are associated with CIMP and MSI-H CC, especially among aspirin users.
[134] Slattery 2010 CCS CC KPMCP-UT-MN. 1198 CC, 1987 controls SMAD7 SNPs (rs4939827, rs12953717, rs4464148) MSI, CIMP, KRAS, TP53 mutations in CC SMAD7 SNPs were not differentially associated with CC risk by MSI, CIMP, KRAS or TP53 status.
[135] Slattery 2010 CCS Rectal cancer KPMCP-UT-MN. 750 rectal cancers, 1205 controls Diet, physical activity, body size CIMP, TP53 mutation, KRAS mutation in rectal cancer Certain dietary factors and physical activity are associated with CIMP, TP53 mutation or KRAS mutation in rectal cancer. However, no comparison (CIMP+ vs. CIMP−; TP53 mutation vs. WT; KRAS mutation vs. WT) is performed.
[136] Slattery 2010 CCS Rectal cancer KPMCP-UT-MN. 750 rectal cancers, 1250 controls Calcium, vitamin D, VDR genotypes CIMP, TP53 mutation, KRAS mutation in rectal cancer Vitamin D intake and certain VDR genotypes are associated with certain TP53 mutations in rectal cancer
[137] Slattery 2010 CCS Rectal cancer KPMCP-UT-MN. 337 rectal cancers, 1192 controls Alcohol intake CIMP, TP53 mutation, KRAS mutation in rectal cancer Recent high beer consumption is associated with TP53 mutation in rectal cancer. However, no comparison (TP53 mutation vs. WT) is performed.
[138] Slattery CCS CRC KPMCP-UT-MN. 794 CRC, 1956 controls SNPs in metabolic signaling pathway genes (MTOR, PTEN, STK11, PRKAA1, PRKAG2, TSC1, TSC2, PIK3CA, AKT1) CIMP, MSI, KRAS mutation, TP53 mutation in CRC PRKAA1 SNP (rs461404) is inversely associated with CIMP, and PRKAA1 SNP rs13167906 is positively associated with CIMP. However, no comparison (CIMP+ vs. CIMP−; MSI-high vs. MSS; TP53 mutation vs. WT; KRAS mutation vs. WT) is performed.
[139] Urlich 2005 CCS CC KPMCP-UT-MN. 1248 CC, 1972 controls MTHFR SNPs TP53, KRAS mutations in CC MTHFR codon 222 SNP variant is inversely associated with G>A mutations at CpG sites in TP53 in CC.
[140] van den Donk 2007 CCS CRA POLIER study. 149 CRA, 286 controls Various nutrients, MTHFR codon 222 SNP Methylation in APC, CDKN2A (p16), p14, MLH1, MGMT, RASSF1A in CRC Folate intake may increase risk of adenoma without promoter methylation.
[145] Wark 2006 CCS CRA 534 CRA, 709 controls Smoking, various food and nutrients KRAS mutation in CRA Smoking may increase risk of KRAS-WT CRA, but not that of KRAS-mutated CRA.
[151] Yang 2000 CCS CRC 161 CRC, 191 controls SERPINA1 (A1AT) SNP smoking MSI in CRC SERPINA1 SNP variant and smoking may synergistically increase risk of MSI-H CRC.
Nested case-control study
[142] Van Guelpen 2010 Nested CCS (in PCS) CRC NSHDS. 190 CRC, 380 (?) controls Plasma folate, vitamin B12, homocysteine; MTHFR SNPs CIMP, MSI, BRAF mutation in CRC MTHFR rs1801131 (codon 429) SNP variant may be associated with CIMP-negative CRC, but not with CIMP-high or CIMP-low CRC.
Prospective cohort studies (PCS)
[36] Chan 2007 PCS CRC NHS, HPFS. 13,0274 participants, 636 CRC Aspirin PTGS2 (COX-2) expression in CRC Aspirin is associated with decreased risk of PTGS2 (COX-2)-positive CRC, but not with PTGS2-negative CRC.
[53] English 2008 PCS CRC MCCS. 41528 participants, 582 CRC Ethnicity (Anglo-Celtic vs. southern European origins) CIMP, BRAF mutation in CRC Southern European origin is associated with lower risk for CIMP+ or BRAF-mutated CRC, but not with risk for CIMP-negative or BRAF-wild-type CRC.
[78] Limsui 2010 PCS CRC IWHS. 37,399 participants, 540 CRC Smoking MSI, CIMP, BRAF mutation in CRC Smoking increases risks of MSI-high cancer, CIMP-high cancer, and BRAF-mutated cancer, but not MSS-low/MSS, non-CIMP-high or BRAF-wild-type cancer.
[117] Schernhammer 2008 PCS CC NHS. 88,691 participants, 399 CC Dietary one-carbon nutrients, alcohol TP53 expression in CC Folate intake decreases TP53-positive CC risk, but not TP53-negative CC risk.
[118] Schernhammer 2008 PCS CC NHS, HPFS. 136,062 participants, 669 CC Dietary one-carbon nutrients, alcohol MSI, KRAS mutation in CC CC risk does not significantly differ by MSI or KRAS mutation status.
[119] Schernhammer 2010 PCS CC NHS, HPFS. 136,054 participants, 609 CC Dietary one-carbon nutrients, alcohol LINE-1 methylation level in CC Folate intake decreases LINE-1 hypomethylated CC risk, but not LINE-1 hypermethylated CC risk.
[148] Wish 2010 PCS CRC 4337 at-risk first degree relatives of 552 index CRC patients in the Newfoundland Cancer Registry MSI, BRAF mutation in CRC CRC events in first degree relatives Compared to family members of patients with MSS BRAF-wild-type CRC, family members of patients with MSI-high BRAF-mutated CRC and those with MSS BRAF-mutated CRC show higher risks of developing CRC.

Official gene and protein symbols are described in the HUGO-Gene Nomenclature Committee (HGNC) website (www.genenames.org). Studies with less than 100 cases with tumor tissue data are not listed, except for studies on rarely examined exposures or outcome. Studies on etiologically well-known types (polyposis syndromes, hereditary nonpolyposis colorectal cancer, inflammatory bowel disease-associated CRC) are not listed.

*

Sample size is based on cases with available tumor tissue data.

Abbreviations: A1AT, alpha-1-antitrypsin; BMI, body mass index; CC, colon cancer; CCFR, Colon Cancer Family Registry; CCS, case-control study; CGH, comparative genomic hybridization; CI, confidence interval; CIMP, CpG island methylator phenotype; COX-2, cyclooxygenase 2; CRA, colorectal adenoma; CRC, colorectal cancer; DMR, differentially methylated region; EPIC, European Prospective Investigation into Cancer and Nutrition; HPFS, Health Professionals Follow-up Study; HR, hazard ratio; HRT, hormone replacement therapy; IWHS, Iowa Women’s Health Study; KPMCP-UT-MN, Kaiser Permanente Medical Care Program of Northern California, the state of Utah and the Twin City Metropolitan area of Minnesota (the M. Slattery group’s case-control study); LOH, loss of heterozygosity; MCCS, Melbourne Collaborative Cohort Study; MECCS, Molecular Epidemiology of Colorectal Cancer Study; MSI, microsatellite instability; MSI-H, microsatellite instability-high; MSI-L, microsatellite instability-low; MSS, microsatellite stability; NCCCS, North Carolina Colon Cancer Study; NHS, Nurses’ Health Study; NLCS, The Netherlands Cohort Study; NSAID, non-steroidal anti-inflammatory drug; NSCCG, National Study of Colorectal Cancer Genetics (UK); NSHDS, Northern Sweden Health and Disease Study; OR, odds ratio; RR, incidence rate ratio; PCS, prospective cohort study; PTGS2, prostaglandin endoperoxide synthase 2; RCT, randomized, placebo-controlled trial; SEER, Surveillance Epidemiology, and End Results; SERPINA1, serpin peptidase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1; SNP, single nucleotide polymorphism; WBFT, Wheat Bran Fiber Trial; WT, wild-type.