PUB 570 AU Association between Obesity and Colorectal Cancer in New York City PPT

PUB 570 AU Association between Obesity and Colorectal Cancer in New York City PPT PUB 570 AU Association between Obesity and Colorectal Cancer in New York City PPT Permalink: https://nursingpaperessays.com/ pub-570-au-assoc…ew-york-city-ppt / ? by Jack London 12-15 minutes Unformatted Attachment Preview RUNNING HEAD: ASSOCIATION BETWEEN OBESITY AND COLORECTAL CANCER Principles of Epidemiology (PUB 570) – Fall 2020 Semester Project Association between Obesity and Colorectal Cancer in New York City November 28, 2020 ASSOCIATION BETWEEN OBESITY AND COLORECTAL CANCER 1 Introduction Cancer is a prime cause of ill health and accounts for a significant proportion of overall worldwide deaths. The World Health Organization (WHO) (2020) estimates that 9.6 million people globally succumbed to cancer in the year 2018. Among the many forms of cancer, colorectal cancer is among the deadliest. Indeed, colorectal cancer is the third-leading cause of cancer-associated fatalities in the United States (Centers of Disease Control and Prevention [CDC], 2020). Colorectal cancer is caused by behavioral or dietary risk factors such as high body mass index (BMI), lack of physical activity, low vegetable and fruit diet, alcohol use, and tobacco use. Obesity is an established risk factor for the development of colorectal cancer. Purpose Body mass index (BMI) is an important measure of obesity. Therefore, the relationship between BMI and colorectal cancer has been the subject of many studies. The prevalence of colorectal cancer in New York City is high, so it is necessary to study relevant risk factors influencing colorectal cancer. Obesity is one of the risk factors, so the main purpose of this study is to explore the relationship between obesity and colorectal cancer. Therefore, the primary goal of this study is to assess the degree of association between obesity and colorectal cancer in NYC. Research Question Is there an association between obesity and colorectal cancer? Main aim and Study Hypothesis The purpose of this study was to assess the association between obesity and colorectal cancer in New York City. The study involved obesity and the risk of colorectal cancer in the New York City population. The research hypothesizes that being obese is positively associated with colorectal cancer in people over age 50 in New York City. Background and Literature Review Obesity is associated with numerous health problems, and it is a current issue around the world. Obesity is defined by WHO as a body mass index greater than 30 kg/m2, so BMI is the most widely accepted means of evaluating body adiposity in adults. Overweight and obese persons represent a sizeable proportion of the global population across all age groups. In 2016, it was approximated that 30% of people globally making up about 1.9 billion individuals were overweight, and an additional 650 million were obese (WHO, 2018). These figures indicate that obesity is a particularly pervasive disease. It is even more serious among developed countries 2 including the US where the prevalence of the illness nationally was 42.4% in 2018 (Hales, et al, 2020). Colorectal cancer is a considerable health issue in the New York State (NYS) as it is in the rest of the country. It is the second-leading cause of cancer-associated death in NYS, closely following lung cancer. Every year, almost 4,400 women and 4,600 men are diagnosed with the disease statewide and an average of 1500 women and 1500 men die as a consequence (NYS Department of Health, 2020). In NYC, approximately 3,500 New Yorkers were diagnosed with colorectal cancer annually and 1,200 of those died from its complications (NYC Health, 2020). Colorectal cancer mainly affects older people. Consequently, 60% of newly diagnosed patients with colorectal cancer are at or above 65 years old and almost all (90%) are over 50 years old (Marley & Nan, 2016). As the prevalence of obesity, as determined by BMI, continues to increase country-wide, its association with colorectal cancer becomes more important. Large prospective cohort studies in the US reveal that inactivity and obesity raise the probability of getting colorectal cancer as compared to people within the recommended BMI (Sinicrope et al., 2011). General and central obesity both have a positive correlation with the risk of developing colorectal cancer. A 2015 study that analyzed results from four prospective studies found that a 5kg weight gain in adults culminated in about a 6% rise in the probability of colorectal cancer (Keum et al, 2015). Obesity is one of the risk factors that can be changed, and it can play an important role in preventing colorectal cancer. Methods Study design This study will investigate the association between obesity and colorectal cancer. The data will be obtained from different communities in New York City. This survey is a crosssectional study that will recruit 2,500 NYC residents over 50 years of age as participants, and the study uses the Body Mass Index (BMI) to measure the degree of obesity of participants. According to CDC’s guidance, BMI below 18.5 kg/m2 means underweight, 18.5-24.9 kg/m2 means normal weight, 25.0-29.9 kg/m2 means overweight, and more than 30.0 kg/m2 means obesity. In order to simplify the analysis, the study classified “underweight”, “normal weight” and “overweight” as the No Obesity group, and “obesity” as the Obesity group. Participants will be interviewed whether they have histories of colorectal cancer. In addition, we need to control ASSOCIATION BETWEEN OBESITY AND COLORECTAL CANCER 3 multiple variables that may affect the results to improve the effectiveness of the research. Therefore, we will ask participants about their personal information and living habits by questionnaires, including age, gender, race, alcohol consumption, smoking status, and exercise habits. Study population We plan to select New York City residents over 50 years old as participants. In order to increase the representativeness of the data, we randomly selected ten different communities in New York City for sampling. Then, we conduct simple sampling in areas with high flow of people, such as subway stations, pharmacies, nursing homes, and shopping malls in these communities. Each community will be selected 250 participants, and participants will be identified into two groups “No Obesity” or “Obesity” dependent on their BMI values. In the study, the exposure factor is obesity, and the distribution of colorectal cancer is the outcome variable. Data Collection Methods When people participate in the study, they will be measured for height and weight to calculate BMI. We classify participants based on the BMI values, and they will be asked whether they have medical histories of colorectal cancer. Data analysis is performed using the Statistical Package of Social Sciences (SPSS) software. We used simple logistic regression to evaluate the significance of the association between obesity and colorectal cancer (P<0.05) and obtain the odds ratio (OR). In addition, other confounding variables can be obtained by investigating their age, gender, and race. Participants need to answer whether they have drinking, smoking, and regular exercise habits. We use dummy variables to reflect these multiple variables, and we use multiple logistic regression to analyze the effect of potential confounders on colorectal cancer. Results After collecting all data from 2,500 participants, the data will be input into SPSS for analysis. The obesity status is the primary independent variable in this study, and medical history of colorectal cancer is the dependent variable. We first perform a simple logistic regression analysis. If the regression coefficient is greater than 0, and the p-value is less than 0.05, we believe that obesity is positively correlated with colorectal cancer, and vice versa. Also, if the Odds Ratio greater than 1 and the 95% confidence interval does not include 1, we believe that obese people in New York City are more likely to develop colorectal cancer than non-obes4 people, and vice versa. Moreover, in the multiple logistic regression analysis, when the regression coefficient is greater than 0, and the p-value is less than 0.05, the covariate is statistically positively correlated with colorectal cancer. We consider that the prevalence of colorectal cancer is also related to these confounding variables. Potential biases As a cross-sectional study, there are some potential biases for the study. Participants come from ten communities in New York City, and the data is collected in high people flow areas, which may result in the participants not being able to completely represent whole communities in NYC. The study may not collect data from rural areas or low people flow areas, so this is a selection bias. In order to improve the representativeness of the samples, we randomly select the ten communities. We can expand the scope of collection as much as possible in communities instead of collecting data in one place. The study uses questionnaire surveys to collect information. Questionnaires have high efficiency, uniformity and objectivity, but it also lacks elasticity in the content of questions. Some questions involve privacy, such as weight and family disease history, which may cause discomfort to participants so that they could refuse to answer. Also, some participants might not know whether they had colorectal cancer because they have not been tested for the disease, and it can affect the validity of the experimental data. This will inevitably lead to non-participants/nonresponders bias. To minimize information bias, the interviewers should be given standardized training so that they can better understand the questions in the questionnaire. At the same time, we should make sure that questions are clearly understood through careful wording and presenting. Also, we can use standardized data collection forms to guide participants filling that may decrease information bias. A potential source of measurement error in the measurement of an outcome is multiple confounders interference. Actually, there are many risk factors leading colorectal cancer, such as long-term ulcerative colitis, large intestine polyps and genetic factors. Even though we control some confounders, there are still other unknown confounders that can influence the outcome. One way to reduce this error would be to design more rational and comprehensive questionnaires, such as asking participants about their family cancer history, smoking, drinking ASSOCIATION BETWEEN OBESITY AND COLORECTAL CANCER 5 and regular exercise. Specifically, participants with colorectal cancer will be asked in more detail about their exposure to other risk factors for colorectal cancer. 6 References Centers for Disease Control and Prevention. (2020). Colorectal (Colon) Cancer. Retrieved from https://www.cdc.gov/cancer/colorectal/statistics/index.htm Hales, C., Carroll, M., Fryar, C., & Ogden, C. (2020). Prevalence of Obesity and Severe Obesity among Adults: United States, 2017–2018. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db360.htm Keum, N., Greenwood, D. C., Lee, D. H., Kim, R., Aune, D., Ju, W., Hu, F. B., & Giovannucci, E. L. (2015). Adult weight gain and adiposity-related cancers: a dose-response metaanalysis of prospective observational studies. Journal of the National Cancer Institute, 107(2), djv088. https://doi.org/10.1093/jnci/djv088 Marley, A. R., & Nan, H. (2016). Epidemiology of colorectal cancer. International journal of molecular epidemiology and genetics, 7(3), 105–114. New York City (NYC) Health. (2020). Colon Cancer. Retrieved from https://www1.nyc.gov/site/doh/health/health-topics/coloncancer.page#:~:text=Colon%20cancer%20(also%20called%20colorectal,New%20Yorker s%20are%20newly%20diagnosed. New York State (NYS) Department of Health. (2020). About Colorectal Cancer. Retrieved from https://www.health.ny.gov/statistics/cancer/registry/abouts/colorectal.htm Park, J. Y., Mitrou, P. N., Keogh, R. H., Luben, R. N., Wareham, N. J., & Khaw, K. T. (2012). Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC-Norfolk study. International journal of obesity, 36(1), 107–118. https://doi.org/10.1038/ijo.2011.61 Sinicrope, F. A., Foster, N. R., Sargent, D. J., O’Connell, M. J., & Rankin, C. (2011). Obesity is an independent prognostic variable in colon cancer survivors. Clinical Cancer Research: An Official Journal of the American Association for Cancer Research, 16(6), 1884–1893. https://doi.org/10.1158/1078-0432.CCR-09-2636 World Health Organization. (2020). Cancer. Retrieved from https://www.who.int/newsroom/fact-sheets/detail/cancer World Health organization. (2018). World Health Organization: Obesity and overweight factsheet. 2018. http://www.who.int/mediacentre/factsheets/fs311/en/ … Purchase answer to see full attachment Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10