No abstract

Background:Recently, several genome-wide association studies (GWAS) have independently found numerous loci at which common single-nucleotide polymorphisms (SNPs) modestly influence the risk of developing colorectal cancer. The aim of this study was to test 11 loci, reported to be associated with an increased or decreased risk of colorectal cancer: 8q23.3 (rs16892766), 8q24.21 (rs6983267), 9p24 (rs719725), 10p14 (rs10795668), 11q23.1 (rs3802842), 14q22.2 (rs4444235), 15q13.3 (rs4779584), 16q22.1 (rs9929218), 18q21.1 (rs4939827), 19q13.1 (rs10411210) and 20p12.3 (rs961253), in a Swedish-based cohort.Methods:The cohort was composed of 1786 cases and 1749 controls that were genotyped and analysed statistically. Genotype–phenotype analysis, for all 11 SNPs and sex, age of onset, family history of CRC and tumour location, was performed.Results:Of eleven loci, 5 showed statistically significant odds ratios similar to previously published findings: 8q23.3, 8q24.21, 10p14, 15q13.3 and 18q21.1. The remaining loci 11q23.1, 16q22.1, 19q13.1 and 20p12.3 showed weak trends but somehow similar to what was previously published. The loci 9p24 and 14q22.2 could not be confirmed. We show a higher number of risk alleles in affected individuals compared to controls. Four statistically significant genotype–phenotype associations were found; the G allele of rs6983267 was associated to older age, the G allele of rs1075668 was associated with a younger age and sporadic cases, and the T allele of rs10411210 was associated with younger age.Conclusions:Our study, using a Swedish population, supports most genetic variants published in GWAS. More studies are needed to validate the genotype–phenotype correlations.

The new organization, with centralized rectal cancer surgery using modern techniques, reduced postoperative mortality and overall morbidity rates to less than half.

The new organization, with centralized rectal cancer surgery using modern techniques, reduced postoperative mortality and overall morbidity rates to less than half.

Objective: To develop a feasible, valid, reliable web-based instrument to objectively evaluate school meal quality in Swedish primary schools. Design: The construct 'school meal quality' was operationalized by an expert panel into six domains, one of which was nutritional quality. An instrument was drafted and pilot-tested. Face validity was evaluated by the panel. Feasibility was established via a large national study. Food-based criteria to predict the nutritional adequacy of school meals in terms of fat quality, iron, vitamin D and fibre content were developed. Predictive validity was evaluated by comparing the nutritional adequacy of school menus based on these criteria with the results from a nutritional analysis. Inter-rater reliability was also assessed. Setting: The instrument was developed between 2010 and 2012. It is designed for use in all primary schools by school catering and/or management representatives. Subjects: A pilot-test of eighty schools in Stockholm (autumn 2010) and a further test of feasibility in 191 schools nationally (spring 2011).Results: The four nutrient-specific food-based criteria predicted nutritional adequacy with sensitivity ranging from 0?85 to 1?0, specificity from 0?45 to 1?0 and accuracy from 0?67 to 1?0. The sample in the national study was statistically representative and the majority of users rated the questionnaire positively, suggesting the instrument is feasible. The inter-rater reliability was fair to almost perfect for continuous variables and agreement was $67 % for categorical variables. Conclusions: An innovative web-based system to comprehensively monitor school meal quality across several domains, with validated questions in the nutritional domain, is available in Sweden for the first time.