Colorectal cancer (CRC) is the third most common cause of cancer and the second leading cause of cancer death in Europe and the USA . From a clinical point of view, malignancies in the colon (CC) and the rectum (RC, comprising approximately 33%) represent two distinct entities that require different treatment strategies. The distinction between the CC and RC is largely anatomical but it impacts both surgical and radiotherapeutic management with often different prognoses . In contrast with CC, which has a low incidence of local recurrence and longer survival time, patients with RC have a higher incidence of recurrence requiring the addition of pelvic radiation therapy (chemoradiation) [3,4]. As a consequence, the clinical management of patients with RC differs significantly from that of the CC in terms of surgical technique, the more frequent use of radiotherapy and method of chemotherapy administration .
There are some examples of studies that tried to clarify whether established CRC risk factors may or may not be risk factors for CC or RC separately . For example, physical inactivity and body mass index have been associated with CC cancer but not with rectal cancer . However, for RC only, very limited data are available, since existing studies usually failed to separate these entities.
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