Perfil clínico nutricional de indivíduos com risco para câncer colorretal

Abstract

Currently, colorectal cancer (CCR) is the third most incident cancer and the second most killing in the world. In Brazil, this neoplasm also has high incidence and mortality rates. CCR has a complex and multifactorial etiology, comprising interactions between genetic and environmental factors. Most cases are of sporadic origin, without the presence of hereditary syndrome or associated family history, mainly due to environmental risk factors. Colorectal tumorigenesis takes place in four continuous stages: initiation, promotion, progression and metastasis, the course from initiation to disease progression lasting decades, enabling effective disease prevention. Thus, the reduction in the incidence and mortality of CCR can be achieved by adopting different prevention strategies, which mainly include the reduction of risk factors and adherence to healthy lifestyle recommendations, and screening for the disease, in order to detect cancer or pre-neoplastic lesions early. This context motivated this dissertation, which is divided into a literature review chapter, addressing epidemiology, etiology, including genetic and environmental factors, as well as disease prevention strategies, in addition to an original article. The article aims to evaluate the clinical nutritional profile of individuals at medium risk screened for CRC residing in the city of Piranhas/Alagoas. Cross-sectional study conducted from September to October 2020, with individuals at medium risk for CRC, of both sexes and aged between 50 and 70 years. Participants were screened for CRC with fecal immunochemical testing (FIT) and colonoscopy. Personal, socioeconomic, clinical, lifestyle and nutritional assessment data were collected. The latter was performed using anthropometric data (weight, height, arm circumference and triceps skinfold thickness), body composition (bioimpedance) and physical examination. Descriptive analysis of data frequencies and dichotomization according to the presence or absence of overweight was performed, followed by comparison of means and medians and frequencies by chi-square or Fisher's exact test. In total, 82 people agreed to undergo the clinical nutritional assessment, most of them female (56.1%; n=46), adults (56.1%; n=46), with a mean age of 59.02 years ( 6.30 SD). Pre-cancerous lesions were identified in 54.5% (n=42) of those screened, 52.4% (n=43) were smokers or former smokers, and 65.9% (n=54) did not practice scheduled physical activity. Nutritional assessment showed that 64.6% (n=53) were overweight according to body mass index (BMI). On the other hand, the muscle mass, % arm muscle circumference adequacy (AMC) and body muscle mass (kg) markers showed that 32.9% (n=27) and 47.6% (n=39) of the subjects were muscle depleted, respectively. Above all, overweight participants had, in parallel, lower muscle mass (p<0.05), suggesting sarcopenic obesity in this population. Obesity is one of the main risk factors for CRC; when concomitant with sarcopenia, it favors worse health outcomes. In this context, evidence shows the need to assess muscle composition in people with obesity, especially through other methods of assessing body composition. Our results add to the evidence on the importance of the population being guided about screening and adherence to healthy lifestyle recommendations, especially strategies aimed at weight control and the practice of physical activity.