**5. Benefit factors preventing colorectal cancer in Vietnam**

Humans cannot synthesize micronutrients to meet the body's requirement, so supplement from outside is necessary. Good foods provide good materials for the body's energy metabolism and for activities preventing cancer [68].

**47**

activities.

colorectal cancer patients.

ings, some points can be induced:

**6. Perspectives**

*Colorectal Cancer in Vietnam*

**Table 11.**

**Table 12.**

*DOI: http://dx.doi.org/10.5772/intechopen.93730*

*Number of cigarettes per day and colorectal cancer.*

OR = 0.69, 95% CI = 0.48–0.99 (**Table 12**) [50].

*Refrigerator available at home and risk of colorectal cancer.*

**5.2 New areas of interest for future research**

**5.1 The potential ways to improve the health-care system**

The refrigerator is the equipment providing good conditions to keep fresh micronutrients for humans' daily life. An indirect beneficial factor that reduces the risk of colorectal cancer was observed for the refrigerator available at home, with

**Number of cigarettes per day Controls Cases OR 95% CI P**

1–10 22 15 0.82 0.37 1.82 0.618 11+ 5 9 2.08 0.62 6.91 0.233

**Refrigerator available at home Controls Cases OR 95% CI P**

Yes 121 99 0.69 0.48 0.99 0.045

No 123 145 1.00 *Reference*

Nonsmoker 151 140 1.00 *Reference*

With the focus on clinical epidemiology studies on colorectal cancer, the specific risk factors for Vietnamese patients have been identified and they require further investigations to have an instruction on the diet and lifestyle modification. Based on multiple factors in pathological mechanism, the strategy to control this malignancy should have an impact on comprehensive sides: environmental factors, screening strategy, and personalized management. The integration of different diagnostic methods in community, hospital, and individual levels enhanced the improvement in detection of early colorectal cancer and should be invested more. Besides issuing guideline for colorectal cancer from the perspectives of specialists, it is important to have a strategy of prevention and screening in community and to foster educational

In the near future, to identify the relationship between risk factors and colorectal cancer in Vietnam as well as to optimize the environmental factors, the microbiome studies in our population should be performed. It is necessary to have a database for healthy people to compare with the colorectal cancer patients, with the collecting of data on diet and lifestyle habits. Furthermore, the studies on health-care cost-effectiveness in this specific field should be performed to support for building up an effective approach in the prevention, screening, and treating of

Based on the observations in Vietnam for colorectal cancer, the distribution of this disease and its causality as well as risk factors were identified. With these find-


### **Table 11.**

*Colorectal Cancer*

**levels**

Bread

Biscuits

**Table 10.**

Barbecued meats

P for trend = 0.002

*P for trend = 0.016*

*Dietary habits and risk of colorectal cancer.*

**Heated food items and heated** 

Usual outside appearance: lightly browned of cooked meats

Usual outside appearance: medium-, well-, and blackened/ charred of cooked meats

*4.3.3 Cigarette smoking and risk of colorectal cancer*

development of cancer in humans.

The heating and burning of tobacco products lead to the formation of mainstream smoke and sidestream smoke. Mainstream smoke from cigarettes and cigars is generated during puff-drawing in the burning cone and hot zones; it travels through the tobacco column and exits from the mouthpiece. Sidestream smoke is formed during puff-drawing and is emitted freely from the smoldering tobacco product into the ambient air. A variety of chemical and physical processes occur in the oxygen-deficient, hydrogen-rich environment of the burning cone at temperatures up to 950°C. Tobacco smoke contains more than 3800 constituents and many of them are chemical carcinogens to humans [61]. Tobacco smoking was reported to be responsible for about 25–35% of all cancer in humans [3]. In our study, daily smoking of 11 cigarettes or more increased the risk of colorectal cancer, with OR = 2.08, 95% CI = 0.62–6.91, but it is not significant (**Table 11**) [50].

No intake or rare 207 179 1.00 Reference

No intake or rare 231 206 1.00 Reference

Some intake per month 66 67 1.17 0.79 1.74 0.432 Daily or weekly intake 35 65 2.15 1.36 3.40 0.001

Some intake per month 68 81 1.34 0.92 1.95 0.125 Daily or weekly intake 14 25 2.05 1.03 4.07 0.040

**Control Case OR 95% CI P**

43 62 1.70 1.09 2.63 0.019

220 194 1.00 Reference

Both the burning of tobacco and heating of foods leads to the formation of chemical carcinogens, known as "heat-generated carcinogens" or "dietary carcinogens." Thousands of chemicals were reported in the smoke of burning tobacco and heating foods. These chemicals were detected in the user's blood and urine after the intake of these products [60–67]. With this evidence, we should seriously consider the study of heat-generated carcinogens and dietary carcinogens to prevent the

Humans cannot synthesize micronutrients to meet the body's requirement, so supplement from outside is necessary. Good foods provide good materials for the

**5. Benefit factors preventing colorectal cancer in Vietnam**

body's energy metabolism and for activities preventing cancer [68].

**46**

*Number of cigarettes per day and colorectal cancer.*


### **Table 12.**

*Refrigerator available at home and risk of colorectal cancer.*

The refrigerator is the equipment providing good conditions to keep fresh micronutrients for humans' daily life. An indirect beneficial factor that reduces the risk of colorectal cancer was observed for the refrigerator available at home, with OR = 0.69, 95% CI = 0.48–0.99 (**Table 12**) [50].
