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Case-Control Study of Colorectal Cancer and Fecapentaene Excretion¹

Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892 [M. H. S., R. N. H., R. W., H. P.]; Department of Anaerobic Microbiology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061 [R. L. V., T. D. W.]; National Naval Medical Center, Bethesda, Maryland 20814 [A. R., S. C.]; George Washington University Hospital, Washington, DC 20037 [L. S.]; Walter Reed Army Medical Center, Washington, DC 20307 [J. D.]; Westat, Inc., Rockville, Maryland 20850 [J. R.]; Lipid Nutrition Lab, United States Department of Agriculture, Beltsville, Maryland 20705 [P. P. N.]; Minneapolis Medical Research Foundation, Minneapolis, Minnesota, 55404 [S. S.]; Division of Cancer Treatment, National Cancer Institute, Bethesda, Maryland 20892 [G. Ba.]; and Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Maryland 20892 [G. Bl.]

The fecapentaenes are potent mutagens found in high concentrations in the stools of some individuals. These compounds are produced in vivo by common species of the colonic microflora, from precursors of unknown origin. The fecapentaenes have been postulated to increase the risk of colorectal cancer. To test this hypothesis, we measured fecapentaene excretion in 69 patients with adenocarcinoma of the colon or rectum, newly diagnosed at three Washington, DC area hospitals. The cases were compared with 114 surgical controls, frequency matched to the cases on age, sex, and hospital. We attempted to measure fecapentaene excretion 4 times for each subject: before surgery; and at 1 mo; 3 mo; and 6 mo following surgery. Contrary to our study hypothesis, we found fecapentaene excretion during the four study periods to be similar or even lower in cases compared to controls. An indirect measurement of fecapentaene precursors also tended to be lower in cases. The case-control differences could not be explained as effects of bleeding or of the colorectal diagnostic workup, which was assessed in a separate group of 86 patients. We conclude from these data that the excretion of fecapentaenes does not increase the risk of colorectal cancer, at least when measured near the time of diagnosis.

¹ This research was supported in part by National Cancer Institute Contract FOD-0653.

² To whom requests for reprints should be addressed.

Received 6/24/88. Revised 11/ 3/88. Accepted 11/14/88.

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