Dietary fiber intake and risk of colorectal cancer: A pooled analysis of prospective cohort studies
article
Park, Y.
Hunter, D.J.
Spiegelman, D.
Bergkvist, L.
Berrino, F.
Brandt, P.A. van den
Buring, J.E.
Colditz, G.A.
Freudenheim, J.L.
Fuchs, C.S.
Giovannucci, E.
Goldbohm, R.A.
Graham, S.
Harnack, L.
Hartman, A.M.
Jacobs, D.R.
Kato, I.
Krogh, V.
Leitzmann, M.F.
McCullough, M.L.
Miller, A.B.
Pietinen, P.
Rohan, T.E.
Schatzkin, A.
Willett, W.C.
Wolk, A.
Zeleniuch-Jacquotte, A.
Zhang, S.M.
Smith-Warner, S.A.
Context: Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective: To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants: From 13 prospective cohort studies included in the Pooling Project of Prospective Studies of Diet and Cancer, 725 628 men and women were followed up for 6 to 20 years across studies. Study- and sex-specific relative risks (RRs) were estimated with the Cox proportional hazards model and were subsequently pooled using a random-effects model. Main Outcome Measure: Incident colorectal cancer. Results: During 6 to 20 years of follow-up across studies, 8081 colorectal cancer cases were identified. For comparison of the highest vs lowest study- and sex-specific quintile of dietary fiber intake, a significant inverse association was found in the age-adjusted model (pooled RR=0.84; 95% confidence interval [CI], 0.77-0.92). However, the association was attenuated and no longer statistically significant after adjusting for other risk factors (pooled multivariate RR=0.94; 95% CI, 0.86-1.03). In categorical analyses compared with dietary fiber intake of 10 to <15 g/d, the pooled multivariate RR was 1.18 (95% CI, 1.05-1.31) for less than 10 g/d (11% of the overall study population); and RR, 1.00 (95% CI, 0.85-1.17) for 30 or more g/d. Fiber intake from cereals, fruits, and vegetables was not associated with risk of colorectal cancer. The pooled multivariate RRs comparing the highest vs lowest study- and sex-specific quintile of dietary fiber intake were 1.00 (95% CI, 0.90-1.11) for colon cancer and 0.85 (95% CI, 0.72-1.01) for rectal cancer (P for common effects by tumor site=.07). Conclusions: In this large pooled analysis, dietary fiber intake was inversely associated with risk of colorectal cancer in age-adjusted analyses. However, after accounting for other dietary risk factors, high dietary fiber intake was not associated with a reduced risk of colorectal cancer. ©2005 American Medical Association. All rights reserved.
Topics
Food and Chemical Risk Analysis
Adult
Cancer incidence
Colorectal carcinoma
Controlled study
Dietary fiber
Dietary intake
Disease association
Evaluation
Female
Follow up
Human
Major clinical study
Male
Multivariate analysis
Priority journal
Prospective study
Risk assessment
Risk factor
Sex ratio
Colorectal Neoplasms
Dietary Fiber
Female
Humans
Male
Proportional Hazards Models
Risk
TNO Identifier
239027
DOI
https://dx.doi.org/10.1001/jama.294.22.2849
ISSN
00987484
Source
Journal of the American Medical Association, 294(22), pp. 2849-2857.
Pages
2849-2857
Files
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