TY - JOUR
T1 - Dietary fiber intake and risk of colorectal cancer
T2 - A pooled analysis of prospective cohort studies
AU - Park, Yikyung
AU - Hunter, David J.
AU - Spiegelman, Donna
AU - Bergkvist, Leif
AU - Berrino, Franco
AU - Van Den Brandt, Piet A.
AU - Buring, Julie E.
AU - Colditz, Graham A.
AU - Freudenheim, Jo L.
AU - Fuchs, Charles S.
AU - Giovannucci, Edward
AU - Goldbohm, R. Alexandra
AU - Graham, Saxon
AU - Harnack, Lisa
AU - Hartman, Anne M.
AU - Jacobs, David R.
AU - Kato, Ikuko
AU - Krogh, Vittorio
AU - Leitzmann, Michael F.
AU - McCullough, Marjorie L.
AU - Miller, Anthony B.
AU - Pietinen, Pirjo
AU - Rohan, Thomas E.
AU - Schatzkin, Arthur
AU - Willett, Walter C.
AU - Wolk, Alicja
AU - Zeleniuch-Jacquotte, Anne
AU - Zhang, Shumin M.
AU - Smith-Warner, Stephanie A.
PY - 2005/12/14
Y1 - 2005/12/14
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/28944439010
U2 - 10.1001/jama.294.22.2849
DO - 10.1001/jama.294.22.2849
M3 - Article
C2 - 16352792
SN - 0098-7484
VL - 294
SP - 2849
EP - 2857
JO - JAMA
JF - JAMA
IS - 22
ER -