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Dietary fiber intake and risk of colorectal cancer and incident and recurrent adenoma in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Kunzmann, Andrew T ; Coleman, Helen G ; Huang, Wen-Yi ; Kitahara, Cari M ; Cantwell, Marie M ; Berndt, Sonja I

The American journal of clinical nutrition, 2015-10, Vol.102 (4), p.881-890 [Peer Reviewed Journal]

United States: American Society for Clinical Nutrition, Inc

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Title:
Dietary fiber intake and risk of colorectal cancer and incident and recurrent adenoma in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Author: Kunzmann, Andrew T ; Coleman, Helen G ; Huang, Wen-Yi ; Kitahara, Cari M ; Cantwell, Marie M ; Berndt, Sonja I
Subjects: Aged ; Body Mass Index ; Clinical trials ; Colorectal cancer ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - prevention & control ; Diet ; Dietary fiber ; Dietary Fiber - administration & dosage ; Early Detection of Cancer - methods ; Edible Grain ; Feeding Behavior ; Female ; Follow-Up Studies ; Fruit ; Health risk assessment ; Humans ; Logistic Models ; Lung Neoplasms - diagnosis ; Lung Neoplasms - prevention & control ; Male ; Medical screening ; Middle Aged ; Motor Activity ; Ovarian Neoplasms - diagnosis ; Ovarian Neoplasms - prevention & control ; Proportional Hazards Models ; Prospective Studies ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - prevention & control ; Randomized Controlled Trials as Topic ; Risk Factors
Is Part Of: The American journal of clinical nutrition, 2015-10, Vol.102 (4), p.881-890
Description: Dietary fiber has been associated with a reduced risk of colorectal cancer. However, it remains unclear at which stage in the carcinogenic pathway fiber may act or which food sources of dietary fiber may be most beneficial against colorectal cancer development. The objective was to prospectively evaluate the association between dietary fiber intake and the risk of incident and recurrent colorectal adenoma and incident colorectal cancer. Study participants were identified from the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Participants received flexible sigmoidoscopy at baseline and 3 or 5 y after. Dietary fiber intake was measured by using a self-reported dietary questionnaire. The colorectal cancer, incident adenoma, and recurrent adenoma analyses were based on 57,774, 16,980, and 1667 participants, respectively. Unconditional logistic regression was used to assess the risk of incident and recurrent adenoma, and Cox proportional hazards models were used to assess the risk of colorectal cancer across categories of dietary fiber intake, with adjustment for potential confounders. Elevated total dietary fiber intake was associated with a significantly reduced risk of incident distal colorectal adenoma (ORhighest vs. lowest tertile of intake: 0.76; 95% CI: 0.63, 0.91; P-trend = 0.003) but not recurrent adenoma (P-trend = 0.67). Although the association was not statistically significant for colorectal cancer overall (HR: 0.85; 95% CI: 0.70, 1.03; P-trend = 0.10), a reduced risk of distal colon cancer was observed with increased total fiber intake (HR: 0.62; 95% CI: 0.41, 0.94; P-trend = 0.03). Protective associations were most notable for fiber originating from cereals or fruit. This large, prospective study within a population-based screening trial suggests that individuals consuming the highest intakes of dietary fiber have reduced risks of incident colorectal adenoma and distal colon cancer and that this effect of dietary fiber, particularly from cereals and fruit, may begin early in colorectal carcinogenesis. This trial was registered at clinicaltrials.gov as NCT01696981.
Publisher: United States: American Society for Clinical Nutrition, Inc
Language: English

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Dietary fiber intake and risk of colorectal cancer and incident and recurrent adenoma in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Kunzmann, Andrew T ; Coleman, Helen G ; Huang, Wen-Yi ; Kitahara, Cari M ; Cantwell, Marie M ; Berndt, Sonja I

United States: American Society for Clinical Nutrition, Inc

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