Dietary intake of fiber, whole grains and risk of colorectal cancer: An updated analysis according to food sources, tumor location and molecular subtypes in two large US cohorts.

Autor: He X; Department of Colorectal Surgery, the Six Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Wu K; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA., Zhang X; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA., Nishihara R; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.; Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA., Cao Y; Division of Public Health Sciences, Department of Surgery, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO., Fuchs CS; Yale Cancer Center, New Haven, CT., Giovannucci EL; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA., Ogino S; Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.; Broad Institute of MIT and Harvard, Cambridge, MA., Chan AT; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.; Broad Institute of MIT and Harvard, Cambridge, MA.; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA., Song M; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2019 Dec 01; Vol. 145 (11), pp. 3040-3051. Date of Electronic Publication: 2019 May 21.
DOI: 10.1002/ijc.32382
Abstrakt: Epidemiologic evidence relating fiber intake to colorectal cancer (CRC) remains inconclusive and data are limited on different food sources of fiber and heterogeneity by tumor subsite and molecular profile. We prospectively followed for CRC incidence 90,869 women from the Nurses' Health Study (1980-2012) and 47,924 men from the Health Professionals Follow-up Study (1986-2012), who completed a validated food frequency questionnaire every 4 years. Cox proportional hazards regression was used to examine the associations with CRC risk for total, cereal, fruit and vegetable fiber and whole grains. We also assessed the associations according to tumor subsites (proximal colon, distal colon and rectum) and molecular markers (microsatellite instability, BRAF mutation, CpG island methylator phenotype and KRAS mutation). We documented 3,178 CRC cases during 3,685,903 person-years of follow-up in the NHS and HPFS. Intake of total dietary fiber was not associated with CRC risk after multivariable adjustment in either women (hazard ratio [HR] comparing extreme deciles, 1.17; 95% CI, 0.92-1.48, p trend = 0.55) or men (HR, 0.90; 95% CI, 0.67-1.21, p trend = 0.47). Higher intake of cereal fiber and whole grains was associated with lower CRC risk in men with an HR of 0.75 (95% CI, 0.57-1.00) and 0.72 (95% CI, 0.54-0.96), respectively. No heterogeneity was detected by tumor subsite or molecular markers (p heterogeneity  > 0.05). Higher intake of total dietary fiber within the range of a typical American diet is unlikely to substantially reduce CRC risk. The potential benefit of cereal fiber and whole grains in men warrants further confirmation.
(© 2019 UICC.)
Databáze: MEDLINE
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