Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)

Neil Murphy, Teresa Norat, Pietro Ferrari, Mazda Jenab, Bas Bueno-de-Mesquita, Guri Skeie, Christina C. Dahm, Kim Overvad, Anja Olsen, Anne Tjønneland, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Antoine Racine, Rudolf Kaaks, Birgit Teucher, Heiner Boeing, Manuela M. Bergmann, Antonia Trichopoulou, Dimitrios Trichopoulos, Pagona Lagiou & 28 others Domenico Palli, Valeria Pala, Salvatore Panico, Rosario Tumino, Paolo Vineis, Peter Siersema, Franzel van Duijnhoven, Petra H M Peeters, Anette Hjartaker, Dagrun Engeset, Carlos A. González, Maria José Sánchez, Miren Dorronsoro, Carmen Navarro, Eva Ardanaz, José R. Quirós, Emily Sonestedt, Ulrika Ericson, Lena Nilsson, Richard Palmqvist, Kay Tee Khaw, Nick Wareham, Timothy J. Key, Francesca L. Crowe, Veronika Fedirko, Petra A. Wark, Shu Chun Chuang, Elio Riboli

Research output: Contribution to journalArticle

142 Citations (Scopus)

Abstract

Background: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. Methodology/Principal Findings: After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. Conclusions/Significance: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

Original languageEnglish
Article numbere39361
JournalPLoS One
Volume7
Issue number6
DOIs
Publication statusPublished - Jun 22 2012

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Dietary Fiber
rectum
Rectal Neoplasms
Nutrition
colorectal neoplasms
Colonic Neoplasms
Colorectal Neoplasms
dietary fiber
nutrition
neoplasms
Fibers
Hazards
Vegetables
Neoplasms
Fruits
Fruit
Confidence Intervals
Meats
Social Adjustment
Oral Contraceptives

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). / Murphy, Neil; Norat, Teresa; Ferrari, Pietro; Jenab, Mazda; Bueno-de-Mesquita, Bas; Skeie, Guri; Dahm, Christina C.; Overvad, Kim; Olsen, Anja; Tjønneland, Anne; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie Christine; Racine, Antoine; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Bergmann, Manuela M.; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Pala, Valeria; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Siersema, Peter; van Duijnhoven, Franzel; Peeters, Petra H M; Hjartaker, Anette; Engeset, Dagrun; González, Carlos A.; Sánchez, Maria José; Dorronsoro, Miren; Navarro, Carmen; Ardanaz, Eva; Quirós, José R.; Sonestedt, Emily; Ericson, Ulrika; Nilsson, Lena; Palmqvist, Richard; Khaw, Kay Tee; Wareham, Nick; Key, Timothy J.; Crowe, Francesca L.; Fedirko, Veronika; Wark, Petra A.; Chuang, Shu Chun; Riboli, Elio.

In: PLoS One, Vol. 7, No. 6, e39361, 22.06.2012.

Research output: Contribution to journalArticle

Murphy, N, Norat, T, Ferrari, P, Jenab, M, Bueno-de-Mesquita, B, Skeie, G, Dahm, CC, Overvad, K, Olsen, A, Tjønneland, A, Clavel-Chapelon, F, Boutron-Ruault, MC, Racine, A, Kaaks, R, Teucher, B, Boeing, H, Bergmann, MM, Trichopoulou, A, Trichopoulos, D, Lagiou, P, Palli, D, Pala, V, Panico, S, Tumino, R, Vineis, P, Siersema, P, van Duijnhoven, F, Peeters, PHM, Hjartaker, A, Engeset, D, González, CA, Sánchez, MJ, Dorronsoro, M, Navarro, C, Ardanaz, E, Quirós, JR, Sonestedt, E, Ericson, U, Nilsson, L, Palmqvist, R, Khaw, KT, Wareham, N, Key, TJ, Crowe, FL, Fedirko, V, Wark, PA, Chuang, SC & Riboli, E 2012, 'Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)', PLoS One, vol. 7, no. 6, e39361. https://doi.org/10.1371/journal.pone.0039361
Murphy, Neil ; Norat, Teresa ; Ferrari, Pietro ; Jenab, Mazda ; Bueno-de-Mesquita, Bas ; Skeie, Guri ; Dahm, Christina C. ; Overvad, Kim ; Olsen, Anja ; Tjønneland, Anne ; Clavel-Chapelon, Françoise ; Boutron-Ruault, Marie Christine ; Racine, Antoine ; Kaaks, Rudolf ; Teucher, Birgit ; Boeing, Heiner ; Bergmann, Manuela M. ; Trichopoulou, Antonia ; Trichopoulos, Dimitrios ; Lagiou, Pagona ; Palli, Domenico ; Pala, Valeria ; Panico, Salvatore ; Tumino, Rosario ; Vineis, Paolo ; Siersema, Peter ; van Duijnhoven, Franzel ; Peeters, Petra H M ; Hjartaker, Anette ; Engeset, Dagrun ; González, Carlos A. ; Sánchez, Maria José ; Dorronsoro, Miren ; Navarro, Carmen ; Ardanaz, Eva ; Quirós, José R. ; Sonestedt, Emily ; Ericson, Ulrika ; Nilsson, Lena ; Palmqvist, Richard ; Khaw, Kay Tee ; Wareham, Nick ; Key, Timothy J. ; Crowe, Francesca L. ; Fedirko, Veronika ; Wark, Petra A. ; Chuang, Shu Chun ; Riboli, Elio. / Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). In: PLoS One. 2012 ; Vol. 7, No. 6.
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T1 - Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)

AU - Murphy, Neil

AU - Norat, Teresa

AU - Ferrari, Pietro

AU - Jenab, Mazda

AU - Bueno-de-Mesquita, Bas

AU - Skeie, Guri

AU - Dahm, Christina C.

AU - Overvad, Kim

AU - Olsen, Anja

AU - Tjønneland, Anne

AU - Clavel-Chapelon, Françoise

AU - Boutron-Ruault, Marie Christine

AU - Racine, Antoine

AU - Kaaks, Rudolf

AU - Teucher, Birgit

AU - Boeing, Heiner

AU - Bergmann, Manuela M.

AU - Trichopoulou, Antonia

AU - Trichopoulos, Dimitrios

AU - Lagiou, Pagona

AU - Palli, Domenico

AU - Pala, Valeria

AU - Panico, Salvatore

AU - Tumino, Rosario

AU - Vineis, Paolo

AU - Siersema, Peter

AU - van Duijnhoven, Franzel

AU - Peeters, Petra H M

AU - Hjartaker, Anette

AU - Engeset, Dagrun

AU - González, Carlos A.

AU - Sánchez, Maria José

AU - Dorronsoro, Miren

AU - Navarro, Carmen

AU - Ardanaz, Eva

AU - Quirós, José R.

AU - Sonestedt, Emily

AU - Ericson, Ulrika

AU - Nilsson, Lena

AU - Palmqvist, Richard

AU - Khaw, Kay Tee

AU - Wareham, Nick

AU - Key, Timothy J.

AU - Crowe, Francesca L.

AU - Fedirko, Veronika

AU - Wark, Petra A.

AU - Chuang, Shu Chun

AU - Riboli, Elio

PY - 2012/6/22

Y1 - 2012/6/22

N2 - Background: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. Methodology/Principal Findings: After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. Conclusions/Significance: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

AB - Background: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. Methodology/Principal Findings: After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. Conclusions/Significance: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

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