Is the association with fiber from foods in colorectal cancer confounded by folate intake?

Sheila A. Bingham, Teresa Norat, Aurelie Moskal, Pietro Ferrari, Nadia Slimani, Françoise Clavel-Chapelon, Emmanuelle Kesse, Alexandra Nieters, Heiner Boeing, Anne Tjønneland, Kim Overvad, Carmen Martinez, Miren Dorronsoro, Carlos A. González, Eva Ardanaz, Carmen Navarro, José R. Quirós, Timothy J. Key, Nicholas E. Day, Antonia TrichopoulouAndroniki Naska, Vittorio Krogh, Rosario Tumino, Domenico Palli, Salvatore Panico, Paolo Vineis, H. B. Bueno-De-Mesquita, Marga C. Ocké, Petra H M Peeters, Göran Berglund, Göran Hallmans, Eiliv Lund, Guri Skeie, Rudolf Kaaks, Elio Riboli

Research output: Contribution to journalArticlepeer-review


The effect of multivariate adjustment including folate on the strong protective effect of fiber in foods on colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition was investigated in 1,721 cases identified in the latest follow-up. The inclusion of an additional 656 cases confirmed our previously published results, with a strong and significant reduction in colorectal cancer risk of ∼ 9% for each uncalibrated quintile increase in fiber (P linear trend <0.001) compared with an 8% reduction in our previous report, which had not been adjusted for folate. Inclusion of the other covariates (physical activity, alcohol, smoking, and red and processed meat) confirmed this significant inverse association for colon cancer and strengthened the association with left-sided colon cancer (P <0.001). After maximum adjustment, the association between fiber and rectal cancer was not significant, as in our previous analysis. The association with fiber from different food sources was analyzed, but again, there were no significance trends after maximum adjustment.

Original languageEnglish
Pages (from-to)1552-1556
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Issue number6
Publication statusPublished - Jun 2005

ASJC Scopus subject areas

  • Epidemiology
  • Oncology


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