Original paper

Cancer Causes & Control

, Volume 18, Issue 7, pp 753-764

First online:

Dietary fiber and colorectal cancer risk: the multiethnic cohort study

  • Abraham M. Y. NomuraAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii Email author 
  • , Jean H. HankinAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii
  • , Brian E. HendersonAffiliated withDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California
  • , Lynne R. WilkensAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii
  • , Suzanne P. MurphyAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii
  • , Malcolm C. PikeAffiliated withDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California
  • , Loic Le MarchandAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii
  • , Daniel O. StramAffiliated withDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California
  • , Kristine R. MonroeAffiliated withDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California
    • , Laurence N. KolonelAffiliated withEpidemiology Program, Cancer Research Center of Hawaii, University of Hawaii

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Abstract

Objective

To investigate the association of dietary fiber with colorectal cancer

Methods

A total of 85,903 men and 105,108 women completed a quantitative food frequency questionnaire in 1993–1996. A total of 1,138 men and 972 women were subsequently diagnosed with adenocarcinoma of the large bowel. Cox proportional hazards models were used to calculate multivariate adjusted relative risks (RR) and 95% confidence intervals (95% CI) for colorectal cancer.

Results

High consumers of dietary fiber were more active, less overweight, and less likely to be cigarette smokers than low consumers in both sexes. Fiber was inversely associated with colorectal cancer risk after adjustment for age and ethnicity in men (RR = 0.49; 95% CI, 0.41–0.60, highest vs. lowest quintile) and women (RR = 0.75; 95% CI, 0.61–0.92). After further adjustment for lifestyle and dietary factors, the inverse association remained significant in men (RR = 0.62; 95% CI, 0.48–0.79), but not in women (RR = 0.88; 95% CI, 0.67–1.14). Adjustment for the combination of replacement hormone use with either cigarette smoking or body mass index accounted for the lack of association with fiber in women.

Conclusion

Dietary fiber was inversely associated with colorectal cancer risk in men, but its relation to replacement hormone use and other factors affected its inverse association in women.

Keywords

Dietary fiber Colorectal cancer Multiethnic cohort