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Plasma enterolactone and risk of colon and rectal cancer in a case–cohort study of Danish men and women

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Abstract

This case–cohort study examined the association between plasma enterolactone concentration and incidence of colon and rectal cancer in the Diet, Cancer and Health cohort, which enrolled 57,053 participants aged 50–64. Information about diet and lifestyle was obtained by questionnaire, and data on prescriptions of antibiotics were obtained from the Danish Prescription Registry. Cases diagnosed during 5.9 years of follow-up and a randomly selected sample of the cohort had a plasma sample analyzed for enterolactone by time-resolved fluoro-immuno assay. Associations were analyzed by Cox proportional hazards model. A total of 244 colon cancer cases, 137 rectal cancer cases, and 370 sub-cohort members were included in the statistical analyses. For each doubling in enterolactone concentration, we found lower risk of colon cancer among women [IRR (95% CI) = 0.76 (0.60–0.96)] and a tendency toward lower risk of rectal cancer [IRR (95% CI) = 0.83 (0.60–1.14)]. Among men, a doubling in enterolactone tended to be associated with higher risk of colon cancer [IRR (95% CI) = 1.09 (0.89–1.34)] and was associated with statistically significantly higher risk of rectal cancer [IRR (95% CI) = 1.74 (1.25–2.44)]. Exclusion of antibiotics users strengthened the results slightly. In conclusion, with higher enterolactone levels, we found lower risk of colon cancer among women and higher risk of rectal cancer among men.

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Acknowledgments

We gratefully acknowledge Katja Boll (programmer, Danish Cancer Society), Connie Stripp (dietician, Danish Cancer Society), and Jytte Fogh Larsen (secretary, Danish Cancer Society) for their contribution in the collection and handling of the data. We thank Winnie Østergaard Thomsen (laboratory technician, Aarhus University, Faculty of Agricultural Sciences) for excellent technical assistance with the biochemical determinations of enterolactone. Financial support: The Danish Cancer Society, Danish Medical Research Counsil, Danish Graduate School in Public Health, Danske Banks Foundation, Foundation of Graduate Engineer Bent Bøgh, and Wife Inge Bøgh.

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Authors and Affiliations

  1. Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark

    Nina Føns Johnsen, Anja Olsen, Birthe Lykke Riegels Thomsen, Jane Christensen, Rikke Egeberg & Anne Tjønneland

  2. Department of Animal Health and Bioscience, Faculty of Agricultural Sciences, Aarhus University, Blichers Allé, Foulum, 8830, Tjele, Denmark

    Knud Erik Bach Knudsen

  3. Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark

    Steffen Loft

  4. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark

    Kim Overvad

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  1. Nina Føns Johnsen
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Johnsen, N.F., Olsen, A., Thomsen, B.L.R. et al. Plasma enterolactone and risk of colon and rectal cancer in a case–cohort study of Danish men and women. Cancer Causes Control 21, 153–162 (2010). https://doi.org/10.1007/s10552-009-9445-5

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