Cancer Causes & Control

, Volume 18, Issue 7, pp 753–764 | Cite as

Dietary fiber and colorectal cancer risk: the multiethnic cohort study

  • Abraham M. Y. Nomura
  • Jean H. Hankin
  • Brian E. Henderson
  • Lynne R. Wilkens
  • Suzanne P. Murphy
  • Malcolm C. Pike
  • Loic Le Marchand
  • Daniel O. Stram
  • Kristine R. Monroe
  • Laurence N. Kolonel
Original paper

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 

Notes

Acknowledgment

This work was supported in part by grant R37 CA054281 from the National Cancer Institute, U.S. Department of Health and Human Services.

References

  1. 1.
    American Cancer Society (2006) Cancer facts & figures. Atlanta, GAGoogle Scholar
  2. 2.
    Burkitt DP (1971) Epidemiology of cancer of the colon and rectum. Cancer 28:3–13PubMedCrossRefGoogle Scholar
  3. 3.
    Committee on Diet, Health, National Research Council (1989) Implications for reducing chronic disease risk. National Academic Press, Washington, DCGoogle Scholar
  4. 4.
    Lupton JR, Turner ND (1999) Potential protective mechanisms of wheat bran fiber. Am J Med 106:24S–27SPubMedCrossRefGoogle Scholar
  5. 5.
    Cummings JH, Bingham SA, Heaton KW, Eastwood MA (1992) Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber). Gastroenterology 103:1783–1789PubMedGoogle Scholar
  6. 6.
    Kritchevsky D (1997) Dietary fibre and cancer. Eur J Cancer Prev 6:435–441PubMedCrossRefGoogle Scholar
  7. 7.
    Harris PJ, Ferguson LR (1993) Dietary fibre: its composition and role in protection against colorectal cancer. Mutat Res 290:97–110PubMedGoogle Scholar
  8. 8.
    Walker AR, Walker BF, Walker AJ (1986) Faecal pH, dietary fibre intake, and proneness to colon cancer in four South African populations. Br J Cancer 53:489–495PubMedGoogle Scholar
  9. 9.
    Gamet L, Daviaud D, Denis-Pouxviel C, Remesy C, Murat JC (1992) Effects of short-chain fatty acids on growth and differentiation of the human colon-cancer cell line HT29. Int J Cancer 52:286–289PubMedCrossRefGoogle Scholar
  10. 10.
    Whitehead RH, Young GP, Bhathal PS (1986) Effects of short chain fatty acids on a new human colon carcinoma cell line (LIM1215). Gut 27:1457–1463PubMedGoogle Scholar
  11. 11.
    Harris PJ, Ferguson LR (1999) Dietary fibres may protect or enhance carcinogenesis. Mutat Res 443:95–110PubMedGoogle Scholar
  12. 12.
    Sengupta S, Tjandra JJ, Gibson PR (2001) Dietary fiber and colorectal neoplasia. Dis Colon Rectum 44:1016–1033PubMedCrossRefGoogle Scholar
  13. 13.
    Trock B, Lanza E, Greenwald P (1990) Dietary fiber, vegetables, and colon cancer: critical review and meta-analyses of the epidemiologic evidence. J Natl Cancer Inst 82:650–661PubMedCrossRefGoogle Scholar
  14. 14.
    Howe GR, Benito E, Castelleto R et al. (1992) Dietary intake of fiber and decreased risk of cancers of the colon and rectum: evidence from the combined analysis of 13 case-control studies. J Natl Cancer Inst 84:1887–1896PubMedCrossRefGoogle Scholar
  15. 15.
    Terry P, Giovannucci E, Michels KB et al. (2001) Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst 93:525–533PubMedCrossRefGoogle Scholar
  16. 16.
    Fuchs CS, Giovannucci EL, Colditz GA et al. (1999) Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 340:169–176PubMedCrossRefGoogle Scholar
  17. 17.
    Pietinen P, Malila N, Virtanen M et al. (1999) Diet and risk of colorectal cancer in a cohort of Finnish men. Cancer Causes Control 10:387–396PubMedCrossRefGoogle Scholar
  18. 18.
    Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC (1994) Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res 54:2390–2397PubMedGoogle Scholar
  19. 19.
    Bingham SA, Day NE, Luben R, Ferrari P et al. (2003) Dietary fibre in food and protection against colorectal cancer in the European prospective investigation into cancer and nutrition (EPIC): an observational study. Lancet 361:1496–1501PubMedCrossRefGoogle Scholar
  20. 20.
    Bingham SA, Norat T, Moskal A et al. (2005) Is the association with fiber from foods in colorectal cancer confounded by folate intake? Cancer Epidemiol Biomarkers Prev 14:1552–1556PubMedCrossRefGoogle Scholar
  21. 21.
    Park Y, Hunter DJ, Spiegelman D et al. (2005) Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA 294:2849–2857PubMedCrossRefGoogle Scholar
  22. 22.
    Kolonel LN, Henderson BE, Hankin JH et al. (2000) A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics. Am J Epidemiol 151:346–357PubMedGoogle Scholar
  23. 23.
    Stram DO, JH Hankin, Wilkens LR et al. (2000) Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles. Am J Epidemiol 151:358–370PubMedGoogle Scholar
  24. 24.
    US Department of Agriculture (1993) USDA nutrient database for standard reference.Release no.10. Riverdale, MD: Nutrient Data Laboratory, Agricultural Research ServiceGoogle Scholar
  25. 25.
    US Department of Agriculture (1991) Nutrient database for nationwide food surveys. Release no. 7. Riverdale, MD: Nutrient Data Laboratory, Agricultural Research ServiceGoogle Scholar
  26. 26.
    Association of Official Analytic Chemists (AOAC) (1990) Official methods of analysis, 15th edn, Sec. 985.29. Arlington, VA: AOACGoogle Scholar
  27. 27.
    Zippin C, Lum D, Hankey BF (1995) Completeness of hospital case reporting from the SEER program of the National Cancer Institute. Cancer 76:2343–2350PubMedCrossRefGoogle Scholar
  28. 28.
    Therneau TM, Grambsch PM (2001) Modeling survival data: extending the Cox model. Springer-Verlag, Inc, New York (NY)Google Scholar
  29. 29.
    Kipnis V, Subar AF, Midthune D et al. (2003) Structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol 158:14–21PubMedCrossRefGoogle Scholar
  30. 30.
    Willett W (1998) Nutritional epidemiology. 2nd ed. Oxford University Press, New York, NYGoogle Scholar
  31. 31.
    Slattery ML (2004) Physical activity and colorectal cancer. Sports Med 34:239–252PubMedCrossRefGoogle Scholar
  32. 32.
    Frezza EE, Wachtel MS, Chiriva-Internati M (2005) Influence of obesity on the risk of developing colon cancer. Gut 55:285–291PubMedCrossRefGoogle Scholar
  33. 33.
    Chlebowski RT, Wactawski-Wende J, Ritenbaugh C et al. (2004) Estrogen plus progestin and colorectal cancer in postmenopausal women. N Engl J Med 350:991–1004PubMedCrossRefGoogle Scholar
  34. 34.
    Calle EE, Miracle-McMahill HL, Thun MJ, Heath Jr CW (1995) Estrogen replacement therapy and risk of fatal colon cancer in a prospective cohort of postmenopausal women. J Natl Cancer Inst 87:517–523PubMedCrossRefGoogle Scholar
  35. 35.
    McMichael AJ, Potter JD (1985) Host factors in carcinogenesis: certain bile-acid metabolic profiles that selectively increase the risk of proximal colon cancer. J Natl Cancer Inst 75:185–191PubMedGoogle Scholar
  36. 36.
    Jacobs ET, Lanza E, Alberts DS, Hsu CH, Jiang R, Schatzkin A, Thompson PA, Martinez ME (2006) Fiber, sex, and colorectal adenoma: results of a pooled analysis. Am J Clin Nutr 83:343–349PubMedGoogle Scholar
  37. 37.
    Institute of Medicine (2005) Dietary reference intakes for energy, carbohydrate, fat, fatty acids, cholesterol, protein, and amino acids. The National Academies P, Washington, DCGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Abraham M. Y. Nomura
    • 1
  • Jean H. Hankin
    • 1
  • Brian E. Henderson
    • 2
  • Lynne R. Wilkens
    • 1
  • Suzanne P. Murphy
    • 1
  • Malcolm C. Pike
    • 2
  • Loic Le Marchand
    • 1
  • Daniel O. Stram
    • 2
  • Kristine R. Monroe
    • 2
  • Laurence N. Kolonel
    • 1
  1. 1.Epidemiology Program, Cancer Research Center of HawaiiUniversity of HawaiiHonoluluUSA
  2. 2.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations