Cancer Causes & Control

, Volume 19, Issue 10, pp 1051–1064 | Cite as

A summary measure of pro- and anti-oxidant exposures and risk of incident, sporadic, colorectal adenomas

  • Michael Goodman
  • Roberd M. Bostick
  • Chiranjeev Dash
  • Paul Terry
  • W. Dana Flanders
  • Jack Mandel
Original Paper


Despite compelling basic science evidence, the search for causal associations linking specific pro- and anti-oxidants to presumably oxidative stress-related neoplasms, such as colorectal adenoma, has produced inconsistent results. We developed an oxidative balance score (OBS) to characterize the pro-oxidant and anti-oxidant exposures of 2,305 participants in a case–control study of colorectal adenoma that used both endoscopy-confirmed and community controls. Twelve lifestyle medical and dietary factors with known pro- or anti-oxidant properties were considered. Each high anti-oxidant exposure and low pro-oxidant exposure was awarded one or two points depending on the level of exposure, and the points for each OBS component were summed. We observed a significant inverse association between OBS (continuous variable) and colorectal adenoma in the analyses with either community, or endoscopy controls (each p-trend < 0.01). When the OBS was treated as an ordinal variable and a score of ≤3 points was used as the referent category, in the analyses with the endoscopy controls the adjusted odds ratios for scores of 4–6, 7–9, 10–12, 13–15, and 16+, were 0.42, 0.32, 0.22, 0.20, and 0.19, respectively, with all 95% confidence intervals excluding 1.0. The corresponding analysis for community controls showed a similar trend. Our findings are in line with the basic science evidence supporting the role of oxidative stress in colorectal neoplasia.


Cancer Colorectal adenoma Oxidative stress Score 


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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Michael Goodman
    • 1
  • Roberd M. Bostick
    • 1
  • Chiranjeev Dash
    • 1
  • Paul Terry
    • 1
  • W. Dana Flanders
    • 1
  • Jack Mandel
    • 1
  1. 1.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA

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