Advertisement

Cancer Causes & Control

, Volume 9, Issue 4, pp 357–367 | Cite as

Diet and risk of colon cancer in a large prospective study of older women: an analysis stratified on family history (Iowa, United States)

  • Amy E. Bazyk
  • Janet E. Olson
  • Thomas A. Sellers
  • Lawrence H. Kushi
  • Kristin E. Anderson
  • DeAnn Lazovich
  • Aaron R. Folsom
  • Roberd M. Bostick
Article

Abstract

Objective: The purpose was to investigate whether dietary associations with risk of colon cancer in women differ by family history of the disease.

Methods: Data were analyzed from a prospective cohort study of 35,216 Iowa (United States) women aged 55 to 69 years at baseline. Through 31 December 1995, 241 colon cancers were identified through record linkage with the State Health Registry. The cohort was stratified on family history of colon cancer in first-degree relatives; nutrient intakes were divided into tertiles.

Results: Analyses using Cox regression revealed that the association of most dietary components with colon cancer incidence were similar for individuals with and without a family history. However, total calcium intake was associated inversely with colon cancer among women with a negative family history (relative risk [RR]=0.50 for upper cf lower tertile, P < 0.001), but was unrelated to incidence for women with a positive family history (RR=1.1 for upper cf lower tertile, P=0.69). Similarly, total vitamin E intake was associated with lower risk among women with a negative family history (RR=0.67 for upper cf lower tertile, P=0.04), but not among women with a positive family history (RR=0.87 for upper cf lower tertile, P=0.67). High intakes of fiber, fruits, and vegetables were each weakly inversely associated with risk among family-history negative women, but not among family-history positive women.

Conclusions: These data, if corroborated, suggest that dietary factors typically associated with lower risk may be less effective risk-reduction interventions against colon cancer for individuals with a family history of colon cancer.

Colon cancer diet family history United States women 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schottenfeld D, Winawer SJ. Cancers of the large intestine. In: Schottenfeld D and Fraumeni JF Jr, eds. Cancer Epidemiology and Prevention, Second Edition. New York, NY (USA): Oxford University Press, 1996: 813–40.Google Scholar
  2. 2.
    Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics 1997. CA Cancer J Clin 1997; 47: 5–27.Google Scholar
  3. 3.
    Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology. Epidemiol Rev 1993; 15: 499–545.Google Scholar
  4. 4.
    Steinmetz KA, Kushi LH, Bostick RM, et al. Vegetables, fruit, and colon cancer in the Iowa’s Women’s Health Study. Am J Epidemiol 1994; 139: 1–15.Google Scholar
  5. 5.
    Steinmetz KA, Potter JD. Food-group consumption and colon cancer in the Adelaide case-control study. I. Vegetables and fruit. Int J Cancer 1993; 53: 711–9.Google Scholar
  6. 6.
    Thun MJ, Calle EE, Namboodiri MM, et al. Risk factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst 1992; 84: 1491–500.Google Scholar
  7. 7.
    Willett WC, Stampfer MJ, Colditz GA, et al. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Eng J Med 1990; 323: 1664–72.Google Scholar
  8. 8.
    Kampman E, Verhoeven D, Sloots L, van’t Veer P. Vegetable and animal products as determinants of colon cancer risk in Dutch men and women. Cancer Causes Control 1995; 6: 225–34.Google Scholar
  9. 9.
    Bostick RM, Potter JD, Kushi LH, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 1994; 5: 38–52.Google Scholar
  10. 10.
    Steinmetz KA, Potter JD. Food-group consumption and colon cancer in the Adelaide case-control study. II. Meat, poultry, seafood, dairy foods and eggs. Int J Cancer 1993; 53: 720–7.Google Scholar
  11. 11.
    Peters RK, Pike MC, Garabrant D, Mack TM. Diet and colon cancer in Los Angeles County, California. Cancer Causes Control 1992; 3: 457–73.Google Scholar
  12. 12.
    Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.Google Scholar
  13. 13.
    Ferraroni M, La Vecchia C, D’Avanzo B, et al. Selected micronutrient intake and the risk of colorectal cancer. Br J Cancer 1994; 70: 1150–5.Google Scholar
  14. 14.
    Greenberg ER, Baron JA, Tosteson TD, et al. A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med 1994; 331: 141–7.Google Scholar
  15. 15.
    Giovannucci E, Stampfer MJ, Colditz GA, et al. Folate, methionine, and alcohol intake and risk of colorectal adenoma. J Natl Cancer Inst 1993; 85: 5–84.Google Scholar
  16. 16.
    Bostick RM, Potter JD, McKenzie DR, et al. Reduced risk of colon cancer with high intake of vitamin E: The Iowa Women’s Health Study. Cancer Res 1993; 53: 4230–7.Google Scholar
  17. 17.
    Bostick RM, Potter JD, Sellers TA, et al. Relation of calcium, vitamin D, and dairy food intake to incidence of colon cancer among older women. The Iowa Women’s Health Study. Am J Epidemiol 1993; 137: 1302–17.Google Scholar
  18. 18.
    Bostick RM, Fosdick L, Wood JR, et al. Calcium and colorectal epithelial cell proliferation in sporadic adenoma patients: a randomized, double-blinded, placebo controlled clinical trial. J Natl Cancer Inst 1995; 87: 1307–15.Google Scholar
  19. 19.
    Cats A, Kleibeuker JH, van der Meer R, et al. Randomized, double-blinded, placebo-controlled intervention study with supplemental calcium in families with hereditary nonpolyposis colorectal cancer. J Natl Cancer Inst 1995; 87: 598–603.Google Scholar
  20. 20.
    Lovett E. Family studies in cancer of the colon and rectum. Br J Surg 1976; 63: 13–8.Google Scholar
  21. 21.
    Kune GA, Kune S, Watson LF. The role of heredity in the etiology of large bowel cancer: data from the Melbourne colorectal cancer study. World J Surg 1989; 13: 124–31.Google Scholar
  22. 22.
    St John DJB, McDermott FT, Hopper JL, et al. Cancer risk in relatives of patients with common colorectal cancer. Ann Intern Med 1993; 118: 785–90.Google Scholar
  23. 23.
    Fuchs CS, Giovannucci EL, Colditz GA, et al. A prospective study of family history and the risk of colorectal cancer. N Engl J Med 1994; 331: 1669–74.Google Scholar
  24. 24.
    Potter JD, Sellers TA, Rich SS. Colorectal Cancer. In Ponder BAJ, Waring MJ, eds. Cancer Biology and Medicine, Volume 4. The Genetics of Cancer. The Netherlands: Kluwer Academic Publishers, 1995; 45–65.Google Scholar
  25. 25.
    Slattery ML, Caan BJ, Potter JD, et al. Dietary energy sources and colon cancer risk. Am J Epidemiol 1997; 145: 199–210.Google Scholar
  26. 26.
    Willett WC, Sampson L, Browne ML, et al. The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol 1988; 127: 188–99.Google Scholar
  27. 27.
    Willett WC, Sampson L, Stampfer MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985; 122: 51–65.Google Scholar
  28. 28.
    Block G, Hartman AM, Dresser CM, et al. A data-based approach to diet questionnaire design and testing. Am J Epidemiol 1986; 124: 453–69.Google Scholar
  29. 29.
    Rimm EB, Giovannucci EL, Stampfer MJ, et al. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professional. Am J Epidemiol 1992; 135: 1114–26.Google Scholar
  30. 30.
    Munger RG, Folsom AR, Kushi LH, et al. Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol 1992; 136: 192–200.Google Scholar
  31. 31.
    Ries LAG, Miller BA, Hankey, Kosary CL, Harras A, Edwards BK, eds. SEER Cancer Statistics Review, 1973-1991: Tables and Graphs. Bethesda, MD (USA): National Cancer Institute, 1994; NIH Pub. No. 94-2789.Google Scholar
  32. 32.
    SAS Institute, Inc. SAS/STAT software: the PHREG procedure preliminary documentation. Cary, NC (USA): SAS Institute, Inc, 1991.Google Scholar
  33. 33.
    DeCosse JJ, Miller HH, Lesser ML. Effect of wheat fiber and vitamins C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 1989; 81: 1290–7.Google Scholar
  34. 34.
    Spagnesi MT, Tonelli F, Dolara P, et al. Rectal proliferation and polyp occurrence in patients with familial adenomatous polyposis after sulindac treatment. Gastroenterology 1994; 106: 362–6.Google Scholar
  35. 35.
    Winde G, Gumbinger HG, Osswald H, et al. The NSAID sulindac reverses rectal adenomas in colectomized patients with familial adenomatous polyposis: clinical results of a dose-finding study on rectal sulindac administration. Int J Colorect Dis 1993; 8: 13–7.Google Scholar
  36. 36.
    Giardiello FM, Hamilton SR, Krush AJ, et al. Treatment of colonic and rectal adenomas with sulindac in familial adenomatous polyposis. N Eng J Med 1993; 328: 1313–6.Google Scholar
  37. 37.
    Nugent KP, Farmer KCR, Spigelman AD, et al. Randomized controlled trial of the effect of sulindac on duodenal and rectal polyposis and cell proliferation in patients with familial adenomatous polyposis. Br J Surg 1993; 80: 1618–9.Google Scholar
  38. 38.
    Freedman AN, Michalek AM, Marshall JR, et al. Familial and nutritional risk factors for p53 overexpression in colorectal cancer. Cancer Epidemiol Biomark Prev 1996; 5: 285–91.Google Scholar
  39. 39.
    Ma J, Stampfer MJ, Giovannucci E, et al. Methylenetetrahydrofolate reductase polymorphism, dietary interactions, and risk of colorectal cancer. Cancer Res 1997; 57: 1098–102.Google Scholar
  40. 40.
    Newmark HL, Wargovich MJ, Bruce WR. Colon cancer and dietary fat, phosphate, and calcium: A hypothesis. J Natl Cancer Inst 1984; 72: 1323–5.Google Scholar
  41. 41.
    Aitken J, Bain C, Ward M, Siskind V, MacLennan R. How accurate is self-reported family history of colorectal cancer? Am J Epidemiol 1995; 141: 863–71.Google Scholar

Copyright information

© Kluwer Academic Publishers 1998

Authors and Affiliations

  • Amy E. Bazyk
    • 1
  • Janet E. Olson
    • 1
  • Thomas A. Sellers
    • 1
    • 2
  • Lawrence H. Kushi
    • 1
    • 2
  • Kristin E. Anderson
    • 1
    • 2
  • DeAnn Lazovich
    • 1
    • 2
  • Aaron R. Folsom
    • 1
    • 2
  • Roberd M. Bostick
    • 3
  1. 1.Division of EpidemiologyUniversity of Minnesota School of Public HealthUSA
  2. 2.University of Minnesota Cancer CenterMinneapolisUSA
  3. 3.Department of Public Health SciencesWake Forest University School of MedicineWinston-SalemUSA

Personalised recommendations