Cancer Causes & Control

, Volume 8, Issue 4, pp 637–648 | Cite as

A case-control study of diet and colorectal cancer in a multiethnic population in Hawaii (United States): lipids and foods of animal origin

  • Loïc Le Marchand
  • Lynne R. Wilkens
  • Jean H. Hankin
  • Laurence N. Kolonel
  • Li-Ching Lyu


Temporal trend and migrant studies have indicated that the etiologyof colorectal cancer is predominantly environmental and, hence, modifiable.Animal fat intake has been frequently, but inconsistently, associated withthe risk of this disease. We conducted a population-based case-control studyin Hawaii (United States) among ethnic groups at different risks of thedisease to evaluate the role of dietary lipids and foods of animal origin onthe risk of colorectal cancer. We interviewed 698 male and 494 femaleJapanese, Caucasian (White), Filipino, Hawaiian, and Chinese patientsdiagnosed during 1987-91 with pathologically confirmed adenocarcinoma of thecolon or rectum, and 1,192 population controls matched to cases on age,gender and ethnicity. Odds ratios (OR), adjusted for caloric intake and otherdietary and non-dietary risk factors, were estimated using conditionallogistic regression. Intakes of total fat, saturated fat (S) andpolyunsaturated fat (P) were not related to the risk of colorectal cancer.However, an inverse association was found for the P/S ratio, with ORs of 0.6in both genders (95 percent confidence interval [CI] = 0.4-1.0 for males; CI= 0.3-0.9 for females) for the highest compared with the lowest quartile (P≤ 0.05 for trend). Intakes of red meat and processed meat were associatedwith the risk of cancer in the right colon and rectum, respectively, in menonly. Fat-trimmed red meat and fish intakes were not related to risk. Chickeneaten without skin was associated inversely with risk in both genders. Thestrongest association was found for eggs, with an OR of 2.7 (CI = 1.7-4.0)and 2.3 (CI = 1.4-3.7) for the highest compared with the lowest quartile ofintake in men and women, respectively (P < 0.001 for trend). This associationwas dose-dependent, not explained by known confounders or other dietaryvariables, and was very consistent between genders, among ethnic groups, andacross all segments of the large bowel. These data sugg est that the ratio ofpolyunsaturated to saturated fat may be a better indicator of colorectalcancer risk than the absolute amount of specific fats in the diet. They alsosuggest that eggs and, possibly, untrimmed red meat and processed meatincrease, and chicken eaten without skin decreases, colorectal cancer risk.

Cholesterol colorectal cancer diet eggs ethnic groups fat lipids meat United States 


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Copyright information

© Chapman and Hall 1997

Authors and Affiliations

  • Loïc Le Marchand
    • 1
  • Lynne R. Wilkens
    • 1
  • Jean H. Hankin
    • 1
  • Laurence N. Kolonel
    • 1
  • Li-Ching Lyu
    • 1
  1. 1.Cancer Research Center of HawaiiUniversity of HawaiiHonoluluUSA

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