Dietary Intake of Fiber and Decreased Risk of Cancers of the Colon and Rectum: Evidence From the Combined Analysis of 13 Case-Control Studies
Identifieur interne : 002E06 ( Istex/Curation ); précédent : 002E05; suivant : 002E07Dietary Intake of Fiber and Decreased Risk of Cancers of the Colon and Rectum: Evidence From the Combined Analysis of 13 Case-Control Studies
Auteurs : Geoffrey R. Howe [Canada] ; Enrique Benito [Espagne] ; Roberto Castelleto [Argentine] ; Jacqueline Cornée [France] ; Jacques Estève [France] ; Richard P. Gallagher [Canada] ; José M. Iscovich [Israël] ; Jiao Deng-Ao [République populaire de Chine] ; Rudolf Kaaks [France] ; Gabriel A. Kune [Australie] ; Susan Kune [Australie] ; Kristan A. L'Abbé [Canada] ; Hin P. Lee ; Marion Lee ; Anthony B. Miller [Canada] ; Ruth K. Peters ; John D. Potter ; Elio Riboli [France] ; Martha L. Slattery ; Dimitrios Trichopoulos ; Albert Tuyns [France] ; Anastasia Tzonou [Grèce] ; Alice S. Whittemore ; Anna H. Wu-Williams ; Zheng Shu [République populaire de Chine]Source :
- JNCI: Journal of the National Cancer Institute [ 0027-8874 ] ; 1992-12-16.
Abstract
Background: Colorectal cancer is a major public health problem in both North America and western Europe, and incidence and mortality rates are rapidly increasing in many previously low-risk countries. It has been hypothesized that increased intakes of fiber, vitamin C, and beta carotene could decrease the risk of colorectal cancer. Purpose: The objective of this study was to examine the effects of fiber, vitamin C, and beta-carotene intakes on colorectal cancer risk in a combined analysis of data from 13 case-control studies previously conducted in populations with differing colorectal cancer rates and dietary practices. The study was designed to estimate risks in the pooled data, to test the consistency of the associations across the studies, and to examine interactions of the effects of the nutrients with cancer site, sex, and age. Methods: Original data records for 5287 case subjects with colorectal cancer and 10470 control subjects without disease were combined. Logistic regression analysis was used to estimate relative risks and confidence intervals for intakes of fiber, vitamin C, and beta carotene, with the effects of study, sex, and age group being adjusted by stratification. Results: Risk decreased as fiber intake increased; relative risks were 0.79, 0.69, 0.63, and 0.53 for the four highest quintiles of intake compared with the lowest quintile (trend, P<.0001). The inverse association with fiber is seen in 12 of the 13 studies and is similar in magnitude for left- and right-sided colon and rectal cancers, for men and for women, and for different age groups. In contrast, after adjustment for fiber intake, only weak inverse associations are seen for the intakes of vitamin C and beta carotene. Conclusion: This analysis provides substantive evidence that intake of fiber-rich foods is inversely related to risk of cancers of both the colon and rectum. Implications: If causality is assumed, we estimate that risk of colorectal cancer in the U.S. population could be reduced about 31% (50000 cases annually) by an average increase in fiber intake from food sources of about 13 g/d, corresponding to an average increase of about 70%. [J Natl Cancer Inst 84:1887–1896, 1992]
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DOI: 10.1093/jnci/84.24.1887
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Hin P. Lee<affiliation><mods:affiliation>Department of Community, Occupational and Family Medicine, National University of Singapore San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, University of California San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation><affiliation><mods:affiliation>Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis</mods:affiliation><wicri:noCountry code="subField">Minneapolis</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Family and Preventive Medicine, University of Utah Salt Lake City</mods:affiliation><wicri:noCountry code="subField">City</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health Boston, Mass</mods:affiliation><wicri:noCountry code="subField">Mass</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Health Research and Policy, Division of Epidemiology, Stanford University Stanford, Calif</mods:affiliation><wicri:noCountry code="subField">Calif</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation>Le document en format XML
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Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada.</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>*Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada.</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>*Correspondence to: Geoffrey R. 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Gallagher</name><affiliation wicri:level="1"><mods:affiliation>Cancer Control Agency of British Columbia, Vancouver, British Columbia Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Cancer Control Agency of British Columbia, Vancouver</wicri:regionArea></affiliation></author><author><name sortKey="Iscovich, Jose M" sort="Iscovich, Jose M" uniqKey="Iscovich J" first="José M." last="Iscovich">José M. Iscovich</name><affiliation wicri:level="1"><mods:affiliation>Department of Epidemiology Studies, Ministry of Health, La Plata, Argentina, and Israel Center for Registration of Cancer and Allied Diseases, Ministry of Health Jerusalem, Israel</mods:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Epidemiology Studies, Ministry of Health, La Plata, Argentina, and Israel Center for Registration of Cancer and Allied Diseases, Ministry of Health Jerusalem</wicri:regionArea></affiliation></author><author><name sortKey="Deng Ao, Jiao" sort="Deng Ao, Jiao" uniqKey="Deng Ao J" first="Jiao" last="Deng-Ao">Jiao Deng-Ao</name><affiliation wicri:level="1"><mods:affiliation>Chejiang Medical University Hangzhou, People's Republic of China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Chejiang Medical University Hangzhou</wicri:regionArea></affiliation></author><author><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Kune, Gabriel A" sort="Kune, Gabriel A" uniqKey="Kune G" first="Gabriel A." last="Kune">Gabriel A. Kune</name><affiliation wicri:level="1"><mods:affiliation>Department of Surgery, University of Melbourne Victoria, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea></affiliation></author><author><name sortKey="Kune, Susan" sort="Kune, Susan" uniqKey="Kune S" first="Susan" last="Kune">Susan Kune</name><affiliation wicri:level="1"><mods:affiliation>Department of Surgery, University of Melbourne Victoria, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea></affiliation></author><author><name sortKey="L Abbe, Kristan A" sort="L Abbe, Kristan A" uniqKey="L Abbe K" first="Kristan A." last="L'Abbé">Kristan A. L'Abbé</name><affiliation wicri:level="1"><mods:affiliation>K. A. L'Abbe is a recipient of a National Health Research Scholar Award (Health and Welfare, Canada)</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>K. A. L'Abbe is a recipient of a National Health Research Scholar Award (Health and Welfare</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Hin P" sort="Lee, Hin P" uniqKey="Lee H" first="Hin P." last="Lee">Hin P. Lee</name><affiliation><mods:affiliation>Department of Community, Occupational and Family Medicine, National University of Singapore San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Marion" sort="Lee, Marion" uniqKey="Lee M" first="Marion" last="Lee">Marion Lee</name><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, University of California San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation></author><author><name sortKey="Miller, Anthony B" sort="Miller, Anthony B" uniqKey="Miller A" first="Anthony B." last="Miller">Anthony B. Miller</name><affiliation wicri:level="1"><mods:affiliation>A. B. Miller is a recipient of a National Health Career Scientist Award (Health and Welfare, Canada)</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>A. B. Miller is a recipient of a National Health Career Scientist Award (Health and Welfare</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Peters, Ruth K" sort="Peters, Ruth K" uniqKey="Peters R" first="Ruth K." last="Peters">Ruth K. Peters</name><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation></author><author><name sortKey="Potter, John D" sort="Potter, John D" uniqKey="Potter J" first="John D." last="Potter">John D. Potter</name><affiliation><mods:affiliation>Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis</mods:affiliation><wicri:noCountry code="subField">Minneapolis</wicri:noCountry></affiliation></author><author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Slattery, Martha L" sort="Slattery, Martha L" uniqKey="Slattery M" first="Martha L." last="Slattery">Martha L. Slattery</name><affiliation><mods:affiliation>Department of Family and Preventive Medicine, University of Utah Salt Lake City</mods:affiliation><wicri:noCountry code="subField">City</wicri:noCountry></affiliation></author><author><name sortKey="Trichopoulos, Dimitrios" sort="Trichopoulos, Dimitrios" uniqKey="Trichopoulos D" first="Dimitrios" last="Trichopoulos">Dimitrios Trichopoulos</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health Boston, Mass</mods:affiliation><wicri:noCountry code="subField">Mass</wicri:noCountry></affiliation></author><author><name sortKey="Tuyns, Albert" sort="Tuyns, Albert" uniqKey="Tuyns A" first="Albert" last="Tuyns">Albert Tuyns</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Tzonou, Anastasia" sort="Tzonou, Anastasia" uniqKey="Tzonou A" first="Anastasia" last="Tzonou">Anastasia Tzonou</name><affiliation wicri:level="1"><mods:affiliation>Department of Hygiene and Epidemiology, University of Athens Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Hygiene and Epidemiology</wicri:regionArea></affiliation></author><author><name sortKey="Whittemore, Alice S" sort="Whittemore, Alice S" uniqKey="Whittemore A" first="Alice S." last="Whittemore">Alice S. Whittemore</name><affiliation><mods:affiliation>Department of Health Research and Policy, Division of Epidemiology, Stanford University Stanford, Calif</mods:affiliation><wicri:noCountry code="subField">Calif</wicri:noCountry></affiliation></author><author><name sortKey="Wu Williams, Anna H" sort="Wu Williams, Anna H" uniqKey="Wu Williams A" first="Anna H." last="Wu-Williams">Anna H. Wu-Williams</name><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation></author><author><name sortKey="Shu, Zheng" sort="Shu, Zheng" uniqKey="Shu Z" first="Zheng" last="Shu">Zheng Shu</name><affiliation wicri:level="1"><mods:affiliation>Chejiang Medical University Hangzhou, People's Republic of China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Chejiang Medical University Hangzhou</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F49BD49F4F14BAA65953EC0999B2054DFD504418</idno><date when="1992" year="1992">1992</date><idno type="doi">10.1093/jnci/84.24.1887</idno><idno type="url">https://api.istex.fr/document/F49BD49F4F14BAA65953EC0999B2054DFD504418/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002E06</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002E06</idno><idno type="wicri:Area/Istex/Curation">002E06</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Dietary Intake of Fiber and Decreased Risk of Cancers of the Colon and Rectum: Evidence From the Combined Analysis of 13 Case-Control Studies</title><author><name sortKey="Howe, Geoffrey R" sort="Howe, Geoffrey R" uniqKey="Howe G" first="Geoffrey R." last="Howe">Geoffrey R. Howe</name><affiliation wicri:level="1"><mods:affiliation>Epidemiology Unit, National Cancer Institute of Canada, Faculty of Medicine, University of Toronto Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Epidemiology Unit, National Cancer Institute of Canada, Faculty of Medicine, University of Toronto Ontario</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada.</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>*Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada.</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>*Correspondence to: Geoffrey R. Howe, Ph.D., NCIC Epidemiology Unit, University of Toronto, McMurrich Bldg., 3rd Fl., 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8</wicri:regionArea></affiliation></author><author><name sortKey="Benito, Enrique" sort="Benito, Enrique" uniqKey="Benito E" first="Enrique" last="Benito">Enrique Benito</name><affiliation wicri:level="1"><mods:affiliation>Unitat d'Epidemiologia i Registre de Cancer de Mallorca, Palma de Mallorca Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Unitat d'Epidemiologia i Registre de Cancer de Mallorca</wicri:regionArea></affiliation></author><author><name sortKey="Castelleto, Roberto" sort="Castelleto, Roberto" uniqKey="Castelleto R" first="Roberto" last="Castelleto">Roberto Castelleto</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, La Plata National University La Plata, Argentina</mods:affiliation><country xml:lang="fr">Argentine</country><wicri:regionArea>Department of Pathology, La Plata National University La Plata</wicri:regionArea></affiliation></author><author><name sortKey="Cornee, Jacqueline" sort="Cornee, Jacqueline" uniqKey="Cornee J" first="Jacqueline" last="Cornée">Jacqueline Cornée</name><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santié et de la Recherche Médicale (INSERM) Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santié et de la Recherche Médicale (INSERM) Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Esteve, Jacques" sort="Esteve, Jacques" uniqKey="Esteve J" first="Jacques" last="Estève">Jacques Estève</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Gallagher, Richard P" sort="Gallagher, Richard P" uniqKey="Gallagher R" first="Richard P." last="Gallagher">Richard P. Gallagher</name><affiliation wicri:level="1"><mods:affiliation>Cancer Control Agency of British Columbia, Vancouver, British Columbia Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Cancer Control Agency of British Columbia, Vancouver</wicri:regionArea></affiliation></author><author><name sortKey="Iscovich, Jose M" sort="Iscovich, Jose M" uniqKey="Iscovich J" first="José M." last="Iscovich">José M. Iscovich</name><affiliation wicri:level="1"><mods:affiliation>Department of Epidemiology Studies, Ministry of Health, La Plata, Argentina, and Israel Center for Registration of Cancer and Allied Diseases, Ministry of Health Jerusalem, Israel</mods:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Epidemiology Studies, Ministry of Health, La Plata, Argentina, and Israel Center for Registration of Cancer and Allied Diseases, Ministry of Health Jerusalem</wicri:regionArea></affiliation></author><author><name sortKey="Deng Ao, Jiao" sort="Deng Ao, Jiao" uniqKey="Deng Ao J" first="Jiao" last="Deng-Ao">Jiao Deng-Ao</name><affiliation wicri:level="1"><mods:affiliation>Chejiang Medical University Hangzhou, People's Republic of China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Chejiang Medical University Hangzhou</wicri:regionArea></affiliation></author><author><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Kune, Gabriel A" sort="Kune, Gabriel A" uniqKey="Kune G" first="Gabriel A." last="Kune">Gabriel A. Kune</name><affiliation wicri:level="1"><mods:affiliation>Department of Surgery, University of Melbourne Victoria, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea></affiliation></author><author><name sortKey="Kune, Susan" sort="Kune, Susan" uniqKey="Kune S" first="Susan" last="Kune">Susan Kune</name><affiliation wicri:level="1"><mods:affiliation>Department of Surgery, University of Melbourne Victoria, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea></affiliation></author><author><name sortKey="L Abbe, Kristan A" sort="L Abbe, Kristan A" uniqKey="L Abbe K" first="Kristan A." last="L'Abbé">Kristan A. L'Abbé</name><affiliation wicri:level="1"><mods:affiliation>K. A. L'Abbe is a recipient of a National Health Research Scholar Award (Health and Welfare, Canada)</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>K. A. L'Abbe is a recipient of a National Health Research Scholar Award (Health and Welfare</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Hin P" sort="Lee, Hin P" uniqKey="Lee H" first="Hin P." last="Lee">Hin P. Lee</name><affiliation><mods:affiliation>Department of Community, Occupational and Family Medicine, National University of Singapore San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Marion" sort="Lee, Marion" uniqKey="Lee M" first="Marion" last="Lee">Marion Lee</name><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, University of California San Francisco</mods:affiliation><wicri:noCountry code="subField">Francisco</wicri:noCountry></affiliation></author><author><name sortKey="Miller, Anthony B" sort="Miller, Anthony B" uniqKey="Miller A" first="Anthony B." last="Miller">Anthony B. Miller</name><affiliation wicri:level="1"><mods:affiliation>A. B. Miller is a recipient of a National Health Career Scientist Award (Health and Welfare, Canada)</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>A. B. Miller is a recipient of a National Health Career Scientist Award (Health and Welfare</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Peters, Ruth K" sort="Peters, Ruth K" uniqKey="Peters R" first="Ruth K." last="Peters">Ruth K. Peters</name><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation></author><author><name sortKey="Potter, John D" sort="Potter, John D" uniqKey="Potter J" first="John D." last="Potter">John D. Potter</name><affiliation><mods:affiliation>Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis</mods:affiliation><wicri:noCountry code="subField">Minneapolis</wicri:noCountry></affiliation></author><author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Slattery, Martha L" sort="Slattery, Martha L" uniqKey="Slattery M" first="Martha L." last="Slattery">Martha L. Slattery</name><affiliation><mods:affiliation>Department of Family and Preventive Medicine, University of Utah Salt Lake City</mods:affiliation><wicri:noCountry code="subField">City</wicri:noCountry></affiliation></author><author><name sortKey="Trichopoulos, Dimitrios" sort="Trichopoulos, Dimitrios" uniqKey="Trichopoulos D" first="Dimitrios" last="Trichopoulos">Dimitrios Trichopoulos</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health Boston, Mass</mods:affiliation><wicri:noCountry code="subField">Mass</wicri:noCountry></affiliation></author><author><name sortKey="Tuyns, Albert" sort="Tuyns, Albert" uniqKey="Tuyns A" first="Albert" last="Tuyns">Albert Tuyns</name><affiliation wicri:level="1"><mods:affiliation>International Agency for Research on Cancer Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Agency for Research on Cancer Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Tzonou, Anastasia" sort="Tzonou, Anastasia" uniqKey="Tzonou A" first="Anastasia" last="Tzonou">Anastasia Tzonou</name><affiliation wicri:level="1"><mods:affiliation>Department of Hygiene and Epidemiology, University of Athens Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Hygiene and Epidemiology</wicri:regionArea></affiliation></author><author><name sortKey="Whittemore, Alice S" sort="Whittemore, Alice S" uniqKey="Whittemore A" first="Alice S." last="Whittemore">Alice S. Whittemore</name><affiliation><mods:affiliation>Department of Health Research and Policy, Division of Epidemiology, Stanford University Stanford, Calif</mods:affiliation><wicri:noCountry code="subField">Calif</wicri:noCountry></affiliation></author><author><name sortKey="Wu Williams, Anna H" sort="Wu Williams, Anna H" uniqKey="Wu Williams A" first="Anna H." last="Wu-Williams">Anna H. Wu-Williams</name><affiliation><mods:affiliation>Department of Preventive Medicine, School of Medicine, University of Southern California Los Angeles</mods:affiliation><wicri:noCountry code="subField">Angeles</wicri:noCountry></affiliation></author><author><name sortKey="Shu, Zheng" sort="Shu, Zheng" uniqKey="Shu Z" first="Zheng" last="Shu">Zheng Shu</name><affiliation wicri:level="1"><mods:affiliation>Chejiang Medical University Hangzhou, People's Republic of China</mods:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Chejiang Medical University Hangzhou</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">JNCI: Journal of the National Cancer Institute</title><idno type="ISSN">0027-8874</idno><idno type="eISSN">1460-2105</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="1992-12-16">1992-12-16</date><biblScope unit="volume">84</biblScope><biblScope unit="issue">24</biblScope><biblScope unit="page" from="1887">1887</biblScope><biblScope unit="page" to="1896">1896</biblScope></imprint><idno type="ISSN">0027-8874</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0027-8874</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background: Colorectal cancer is a major public health problem in both North America and western Europe, and incidence and mortality rates are rapidly increasing in many previously low-risk countries. It has been hypothesized that increased intakes of fiber, vitamin C, and beta carotene could decrease the risk of colorectal cancer. Purpose: The objective of this study was to examine the effects of fiber, vitamin C, and beta-carotene intakes on colorectal cancer risk in a combined analysis of data from 13 case-control studies previously conducted in populations with differing colorectal cancer rates and dietary practices. The study was designed to estimate risks in the pooled data, to test the consistency of the associations across the studies, and to examine interactions of the effects of the nutrients with cancer site, sex, and age. Methods: Original data records for 5287 case subjects with colorectal cancer and 10470 control subjects without disease were combined. Logistic regression analysis was used to estimate relative risks and confidence intervals for intakes of fiber, vitamin C, and beta carotene, with the effects of study, sex, and age group being adjusted by stratification. Results: Risk decreased as fiber intake increased; relative risks were 0.79, 0.69, 0.63, and 0.53 for the four highest quintiles of intake compared with the lowest quintile (trend, P<.0001). The inverse association with fiber is seen in 12 of the 13 studies and is similar in magnitude for left- and right-sided colon and rectal cancers, for men and for women, and for different age groups. In contrast, after adjustment for fiber intake, only weak inverse associations are seen for the intakes of vitamin C and beta carotene. Conclusion: This analysis provides substantive evidence that intake of fiber-rich foods is inversely related to risk of cancers of both the colon and rectum. Implications: If causality is assumed, we estimate that risk of colorectal cancer in the U.S. population could be reduced about 31% (50000 cases annually) by an average increase in fiber intake from food sources of about 13 g/d, corresponding to an average increase of about 70%. [J Natl Cancer Inst 84:1887–1896, 1992]</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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