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 : 00DA94 ( Main/Exploration ); précédent : 00DA93; suivant : 00DA95Dietary 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]
Url:
DOI: 10.1093/jnci/84.24.1887
Affiliations:
- Argentine, Australie, Canada, Espagne, France, Grèce, Israël, République populaire de Chine
- Ontario
- Toronto
- Université de Toronto
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Howe</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Epidemiology Unit, National Cancer Institute of Canada, Faculty of Medicine, University of Toronto Ontario</wicri:regionArea><wicri:noRegion>University of Toronto Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><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><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="4"><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><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Benito, Enrique" sort="Benito, Enrique" uniqKey="Benito E" first="Enrique" last="Benito">Enrique Benito</name><affiliation wicri:level="1"><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"><country xml:lang="fr">Argentine</country><wicri:regionArea>Department of Pathology, La Plata National University La Plata</wicri:regionArea><wicri:noRegion>La Plata National University La Plata</wicri:noRegion></affiliation></author><author><name sortKey="Cornee, Jacqueline" sort="Cornee, Jacqueline" uniqKey="Cornee J" first="Jacqueline" last="Cornée">Jacqueline Cornée</name><affiliation wicri:level="1"><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"><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"><country xml:lang="fr">Canada</country><wicri:regionArea>Cancer Control Agency of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></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"><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><wicri:noRegion>Ministry of Health Jerusalem</wicri:noRegion></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"><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"><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"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea><wicri:noRegion>University of Melbourne Victoria</wicri:noRegion></affiliation></author><author><name sortKey="Kune, Susan" sort="Kune, Susan" uniqKey="Kune S" first="Susan" last="Kune">Susan Kune</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, University of Melbourne Victoria</wicri:regionArea><wicri:noRegion>University of Melbourne Victoria</wicri:noRegion></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"><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"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea><wicri:noRegion>University of Toronto Ontario</wicri:noRegion></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><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><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"><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"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Preventive Medicine and Biostatistics), University of Toronto Ontario</wicri:regionArea><wicri:noRegion>University of Toronto Ontario</wicri:noRegion></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><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><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"><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><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><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"><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"><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><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><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"><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><affiliations><list><country><li>Argentine</li><li>Australie</li><li>Canada</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Israël</li><li>République populaire de Chine</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Lee, Hin P" sort="Lee, Hin P" uniqKey="Lee H" first="Hin P." last="Lee">Hin P. Lee</name><name sortKey="Lee, Marion" sort="Lee, Marion" uniqKey="Lee M" first="Marion" last="Lee">Marion Lee</name><name sortKey="Peters, Ruth K" sort="Peters, Ruth K" uniqKey="Peters R" first="Ruth K." last="Peters">Ruth K. Peters</name><name sortKey="Potter, John D" sort="Potter, John D" uniqKey="Potter J" first="John D." last="Potter">John D. Potter</name><name sortKey="Slattery, Martha L" sort="Slattery, Martha L" uniqKey="Slattery M" first="Martha L." last="Slattery">Martha L. Slattery</name><name sortKey="Trichopoulos, Dimitrios" sort="Trichopoulos, Dimitrios" uniqKey="Trichopoulos D" first="Dimitrios" last="Trichopoulos">Dimitrios Trichopoulos</name><name sortKey="Whittemore, Alice S" sort="Whittemore, Alice S" uniqKey="Whittemore A" first="Alice S." last="Whittemore">Alice S. Whittemore</name><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></noCountry><country name="Canada"><noRegion><name sortKey="Howe, Geoffrey R" sort="Howe, Geoffrey R" uniqKey="Howe G" first="Geoffrey R." last="Howe">Geoffrey R. Howe</name></noRegion><name sortKey="Gallagher, Richard P" sort="Gallagher, Richard P" uniqKey="Gallagher R" first="Richard P." last="Gallagher">Richard P. Gallagher</name><name sortKey="Howe, Geoffrey R" sort="Howe, Geoffrey R" uniqKey="Howe G" first="Geoffrey R." last="Howe">Geoffrey R. Howe</name><name sortKey="Howe, Geoffrey R" sort="Howe, Geoffrey R" uniqKey="Howe G" first="Geoffrey R." last="Howe">Geoffrey R. Howe</name><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><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><name sortKey="Miller, Anthony B" sort="Miller, Anthony B" uniqKey="Miller A" first="Anthony B." last="Miller">Anthony B. Miller</name><name sortKey="Miller, Anthony B" sort="Miller, Anthony B" uniqKey="Miller A" first="Anthony B." last="Miller">Anthony B. Miller</name></country><country name="Espagne"><noRegion><name sortKey="Benito, Enrique" sort="Benito, Enrique" uniqKey="Benito E" first="Enrique" last="Benito">Enrique Benito</name></noRegion></country><country name="Argentine"><noRegion><name sortKey="Castelleto, Roberto" sort="Castelleto, Roberto" uniqKey="Castelleto R" first="Roberto" last="Castelleto">Roberto Castelleto</name></noRegion></country><country name="France"><noRegion><name sortKey="Cornee, Jacqueline" sort="Cornee, Jacqueline" uniqKey="Cornee J" first="Jacqueline" last="Cornée">Jacqueline Cornée</name></noRegion><name sortKey="Esteve, Jacques" sort="Esteve, Jacques" uniqKey="Esteve J" first="Jacques" last="Estève">Jacques Estève</name><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name><name sortKey="Tuyns, Albert" sort="Tuyns, Albert" uniqKey="Tuyns A" first="Albert" last="Tuyns">Albert Tuyns</name></country><country name="Israël"><noRegion><name sortKey="Iscovich, Jose M" sort="Iscovich, Jose M" uniqKey="Iscovich J" first="José M." last="Iscovich">José M. Iscovich</name></noRegion></country><country name="République populaire de Chine"><noRegion><name sortKey="Deng Ao, Jiao" sort="Deng Ao, Jiao" uniqKey="Deng Ao J" first="Jiao" last="Deng-Ao">Jiao Deng-Ao</name></noRegion><name sortKey="Shu, Zheng" sort="Shu, Zheng" uniqKey="Shu Z" first="Zheng" last="Shu">Zheng Shu</name></country><country name="Australie"><noRegion><name sortKey="Kune, Gabriel A" sort="Kune, Gabriel A" uniqKey="Kune G" first="Gabriel A." last="Kune">Gabriel A. Kune</name></noRegion><name sortKey="Kune, Susan" sort="Kune, Susan" uniqKey="Kune S" first="Susan" last="Kune">Susan Kune</name></country><country name="Grèce"><noRegion><name sortKey="Tzonou, Anastasia" sort="Tzonou, Anastasia" uniqKey="Tzonou A" first="Anastasia" last="Tzonou">Anastasia Tzonou</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:F49BD49F4F14BAA65953EC0999B2054DFD504418
|texte= Dietary Intake of Fiber and Decreased Risk of Cancers of the Colon and Rectum: Evidence From the Combined Analysis of 13 Case-Control Studies
}}
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