Nutrient Dietary Patterns And Colorectal Cancer Risk In The EPIC Cohort Study
Aurelie MOSKAL, International Agency for Research on Cancer, France
1 Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France
PURPOSE: We investigated the association between nutrient patterns (NP) and colorectal cancer (CRC) risk in adults participating in the European Prospective Investigation into Cancer and nutrition (EPIC) study.
METHODS: Amongst 477,312 EPIC subjects, intakes of 23 nutrients were estimated from validated dietary questionnaires. Four NP, obtained across all centers were identified using principal component analysis, explaining 67% of the total variance of nutrient intakes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox proportional hazards models to quantify associations of 1 standard deviation (SD) increments in NP scores and overall CRC risk and by anatomical subsites. Adjustments were made for relevant confounders.
RESULTS: During an average of 11 years of follow-up, 4,517 first incident cases of colorectal cancer were documented. A NP characterized mainly by vitamins and minerals was inversely associated with CRC risk (HR=0.94, 95% CI 0.92, 0.98) as was a NP characterized by total protein, riboflavin, phosphorus, and calcium (HR=0.96, 95% CI 0.93, 0.99). A NP characterized by nutrients from plant food sources was not associated with CRC risk overall but the findings by anatomical sub-site did suggest an inverse association with cancer of the distal colon (HR=0.93, 95% CI 0.86, 1.00). Finally, a NP characterized mainly by dietary vitamin D was not associated with CRC risk.
CONCLUSIONS: A NP characterized by a high variety of vitamins and minerals, and one driven by total protein, riboflavin, phosphorus, and calcium, were both associated with a modest but statistically significant decreased risk of CRC. This is the first study investigating associations between NP and CRC risk in a large prospective international cohort and adds to the understanding of the role of dietary factors in CRC development.Funding source: the EPIC Study was funded by the EC and this work by the French Institution ‘Fondation de France’ (2010-2011)