Calcium, vitamin D, dairy products, and risk of colorectal cancer in the Cancer Prevention Study II Nutrition Cohort (United States).
OBJECTIVE
Calcium, vitamin D, and dairy product intake may reduce the risk of colorectal cancer. We therefore examined the association between these factors and risk of colorectal cancer in a large prospective cohort of United States men and women.


METHODS
Participants in the Cancer Prevention Study II Nutrition Cohort completed a detailed questionnaire on diet, medical history, and lifestyle in 1992-93. After excluding participants with a history of cancer or incomplete dietary information, 60,866 men and 66,883 women remained for analysis. During follow-up through 31 August 1997 we documented 421 and 262 cases of incident colorectal cancers among men and women, respectively. Multivariate-adjusted rate ratios (RR) were calculated using Cox proportional hazards models.


RESULTS
Total calcium intake (from diet and supplements) was associated with marginally lower colorectal cancer risk in men and women (RR = 0.87, 95% CI 0.67-1.12, highest vs lowest quintiles, p trend = 0.02). The association was strongest for calcium from supplements (RR = 0.69, 95% CI 0.49-0.96 for > or = 500 mg/day vs none). Total vitamin D intake (from diet and multivitamins) was also inversely associated with risk of colorectal cancer, particularly among men (RR = 0.71, 95% CI 0.51-0.98, p trend = 0.02). Dairy product intake was not related to overall risk.


CONCLUSIONS
Our results support the hypothesis that calcium modestly reduces risk of colorectal cancer. Vitamin D was associated with reduced risk of colorectal cancer only in men.
McCullough
Marjorie L
ML
Epidemiology and Surveillance Research Department, American Cancer Society, 1599 Clifton Rd NE, Atlanta GA, 30309 USA.
Robertson
Andrea S
AS
Rodriguez
Carmen
C
Jacobs
Eric J
EJ
Chao
Ann
A
Carolyn
Jonas
J
Calle
Eugenia E
EE
Willett
Walter C
WC
Thun
Michael J
MJ
D000368:Aged; D002118:Calcium / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D003611:Dairy Products; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000627:therapeutic use*
D014807:Vitamin D; D002118:Calcium