Dietary fibre and colorectal adenoma in a colorectal cancer early detection programme.
BACKGROUND
Although dietary fibre has been reported to have no association with colorectal adenoma and cancer, in some studies this topic remains controversial.


METHODS
We used a 137-item food frequency questionnaire to assess the relation of fibre intake and frequency of colorectal adenoma. The study was done within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a randomised controlled trial designed to investigate methods for early detection of cancer. In our analysis, we compared fibre intake of 33971 participants who were sigmoidoscopy-negative for polyps, with 3591 cases with at least one histologically verified adenoma in the distal large bowel (ie, descending colon, sigmoid colon, or rectum). Odds ratios were estimated by logistic regression analysis.


RESULTS
High intakes of dietary fibre were associated with a lower risk of colorectal adenoma, after adjustment for potential dietary and non-dietary risk factors. Participants in the highest quintile of dietary fibre intake had a 27% (95% CI 14-38, p(trend)=0.002) lower risk of adenoma than those in the lowest quintile. The inverse association was strongest for fibre from grains and cereals and from fruits. Risks were similar for advanced and non-advanced adenoma. Risk of rectal adenoma was not significantly associated with fibre intake.


CONCLUSIONS
Dietary fibre, particularly from grains, cereals, and fruits, was associated with decreased risk of distal colon adenoma.
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, US National Institutes of Health, DHHS, MD 20892-7273, USA. petersu@mail.nih.gov <petersu@mail.nih.gov>
Ulrike
U
Peters
Rashmi
R
Sinha
Nilanjan
N
Chatterjee
Amy F
AF
Subar
Regina G
RG
Ziegler
Martin
M
Kulldorff
Robert
R
Bresalier
Joel L
JL
Weissfeld
Andrew
A
Flood
Arthur
A
Schatzkin
Richard B
RB
Hayes
D000236:Adenoma / Q000175:diagnosis / Q000517:prevention & control*; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D004043:Dietary Fiber / Q000008:administration & dosage*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012812:Sigmoidoscopy; D011795:Surveys and Questionnaires