title: Dietary risk factors for colon and rectal cancers: a comparative case-control study.
abstract: BACKGROUND
  In Japan, the incidence rate of colon cancer has more rapidly increased than that of rectal cancer. The differential secular trends may be due to different dietary factors in the development of colon and rectal cancers.
  
  
  METHODS
  To compare dietary risk factors between colon and rectal cancers, we undertook a case-control study at Aichi Cancer Center Hospital, Japan. Subjects were 507 patients with newly diagnosed colon (n = 265) and rectal (n = 242) cancers, and 2,535 cancer-free outpatients (controls). Intakes of nutrients and food groups were assessed with a food frequency questionnaire, and multivariate-adjusted odds ratios (ORs) were estimated using unconditional logistic models.
  
  
  RESULTS
  We found a decreasing risk of colon cancer with increasing intakes of calcium and insoluble dietary fiber; the multivariate ORs across quartiles of intake were 1.00, 0.90, 0.80, and 0.67 (trend p = 0.040), and 1.00, 0.69, 0.64, and 0.65 (trend p = 0.027), respectively. For rectal cancer, a higher consumption of carotene and meat was associated with a reduced risk; the corresponding ORs were 1.00, 1.10, 0.71, and 0.70 for carotene (trend p = 0.028), and 1.00, 0.99, 0.68, and 0.72 for meat (trend p = 0.036). Carbohydrate intake was positively correlated with the risk of rectal cancer (ORs over quartiles: 1.00, 1.14, 1.42, and 1.54; trend p = 0.048). This association was stronger in women, while fat consumption was inversely correlated with the risk of female colon and rectal cancers.
  
  
  CONCLUSIONS
  Dietary risk factors appear to considerably differ between colon and rectal cancers.
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan. wakai@aichi-cc.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakai
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hirose
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ito
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Kuriki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirai
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tajima
mesh_terms: D000328:Adult; D000368:Aged; D002136:Calcium, Dietary / Q000008:administration & dosage; D002338:Carotenoids / Q000008:administration & dosage; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D004032:Diet / Q000145:classification*; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005502:Food / Q000145:classification*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008460:Meat; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D002136:Calcium, Dietary; D004043:Dietary Fiber; D002338:Carotenoids