title: Dietary patterns and the risk of colorectal adenomas: the Black Women's Health Study.
abstract: BACKGROUND
  Colorectal adenomas are benign lesions that may be precursors to colorectal cancer. No studies of African American women have investigated dietary patterns and the risk of developing colorectal adenomas. We examined data from the Black Women's Health Study to determine whether dietary patterns are associated with the risk of developing colorectal adenomas.
  
  
  METHODS
  This is a prospective cohort study of 59,000 participants followed biennially since 1995. During 155,414 person-years of follow-up from 1997 to 2007 among women who had had at least one screening colonoscopy, 620 incident cases of colorectal adenomas were identified. By using Cox regression models, we obtained incidence rate ratios (IRR) for colorectal adenoma in relation to quintiles of each of two dietary patterns, adjusting for other colorectal adenoma risk factors.
  
  
  RESULTS
  Two dietary patterns, Western and prudent, were utilized to assess the association between dietary intake and adenoma risk. The highest quintile of prudent diet, relative to the lowest quintile, was significantly associated with 34% lower colorectal adenoma risk overall (IRR = 0.66; 95% CI, 0.50-0.88; P(trend) < 0.01). Higher scores on the Western pattern were associated with a higher risk of developing colorectal adenoma (IRR = 1.42; 95% CI, 1.09-1.85 for the highest quintile relative to the lowest; P(trend) = 0.01).
  
  
  CONCLUSIONS
  Our findings suggest that African American women may be able to reduce their risk of developing colorectal adenomas by following a prudent dietary pattern and avoiding a more Western pattern.
  
  
  CONCLUSIONS
  A dietary modification could have a strong impact in colorectal adenoma prevention in African American women.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA. khm33@georgetown.edu
authors.forename: Kepher H
authors.initials: KH
authors.lastname: Makambi
authors.forename: Tanya
authors.initials: T
authors.lastname: Agurs-Collins
authors.forename: Mireille
authors.initials: M
authors.lastname: Bright-Gbebry
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Lucile L
authors.initials: LL
authors.lastname: Adams-Campbell
mesh_terms: D000236:Adenoma / Q000209:etiology*; D001741:Black or African American / Q000706:statistics & numerical data; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016387:Women's Health