title: Dietary supplement use is not associated with recurrence of colorectal adenomas: a prospective cohort study.
abstract: Diet and lifestyle influence colorectal adenoma recurrence. The role of dietary supplement use in colorectal adenoma recurrence remains controversial. In this prospective cohort study, we examined the association between dietary supplement use, total colorectal adenoma recurrence and advanced adenoma recurrence. Colorectal adenoma cases (n = 565) from a former case-control study, recruited between 1995 and 2002, were prospectively followed until 2008. Adenomas with a diameter of ≥1 cm and/or (tubulo)villous histology and/or with high grade dysplasia and/or ≥3 adenomas detected at the same colonic examination were considered advanced adenomas. Hazard ratios (HRs) and 95% confidence intervals (CIs) for dietary supplement users (use of any supplement during the past year) compared to nonusers and colorectal adenoma recurrence were calculated using stratified Cox proportional hazard models for counting processes and were adjusted for age, sex, educational level and number of colonoscopies during follow-up. Robust sandwich covariance estimation was used to adjust for the within subject correlation. A number of 165 out of 565 adenoma patients had at least one colorectal adenoma recurrence during a median person-time of 5.4 years and of these, 37 patients had at least one advanced adenoma. One-third of the total study population (n = 203) used a dietary supplement. Compared to no use, dietary supplement use was neither statistically significantly associated with total colorectal adenoma recurrence (HR = 1.03; 95% CI 0.79-1.34) nor with recurrent advanced adenomas (HR = 1.59; 95% CI 0.88-2.87). This prospective cohort study did not suggest an association between dietary supplement use and colorectal adenoma recurrence.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Renate C
authors.initials: RC
authors.lastname: Heine-Bröring
authors.forename: Renate M
authors.initials: RM
authors.lastname: Winkels
authors.forename: Akke
authors.initials: A
authors.lastname: Botma
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wahab
authors.forename: Adriaan C I T L
authors.initials: AC
authors.lastname: Tan
authors.forename: Fokko M
authors.initials: FM
authors.lastname: Nagengast
authors.forename: Ben J M
authors.initials: BJ
authors.lastname: Witteman
authors.forename: Ellen
authors.initials: E
authors.lastname: Kampman
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D004032:Diet; D019587:Dietary Supplements / Q000009:adverse effects*; D055088:Early Detection of Cancer; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies