title: Italian Mediterranean Index and risk of colorectal cancer in the Italian section of the EPIC cohort.
abstract: Colorectal cancer is among the commonest cancers worldwide. Dietary factors have been linked to colorectal cancer risk, however, few studies have evaluated the relationship between a priori dietary patterns and colorectal cancer risk. We evaluated the effect of adherence to a Mediterranean dietary pattern, as measured by the Italian Mediterranean Index, on the risk of colorectal cancer in the 45,275 participants of the Italian section of the EPIC study who completed a dietary questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) for colorectal cancer in relation to categories of Italian Mediterranean Index score were estimated by multivariate Cox models adjusted for known risk factors, on the whole cohort, on men and women and according to cancer subsite. During a mean follow-up of 11.28 years, 435 colorectal cancer cases were identified. The Italian Mediterranean Index was inversely associated with colorectal cancer risk (HR: 0.50; 95% CI: 0.35-0.71 for the highest category compared to the lowest, P-trend: 0.043). Results did not differ by sex. Highest Italian Mediterranean Index score was also significantly associated with reduced risks of any colon cancer (HR: 0.54, 95% CI: 0.36-0.81), distal colon cancer (HR: 0.44, 95% CI: 0.26-0.75) and rectal cancer (HR: 0.41, 95% CI: 0.20-0.81), but not of proximal colon cancer. These findings suggest that adherence to a Mediterranean diet (as measured by the Italian Mediterranean Index) protects against colorectal cancer in general but not against cancer developing in the proximal colon.
authors: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Claudia
authors: C
authors: Agnoli
authors: Sara
authors: S
authors: Grioni
authors: Sabina
authors: S
authors: Sieri
authors: Domenico
authors: D
authors: Palli
authors: Giovanna
authors: G
authors: Masala
authors: Carlotta
authors: C
authors: Sacerdote
authors: Paolo
authors: P
authors: Vineis
authors: Rosario
authors: R
authors: Tumino
authors: Maria Concetta
authors: MC
authors: Giurdanella
authors: Valeria
authors: V
authors: Pala
authors: Franco
authors: F
authors: Berrino
authors: Amalia
authors: A
authors: Mattiello
authors: Salvatore
authors: S
authors: Panico
authors: Vittorio
authors: V
authors: Krogh
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D004034:Diet Surveys; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D011795:Surveys and Questionnaires