title: Consumption of dairy products and colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: BACKGROUND
  Prospective studies have consistently reported lower colorectal cancer risks associated with higher intakes of total dairy products, total milk and dietary calcium. However, less is known about whether the inverse associations vary for individual dairy products with differing fat contents.
  
  
  METHODS
  In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between intakes of total milk and milk subtypes (whole-fat, semi-skimmed and skimmed), yoghurt, cheese, and dietary calcium with colorectal cancer risk amongst 477,122 men and women. Dietary questionnaires were administered at baseline. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for relevant confounding variables.
  
  
  RESULTS
  During the mean 11 years of follow-up, 4,513 incident cases of colorectal cancer occurred. After multivariable adjustments, total milk consumption was inversely associated with colorectal cancer risk (HR per 200 g/day 0.93, 95% CI: 0.89-0.98). Similar inverse associations were observed for whole-fat (HR per 200 g/day 0.90, 95% CI: 0.82-0.99) and skimmed milk (HR per 200 g/day 0.90, 95% CI: 0.79-1.02) in the multivariable models. Inverse associations were observed for cheese and yoghurt in the categorical models; although in the linear models, these associations were non-significant. Dietary calcium was inversely associated with colorectal cancer risk (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99); this association was limited to dairy sources of calcium only (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99), with no association observed for non-dairy calcium sources (HR per 200 mg/day 1.00, 95% CI: 0.81-1.24).
  
  
  CONCLUSIONS
  Our results strengthen the evidence for a possible protective role of dairy products on colorectal cancer risk. The inverse associations we observed did not differ by the fat content of the dairy products considered.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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authors.lastname: Dahm
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authors.lastname: Overvad
authors.forename: Marie Christine
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authors.lastname: Boutron-Ruault
authors.forename: Françoise
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authors.lastname: Clavel-Chapelon
authors.forename: Laura
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authors.lastname: Nailler
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authors.lastname: Kaaks
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Manuela M
authors.initials: MM
authors.lastname: Bergmann
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Vincent K
authors.initials: VK
authors.lastname: Dik
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Jose Ramon Quiros
authors.initials: JR
authors.lastname: Garcia
authors.forename: Raul
authors.initials: R
authors.lastname: Zamora-Ros
authors.forename: Maria José Sánchez
authors.initials: MJ
authors.lastname: Pérez
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Johansson
authors.forename: Richard
authors.initials: R
authors.lastname: Palmqvist
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nick
authors.initials: N
authors.lastname: Wareham
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Crowe
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
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authors.initials: MJ
authors.lastname: Gunter
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mesh_terms: D000368:Aged; D000818:Animals; D002136:Calcium, Dietary; D002611:Cheese; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003611:Dairy Products; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk; D011446:Prospective Studies; D015014:Yogurt
chemical_list: D002136:Calcium, Dietary
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