Fibre intake and incident colorectal cancer depending on fibre source, sex, tumour location and Tumour, Node, Metastasis stage.
Studies on fibre intake and incident colorectal cancer (CRC) indicate inverse associations. Differences by tumour stage have not been examined. We examined associations between fibre intake and its sources, and incidental CRC. Separate analyses were carried out on the basis of sex, tumour location and the Tumour, Node, Metastasis (TNM) classification. The Malmö Diet and Cancer Study is a population-based cohort study, including individuals aged 45-74 years. Dietary data were collected through a modified diet history method. The TNM classification was obtained from pathology/clinical records and re-evaluated. Among 27 931 individuals (60% women), we found 728 incident CRC cases during 428 924 person-years of follow-up. Fibre intake was inversely associated with CRC risk (P(trend) = 0.026). Concerning colon cancer, we observed borderline interaction between fibre intake and sex (P = 0.052) and significant protective association restricted to women (P(trend) = 0.013). Intake of fruits and berries was inversely associated with colon cancer in women (P(trend) = 0.022). We also observed significant interactions between intakes of fibre (P = 0.048) and vegetables (P = 0.039) and sex on rectal cancer, but no significant associations were seen between intake of fibre, or its sources, in either of the sexes. Except for inverse associations between intake of fibre-rich cereal products and N0- and M0-tumours, we did not observe significant associations with different TNM stages. Our findings suggest different associations between fibre intake and CRC depending on sex, tumour site and fibre source. High fibre intake, especially from fruits and berries, may, above all, prevent tumour development in the colon in women. No clear differences by TNM classification were detected.
1Department of Clinical Sciences,Division of Gastroenterology,Lund University,Skåne University Hospital,Malmö,Sweden.
Alexandra
A
Vulcan
2Department of Clinical Sciences,Division of Surgery,Lund University,Skåne University Hospital,Malmö,Sweden.
Jenny
J
Brändstedt
3Department of Clinical Sciences,Division of Plastic Surgery,Lund University,Skåne University Hospital,Malmö,Sweden.
Jonas
J
Manjer
4Department of Clinical Sciences,Division of Pathology,Lund University, Skåne University Hospital,Lund,Sweden.
Karin
K
Jirström
5Department of Clinical Sciences,Division of Internal Medicine,Lund University,Skåne University Hospital,Malmö,Sweden.
Bodil
B
Ohlsson
6Diabetes and Cardiovascular Disease,Genetic Epidemiology,Lund University,Skåne University Hospital,Malmö,Sweden.
Ulrika
U
Ericson
D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology / Q000517:prevention & control*; D004043:Dietary Fiber / Q000627:therapeutic use*; D002523:Edible Grain; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D055951:Functional Food; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009749:Nutrition Surveys; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology / Q000517:prevention & control*; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D014504:Urban Health / Q000208:ethnology; D014675:Vegetables
CRC colorectal cancer; Colorectal cancer; Fibre; HR hazard ratio; MDCS Malmö Diet and Cancer Study; Malmö Diet and Cancer Study; Metastasis classification; Node; Sex; TNM Tumour; Tumour