title: Use of glucosamine and chondroitin supplements in relation to risk of colorectal cancer: Results from the Nurses' Health Study and Health Professionals follow-up study.
abstract: Recent epidemiologic evidence has emerged to suggest that use of glucosamine and chondroitin supplements may be associated with reduced risk of colorectal cancer (CRC). We therefore evaluated the association between use of these non-vitamin, non-mineral supplements and risk of CRC in two prospective cohorts, the Nurses' Health Study and Health Professionals Follow-up Study. Regular use of glucosamine and chondroitin was first assessed in 2002 and participants were followed until 2010, over which time 672 CRC cases occurred. Cox proportional hazards regression was used to estimate relative risks (RRs) within each cohort, and results were pooled using a random effects meta-analysis. Associations were comparable across cohorts, with a RR of 0.79 (95% CI: 0.63-1.00) observed for any use of glucosamine and a RR of 0.77 (95% CI: 0.59-1.01) observed for any use of chondroitin. Use of glucosamine in the absence of chondroitin was not associated with risk of CRC, whereas use of glucosamine + chondroitin was significantly associated with risk (RR: 0.77; 95% CI: 0.58-0.999). The association between use of glucosamine + chondroitin and risk of CRC did not change markedly when accounting for change in exposure status over follow-up (RR: 0.75; 95% CI: 0.58-0.96), nor did the association significantly vary by sex, aspirin use, body mass index, or physical activity. The association was comparable for cancers of the colon and rectum. Results support a protective association between use of glucosamine and chondroitin and risk of CRC. Further study is needed to better understand the chemopreventive potential of these supplements.
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Kantor
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Xuehong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Kana
authors.initials: K
authors.lastname: Wu
authors.affiliation: Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Signorello
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA.|Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.|Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Chan
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.|Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
mesh_terms: D000328:Adult; D000368:Aged; D002807:Chondroitin / Q000008:administration & dosage* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D019587:Dietary Supplements; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D005944:Glucosamine / Q000008:administration & dosage* / Q000627:therapeutic use; D006282:Health Personnel / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D002807:Chondroitin; D005944:Glucosamine
keywords: chemoprevention; chondroitin; colorectal cancer; epidemiology; glucosamine