Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)

Neil Murphy, Teresa Norat, Pietro Ferrari, Mazda Jenab, Bas Bueno-de-Mesquita, Guri Skeie, Christina C. Dahm, Kim Overvad, Anja Olsen, Anne Tjønneland, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Antoine Racine, Rudolf Kaaks, Birgit Teucher, Heiner Boeing, Manuela M. Bergmann, Antonia Trichopoulou, Dimitrios Trichopoulos, Pagona Lagiou & 28 others Domenico Palli, Valeria Pala, Salvatore Panico, Rosario Tumino, Paolo Vineis, Peter Siersema, Franzel van Duijnhoven, Petra H M Peeters, Anette Hjartaker, Dagrun Engeset, Carlos A. González, Maria José Sánchez, Miren Dorronsoro, Carmen Navarro, Eva Ardanaz, José R. Quirós, Emily Sonestedt, Ulrika Ericson, Lena Nilsson, Richard Palmqvist, Kay Tee Khaw, Nick Wareham, Timothy J. Key, Francesca L. Crowe, Veronika Fedirko, Petra A. Wark, Shu Chun Chuang, Elio Riboli

    Research output: Contribution to journalArticle

    144 Citations (Scopus)
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    Abstract

    Background

    Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.

    Methodology/Principal Findings

    After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79–0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.

    Conclusions/Significance

    Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

    Original languageEnglish
    Article numbere39361
    JournalPLoS ONE
    Volume7
    Issue number6
    DOIs
    Publication statusPublished - 22 Jun 2012

    Fingerprint

    Dietary Fiber
    rectum
    Rectal Neoplasms
    Nutrition
    colorectal neoplasms
    Colonic Neoplasms
    Colorectal Neoplasms
    dietary fiber
    nutrition
    neoplasms
    Fibers
    Hazards
    Vegetables
    Neoplasms
    Fruits
    Fruit
    Confidence Intervals
    Meats
    Social Adjustment
    Oral Contraceptives

    ASJC Scopus subject areas

    • Medicine(all)
    • Biochemistry, Genetics and Molecular Biology(all)
    • Agricultural and Biological Sciences(all)

    Cite this

    Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). / Murphy, Neil; Norat, Teresa; Ferrari, Pietro; Jenab, Mazda; Bueno-de-Mesquita, Bas; Skeie, Guri; Dahm, Christina C.; Overvad, Kim; Olsen, Anja; Tjønneland, Anne; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie Christine; Racine, Antoine; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Bergmann, Manuela M.; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Pala, Valeria; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Siersema, Peter; van Duijnhoven, Franzel; Peeters, Petra H M; Hjartaker, Anette; Engeset, Dagrun; González, Carlos A.; Sánchez, Maria José; Dorronsoro, Miren; Navarro, Carmen; Ardanaz, Eva; Quirós, José R.; Sonestedt, Emily; Ericson, Ulrika; Nilsson, Lena; Palmqvist, Richard; Khaw, Kay Tee; Wareham, Nick; Key, Timothy J.; Crowe, Francesca L.; Fedirko, Veronika; Wark, Petra A.; Chuang, Shu Chun; Riboli, Elio.

    In: PLoS ONE, Vol. 7, No. 6, e39361, 22.06.2012.

    Research output: Contribution to journalArticle

    Murphy, N, Norat, T, Ferrari, P, Jenab, M, Bueno-de-Mesquita, B, Skeie, G, Dahm, CC, Overvad, K, Olsen, A, Tjønneland, A, Clavel-Chapelon, F, Boutron-Ruault, MC, Racine, A, Kaaks, R, Teucher, B, Boeing, H, Bergmann, MM, Trichopoulou, A, Trichopoulos, D, Lagiou, P, Palli, D, Pala, V, Panico, S, Tumino, R, Vineis, P, Siersema, P, van Duijnhoven, F, Peeters, PHM, Hjartaker, A, Engeset, D, González, CA, Sánchez, MJ, Dorronsoro, M, Navarro, C, Ardanaz, E, Quirós, JR, Sonestedt, E, Ericson, U, Nilsson, L, Palmqvist, R, Khaw, KT, Wareham, N, Key, TJ, Crowe, FL, Fedirko, V, Wark, PA, Chuang, SC & Riboli, E 2012, 'Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)' PLoS ONE, vol. 7, no. 6, e39361. https://doi.org/10.1371/journal.pone.0039361
    Murphy, Neil ; Norat, Teresa ; Ferrari, Pietro ; Jenab, Mazda ; Bueno-de-Mesquita, Bas ; Skeie, Guri ; Dahm, Christina C. ; Overvad, Kim ; Olsen, Anja ; Tjønneland, Anne ; Clavel-Chapelon, Françoise ; Boutron-Ruault, Marie Christine ; Racine, Antoine ; Kaaks, Rudolf ; Teucher, Birgit ; Boeing, Heiner ; Bergmann, Manuela M. ; Trichopoulou, Antonia ; Trichopoulos, Dimitrios ; Lagiou, Pagona ; Palli, Domenico ; Pala, Valeria ; Panico, Salvatore ; Tumino, Rosario ; Vineis, Paolo ; Siersema, Peter ; van Duijnhoven, Franzel ; Peeters, Petra H M ; Hjartaker, Anette ; Engeset, Dagrun ; González, Carlos A. ; Sánchez, Maria José ; Dorronsoro, Miren ; Navarro, Carmen ; Ardanaz, Eva ; Quirós, José R. ; Sonestedt, Emily ; Ericson, Ulrika ; Nilsson, Lena ; Palmqvist, Richard ; Khaw, Kay Tee ; Wareham, Nick ; Key, Timothy J. ; Crowe, Francesca L. ; Fedirko, Veronika ; Wark, Petra A. ; Chuang, Shu Chun ; Riboli, Elio. / Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC). In: PLoS ONE. 2012 ; Vol. 7, No. 6.
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    title = "Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)",
    abstract = "BackgroundEarlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.Methodology/Principal FindingsAfter a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95{\%} CI: 0.79–0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.Conclusions/SignificanceOur results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.",
    author = "Neil Murphy and Teresa Norat and Pietro Ferrari and Mazda Jenab and Bas Bueno-de-Mesquita and Guri Skeie and Dahm, {Christina C.} and Kim Overvad and Anja Olsen and Anne Tj{\o}nneland and Fran{\cc}oise Clavel-Chapelon and Boutron-Ruault, {Marie Christine} and Antoine Racine and Rudolf Kaaks and Birgit Teucher and Heiner Boeing and Bergmann, {Manuela M.} and Antonia Trichopoulou and Dimitrios Trichopoulos and Pagona Lagiou and Domenico Palli and Valeria Pala and Salvatore Panico and Rosario Tumino and Paolo Vineis and Peter Siersema and {van Duijnhoven}, Franzel and Peeters, {Petra H M} and Anette Hjartaker and Dagrun Engeset and Gonz{\'a}lez, {Carlos A.} and S{\'a}nchez, {Maria Jos{\'e}} and Miren Dorronsoro and Carmen Navarro and Eva Ardanaz and Quir{\'o}s, {Jos{\'e} R.} and Emily Sonestedt and Ulrika Ericson and Lena Nilsson and Richard Palmqvist and Khaw, {Kay Tee} and Nick Wareham and Key, {Timothy J.} and Crowe, {Francesca L.} and Veronika Fedirko and Wark, {Petra A.} and Chuang, {Shu Chun} and Elio Riboli",
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    TY - JOUR

    T1 - Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC)

    AU - Murphy, Neil

    AU - Norat, Teresa

    AU - Ferrari, Pietro

    AU - Jenab, Mazda

    AU - Bueno-de-Mesquita, Bas

    AU - Skeie, Guri

    AU - Dahm, Christina C.

    AU - Overvad, Kim

    AU - Olsen, Anja

    AU - Tjønneland, Anne

    AU - Clavel-Chapelon, Françoise

    AU - Boutron-Ruault, Marie Christine

    AU - Racine, Antoine

    AU - Kaaks, Rudolf

    AU - Teucher, Birgit

    AU - Boeing, Heiner

    AU - Bergmann, Manuela M.

    AU - Trichopoulou, Antonia

    AU - Trichopoulos, Dimitrios

    AU - Lagiou, Pagona

    AU - Palli, Domenico

    AU - Pala, Valeria

    AU - Panico, Salvatore

    AU - Tumino, Rosario

    AU - Vineis, Paolo

    AU - Siersema, Peter

    AU - van Duijnhoven, Franzel

    AU - Peeters, Petra H M

    AU - Hjartaker, Anette

    AU - Engeset, Dagrun

    AU - González, Carlos A.

    AU - Sánchez, Maria José

    AU - Dorronsoro, Miren

    AU - Navarro, Carmen

    AU - Ardanaz, Eva

    AU - Quirós, José R.

    AU - Sonestedt, Emily

    AU - Ericson, Ulrika

    AU - Nilsson, Lena

    AU - Palmqvist, Richard

    AU - Khaw, Kay Tee

    AU - Wareham, Nick

    AU - Key, Timothy J.

    AU - Crowe, Francesca L.

    AU - Fedirko, Veronika

    AU - Wark, Petra A.

    AU - Chuang, Shu Chun

    AU - Riboli, Elio

    PY - 2012/6/22

    Y1 - 2012/6/22

    N2 - BackgroundEarlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.Methodology/Principal FindingsAfter a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79–0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.Conclusions/SignificanceOur results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

    AB - BackgroundEarlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.Methodology/Principal FindingsAfter a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79–0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.Conclusions/SignificanceOur results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

    U2 - 10.1371/journal.pone.0039361

    DO - 10.1371/journal.pone.0039361

    M3 - Article

    VL - 7

    JO - PLoS ONE

    JF - PLoS ONE

    SN - 1932-6203

    IS - 6

    M1 - e39361

    ER -