Dairy foods, calcium, and colorectal cancer

A pooled analysis of 10 cohort studies

Eunyoung Cho, Stephanie A. Smith-Warner, Donna Spiegelman, W. Lawrence Beeson, Piet A. van den Brandt, Graham A. Colditz, Aaron R. Folsom, Gary E. Fraser, Jo L. Freudenheim, Edward Giovannucci, R. Alexandra Goldbohm, Saxon Graham, Anthony B. Miller, Pirjo Pietinen, John D. Potter, Thomas E. Rohan, Paul Terry, Paolo Toniolo, Mikko J. Virtanen, Walter C. Willet & 5 others Alicja Wolk, Kana Wu, Shiaw Shyuan Yaun, Anne Zeleniuch-Jacquotte, David J. Hunter

Research output: Contribution to journalArticle

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Abstract

Background: Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. Methods: We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 individuals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95% confidence intervals (CIs) were calculated. All statistical tests were two-sided. Results: Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake (<70 g/day), relative risks of colorectal cancer for increasing categories (70-174, 175-249, and ≥250 g/day) of milk intake were 0.94 (95% CI = 0.86 to 1.02), 0.88 (95% CI = 0.81 to 0.96), and 0.85 (95% CI = 0.78 to 0.94), respectively (Ptrend <.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95% CI = 0.78 to 0.95; Ptrend = .02) for dietary calcium and 0.78 (95% CI = 0.69 to 0.88; Ptrend <.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (Ptrend <.001) and rectum (Ptrend = .02). Conclusion: Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.

Original languageEnglish (US)
Pages (from-to)1015-1022
Number of pages8
JournalJournal of the National Cancer Institute
Volume96
Issue number13
StatePublished - Jul 7 2004

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Colorectal Neoplasms
Cohort Studies
Calcium
Food
Confidence Intervals
Milk
Dietary Calcium
Calcium Carbonate
Rectum
Colonic Neoplasms
Publications
Epidemiologic Studies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cho, E., Smith-Warner, S. A., Spiegelman, D., Beeson, W. L., van den Brandt, P. A., Colditz, G. A., ... Hunter, D. J. (2004). Dairy foods, calcium, and colorectal cancer: A pooled analysis of 10 cohort studies. Journal of the National Cancer Institute, 96(13), 1015-1022.

Dairy foods, calcium, and colorectal cancer : A pooled analysis of 10 cohort studies. / Cho, Eunyoung; Smith-Warner, Stephanie A.; Spiegelman, Donna; Beeson, W. Lawrence; van den Brandt, Piet A.; Colditz, Graham A.; Folsom, Aaron R.; Fraser, Gary E.; Freudenheim, Jo L.; Giovannucci, Edward; Goldbohm, R. Alexandra; Graham, Saxon; Miller, Anthony B.; Pietinen, Pirjo; Potter, John D.; Rohan, Thomas E.; Terry, Paul; Toniolo, Paolo; Virtanen, Mikko J.; Willet, Walter C.; Wolk, Alicja; Wu, Kana; Yaun, Shiaw Shyuan; Zeleniuch-Jacquotte, Anne; Hunter, David J.

In: Journal of the National Cancer Institute, Vol. 96, No. 13, 07.07.2004, p. 1015-1022.

Research output: Contribution to journalArticle

Cho, E, Smith-Warner, SA, Spiegelman, D, Beeson, WL, van den Brandt, PA, Colditz, GA, Folsom, AR, Fraser, GE, Freudenheim, JL, Giovannucci, E, Goldbohm, RA, Graham, S, Miller, AB, Pietinen, P, Potter, JD, Rohan, TE, Terry, P, Toniolo, P, Virtanen, MJ, Willet, WC, Wolk, A, Wu, K, Yaun, SS, Zeleniuch-Jacquotte, A & Hunter, DJ 2004, 'Dairy foods, calcium, and colorectal cancer: A pooled analysis of 10 cohort studies', Journal of the National Cancer Institute, vol. 96, no. 13, pp. 1015-1022.
Cho E, Smith-Warner SA, Spiegelman D, Beeson WL, van den Brandt PA, Colditz GA et al. Dairy foods, calcium, and colorectal cancer: A pooled analysis of 10 cohort studies. Journal of the National Cancer Institute. 2004 Jul 7;96(13):1015-1022.
Cho, Eunyoung ; Smith-Warner, Stephanie A. ; Spiegelman, Donna ; Beeson, W. Lawrence ; van den Brandt, Piet A. ; Colditz, Graham A. ; Folsom, Aaron R. ; Fraser, Gary E. ; Freudenheim, Jo L. ; Giovannucci, Edward ; Goldbohm, R. Alexandra ; Graham, Saxon ; Miller, Anthony B. ; Pietinen, Pirjo ; Potter, John D. ; Rohan, Thomas E. ; Terry, Paul ; Toniolo, Paolo ; Virtanen, Mikko J. ; Willet, Walter C. ; Wolk, Alicja ; Wu, Kana ; Yaun, Shiaw Shyuan ; Zeleniuch-Jacquotte, Anne ; Hunter, David J. / Dairy foods, calcium, and colorectal cancer : A pooled analysis of 10 cohort studies. In: Journal of the National Cancer Institute. 2004 ; Vol. 96, No. 13. pp. 1015-1022.
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title = "Dairy foods, calcium, and colorectal cancer: A pooled analysis of 10 cohort studies",
abstract = "Background: Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. Methods: We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 individuals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95{\%} confidence intervals (CIs) were calculated. All statistical tests were two-sided. Results: Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake (<70 g/day), relative risks of colorectal cancer for increasing categories (70-174, 175-249, and ≥250 g/day) of milk intake were 0.94 (95{\%} CI = 0.86 to 1.02), 0.88 (95{\%} CI = 0.81 to 0.96), and 0.85 (95{\%} CI = 0.78 to 0.94), respectively (Ptrend <.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95{\%} CI = 0.78 to 0.95; Ptrend = .02) for dietary calcium and 0.78 (95{\%} CI = 0.69 to 0.88; Ptrend <.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (Ptrend <.001) and rectum (Ptrend = .02). Conclusion: Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.",
author = "Eunyoung Cho and Smith-Warner, {Stephanie A.} and Donna Spiegelman and Beeson, {W. Lawrence} and {van den Brandt}, {Piet A.} and Colditz, {Graham A.} and Folsom, {Aaron R.} and Fraser, {Gary E.} and Freudenheim, {Jo L.} and Edward Giovannucci and Goldbohm, {R. Alexandra} and Saxon Graham and Miller, {Anthony B.} and Pirjo Pietinen and Potter, {John D.} and Rohan, {Thomas E.} and Paul Terry and Paolo Toniolo and Virtanen, {Mikko J.} and Willet, {Walter C.} and Alicja Wolk and Kana Wu and Yaun, {Shiaw Shyuan} and Anne Zeleniuch-Jacquotte and Hunter, {David J.}",
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T1 - Dairy foods, calcium, and colorectal cancer

T2 - A pooled analysis of 10 cohort studies

AU - Cho, Eunyoung

AU - Smith-Warner, Stephanie A.

AU - Spiegelman, Donna

AU - Beeson, W. Lawrence

AU - van den Brandt, Piet A.

AU - Colditz, Graham A.

AU - Folsom, Aaron R.

AU - Fraser, Gary E.

AU - Freudenheim, Jo L.

AU - Giovannucci, Edward

AU - Goldbohm, R. Alexandra

AU - Graham, Saxon

AU - Miller, Anthony B.

AU - Pietinen, Pirjo

AU - Potter, John D.

AU - Rohan, Thomas E.

AU - Terry, Paul

AU - Toniolo, Paolo

AU - Virtanen, Mikko J.

AU - Willet, Walter C.

AU - Wolk, Alicja

AU - Wu, Kana

AU - Yaun, Shiaw Shyuan

AU - Zeleniuch-Jacquotte, Anne

AU - Hunter, David J.

PY - 2004/7/7

Y1 - 2004/7/7

N2 - Background: Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. Methods: We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 individuals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95% confidence intervals (CIs) were calculated. All statistical tests were two-sided. Results: Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake (<70 g/day), relative risks of colorectal cancer for increasing categories (70-174, 175-249, and ≥250 g/day) of milk intake were 0.94 (95% CI = 0.86 to 1.02), 0.88 (95% CI = 0.81 to 0.96), and 0.85 (95% CI = 0.78 to 0.94), respectively (Ptrend <.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95% CI = 0.78 to 0.95; Ptrend = .02) for dietary calcium and 0.78 (95% CI = 0.69 to 0.88; Ptrend <.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (Ptrend <.001) and rectum (Ptrend = .02). Conclusion: Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.

AB - Background: Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. Methods: We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 individuals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95% confidence intervals (CIs) were calculated. All statistical tests were two-sided. Results: Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake (<70 g/day), relative risks of colorectal cancer for increasing categories (70-174, 175-249, and ≥250 g/day) of milk intake were 0.94 (95% CI = 0.86 to 1.02), 0.88 (95% CI = 0.81 to 0.96), and 0.85 (95% CI = 0.78 to 0.94), respectively (Ptrend <.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95% CI = 0.78 to 0.95; Ptrend = .02) for dietary calcium and 0.78 (95% CI = 0.69 to 0.88; Ptrend <.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (Ptrend <.001) and rectum (Ptrend = .02). Conclusion: Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.

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