TY - JOUR
T1 - The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women
T2 - results from the Women’s Health Initiative
AU - Tabung, Fred K.
AU - Steck, Susan E.
AU - Ma, Yunsheng
AU - Liese, Angela D.
AU - Zhang, Jiajia
AU - Caan, Bette
AU - Hou, Lifang
AU - Johnson, Karen C.
AU - Mossavar-Rahmani, Yasmin
AU - Shivappa, Nitin
AU - Wactawski-Wende, Jean
AU - Ockene, Judith K.
AU - Hebert, James R.
N1 - Funding Information:
This project is supported by the Prevent Cancer Foundation Living in Pink grant. The University of South Carolina SPARC grant supported Dr. Fred Tabung, and the National Institutes of Health/National Cancer Institute provided support to Dr. James Hebert (via U54 CA153461 and K05 CA136975). Dr. Yunsheng Ma was partly supported by grant Nos. 1R21 DK083700-01A1 and 1R01HL094575-01A1. The National Institutes of Health funded the WHI program through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.
Publisher Copyright:
© 2014, Springer International Publishing Switzerland.
PY - 2015/3
Y1 - 2015/3
N2 - Purpose: Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women’s Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. Methods: The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50–79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). Results: During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5–Q1 1.22; 95 % CI 1.05, 1.43; ptrend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5–Q1 1.35; 95 % CI 1.05, 1.67; ptrend = 0.01) but not distal colon cancer (HRQ5–Q1 0.84; 95 % CI 0.61, 1.18; ptrend = 0.63) or rectal cancer (HRQ5–Q1 1.20; 95 % CI 0.84, 1.72; ptrend = 0.65). Conclusion: Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
AB - Purpose: Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women’s Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. Methods: The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50–79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). Results: During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5–Q1 1.22; 95 % CI 1.05, 1.43; ptrend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5–Q1 1.35; 95 % CI 1.05, 1.67; ptrend = 0.01) but not distal colon cancer (HRQ5–Q1 0.84; 95 % CI 0.61, 1.18; ptrend = 0.63) or rectal cancer (HRQ5–Q1 1.20; 95 % CI 0.84, 1.72; ptrend = 0.65). Conclusion: Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
KW - Colorectal cancer
KW - Dietary inflammatory index
KW - Women’s Health Initiative
UR - http://www.scopus.com/inward/record.url?scp=84923356000&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923356000&partnerID=8YFLogxK
U2 - 10.1007/s10552-014-0515-y
DO - 10.1007/s10552-014-0515-y
M3 - Article
C2 - 25549833
AN - SCOPUS:84923356000
SN - 0957-5243
VL - 26
SP - 399
EP - 408
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 3
ER -
