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Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study

Bingham, SA; Day, NE; Luben, R; Ferrari, P; Slimani, N; Norat, T; Clavel-Chapelon, F; Kesse, E; Nieters, A and Boeing, H, et al. (2003) In The Lancet 361(9368). p.1496-1501
Abstract
Background Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect. Methods We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519 978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable. Findings Follow-up... (More)
Background Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect. Methods We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519 978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable. Findings Follow-up consisted of 1939 011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated. Interpretation In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%. (Less)
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Contribution to journal
publication status
published
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in
The Lancet
volume
361
issue
9368
pages
1496 - 1501
publisher
Elsevier Limited
external identifiers
  • wos:000182658900007
  • pmid:12737858
  • scopus:0038637789
ISSN
1474-547X
DOI
10.1016/S0140-6736(03)13174-1
language
English
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yes
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4f919432-1b87-4be0-a807-cdc8946f4ddb (old id 312647)
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2007-08-24 08:38:54
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2018-01-21 03:23:33
@article{4f919432-1b87-4be0-a807-cdc8946f4ddb,
  abstract     = {Background Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect. Methods We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519 978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable. Findings Follow-up consisted of 1939 011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated. Interpretation In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.},
  author       = {Bingham, SA and Day, NE and Luben, R and Ferrari, P and Slimani, N and Norat, T and Clavel-Chapelon, F and Kesse, E and Nieters, A and Boeing, H and Tjonneland, A and Overvad, K and Martinez, C and Dorronsoro, M and Gonzalez, CA and Key, TJ and Trichopoulou, A and Naska, A and Vineis, P and Tumino, R and Krogh, V and Bueno-de-Mesquita, HB and Peeters, PHM and Berglund, Göran and Hallmans, G and Lund, E and Skeie, G and Kaaks, R and Riboli, E},
  issn         = {1474-547X},
  language     = {eng},
  number       = {9368},
  pages        = {1496--1501},
  publisher    = {Elsevier Limited},
  series       = {The Lancet},
  title        = {Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study},
  url          = {http://dx.doi.org/10.1016/S0140-6736(03)13174-1},
  volume       = {361},
  year         = {2003},
}