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A Prospective Diet-Wide Association Study for Risk of Colorectal Cancer in EPIC

Papadimitriou, Nikos ; Bouras, Emmanouil ; van den Brandt, Piet A. ; Muller, David C. ; Papadopoulou, Areti ; Heath, Alicia K. ; Critselis, Elena ; Gunter, Marc J. ; Vineis, Paolo and Ferrari, Pietro , et al. (2022) In Clinical Gastroenterology and Hepatology 20(4). p.13-873
Abstract

Background & Aims: Evidence regarding the association of dietary exposures with colorectal cancer (CRC) risk is not consistent with a few exceptions. Therefore, we conducted a diet-wide association study (DWAS) in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the associations between several dietary exposures with CRC risk. Methods: The association of 92 food and nutrient intakes with CRC risk was assessed in 386,792 participants, 5069 of whom developed incident CRC. Correction for multiple comparisons was performed using the false discovery rate, and emerging associations were examined in the Netherlands Cohort Study (NLCS). Multiplicative gene-nutrient interactions were also tested in EPIC... (More)

Background & Aims: Evidence regarding the association of dietary exposures with colorectal cancer (CRC) risk is not consistent with a few exceptions. Therefore, we conducted a diet-wide association study (DWAS) in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the associations between several dietary exposures with CRC risk. Methods: The association of 92 food and nutrient intakes with CRC risk was assessed in 386,792 participants, 5069 of whom developed incident CRC. Correction for multiple comparisons was performed using the false discovery rate, and emerging associations were examined in the Netherlands Cohort Study (NLCS). Multiplicative gene-nutrient interactions were also tested in EPIC based on known CRC-associated loci. Results: In EPIC, alcohol, liquor/spirits, wine, beer/cider, soft drinks, and pork were positively associated with CRC, whereas milk, cheese, calcium, phosphorus, magnesium, potassium, riboflavin, vitamin B6, beta carotene, fruit, fiber, nonwhite bread, banana, and total protein intakes were inversely associated. Of these 20 associations, 13 were replicated in the NLCS, for which a meta-analysis was performed, namely alcohol (summary hazard ratio [HR] per 1-SD increment in intake: 1.07; 95% confidence interval [CI], 1.04–1.09), liquor/spirits (HR per 1-SD increment in intake, 1.04; 95% CI, 1.02–1.06), wine (HR per 1-SD increment in intake, 1.04; 95% CI, 1.02–1.07), beer/cider (HR per 1-SD increment in intake, 1.06; 95% CI, 1.04–1.08), milk (HR per 1-SD increment in intake, 0.95; 95% CI, 0.93–0.98), cheese (HR per 1-SD increment in intake, 0.96; 95% CI, 0.94–0.99), calcium (HR per 1-SD increment in intake, 0.93; 95% CI, 0.90–0.95), phosphorus (HR per 1-SD increment in intake, 0.92; 95% CI, 0.90–0.95), magnesium (HR per 1-SD increment in intake, 0.95; 95% CI, 0.92–0.98), potassium (HR per 1-SD increment in intake, 0.96; 95% CI, 0.94–0.99), riboflavin (HR per 1-SD increment in intake, 0.94; 95% CI, 0.92–0.97), beta carotene (HR per 1-SD increment in intake, 0.96; 95% CI, 0.93–0.98), and total protein (HR per 1-SD increment in intake, 0.94; 95% CI, 0.92–0.97). None of the gene-nutrient interactions were significant after adjustment for multiple comparisons. Conclusions: Our findings confirm a positive association for alcohol and an inverse association for dairy products and calcium with CRC risk, and also suggest a lower risk at higher dietary intakes of phosphorus, magnesium, potassium, riboflavin, beta carotene, and total protein.

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type
Contribution to journal
publication status
published
subject
keywords
cohort study, colorectal cancer, epidemiology, nutrition
in
Clinical Gastroenterology and Hepatology
volume
20
issue
4
pages
13 - 873
publisher
Elsevier
external identifiers
  • scopus:85111401409
  • pmid:33901663
ISSN
1542-3565
DOI
10.1016/j.cgh.2021.04.028
language
English
LU publication?
yes
id
f11d45fa-5470-4681-a7b2-ac4df2a1687a
date added to LUP
2021-08-31 15:49:48
date last changed
2024-06-16 18:00:30
@article{f11d45fa-5470-4681-a7b2-ac4df2a1687a,
  abstract     = {{<p>Background &amp; Aims: Evidence regarding the association of dietary exposures with colorectal cancer (CRC) risk is not consistent with a few exceptions. Therefore, we conducted a diet-wide association study (DWAS) in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the associations between several dietary exposures with CRC risk. Methods: The association of 92 food and nutrient intakes with CRC risk was assessed in 386,792 participants, 5069 of whom developed incident CRC. Correction for multiple comparisons was performed using the false discovery rate, and emerging associations were examined in the Netherlands Cohort Study (NLCS). Multiplicative gene-nutrient interactions were also tested in EPIC based on known CRC-associated loci. Results: In EPIC, alcohol, liquor/spirits, wine, beer/cider, soft drinks, and pork were positively associated with CRC, whereas milk, cheese, calcium, phosphorus, magnesium, potassium, riboflavin, vitamin B6, beta carotene, fruit, fiber, nonwhite bread, banana, and total protein intakes were inversely associated. Of these 20 associations, 13 were replicated in the NLCS, for which a meta-analysis was performed, namely alcohol (summary hazard ratio [HR] per 1-SD increment in intake: 1.07; 95% confidence interval [CI], 1.04–1.09), liquor/spirits (HR per 1-SD increment in intake, 1.04; 95% CI, 1.02–1.06), wine (HR per 1-SD increment in intake, 1.04; 95% CI, 1.02–1.07), beer/cider (HR per 1-SD increment in intake, 1.06; 95% CI, 1.04–1.08), milk (HR per 1-SD increment in intake, 0.95; 95% CI, 0.93–0.98), cheese (HR per 1-SD increment in intake, 0.96; 95% CI, 0.94–0.99), calcium (HR per 1-SD increment in intake, 0.93; 95% CI, 0.90–0.95), phosphorus (HR per 1-SD increment in intake, 0.92; 95% CI, 0.90–0.95), magnesium (HR per 1-SD increment in intake, 0.95; 95% CI, 0.92–0.98), potassium (HR per 1-SD increment in intake, 0.96; 95% CI, 0.94–0.99), riboflavin (HR per 1-SD increment in intake, 0.94; 95% CI, 0.92–0.97), beta carotene (HR per 1-SD increment in intake, 0.96; 95% CI, 0.93–0.98), and total protein (HR per 1-SD increment in intake, 0.94; 95% CI, 0.92–0.97). None of the gene-nutrient interactions were significant after adjustment for multiple comparisons. Conclusions: Our findings confirm a positive association for alcohol and an inverse association for dairy products and calcium with CRC risk, and also suggest a lower risk at higher dietary intakes of phosphorus, magnesium, potassium, riboflavin, beta carotene, and total protein.</p>}},
  author       = {{Papadimitriou, Nikos and Bouras, Emmanouil and van den Brandt, Piet A. and Muller, David C. and Papadopoulou, Areti and Heath, Alicia K. and Critselis, Elena and Gunter, Marc J. and Vineis, Paolo and Ferrari, Pietro and Weiderpass, Elisabete and Boeing, Heiner and Bastide, Nadia and Merritt, Melissa A. and Lopez, David S. and Bergmann, Manuela M. and Perez-Cornago, Aurora and Schulze, Matthias and Skeie, Guri and Srour, Bernard and Eriksen, Anne Kirstine and Boden, Stina and Johansson, Ingegerd and Nøst, Therese Haugdahl and Lukic, Marco and Ricceri, Fulvio and Ericson, Ulrika and Huerta, José María and Dahm, Christina C. and Agnoli, Claudia and Amiano, Pilar Exezarreta and Tjønneland, Anne and Gurrea, Aurelio Barricarte and Bueno-de-Mesquita, Bas and Ardanaz, Eva and Berntsson, Jonna and Sánchez, Maria Jose and Tumino, Rosario and Panico, Salvatore and Katzke, Verena and Jakszyn, Paula and Masala, Giovanna and Derksen, Jeroen W.G. and Quirós, J. Ramón and Severi, Gianluca and Cross, Amanda J. and Riboli, Ellio and Tzoulaki, Ioanna and Tsilidis, Konstantinos K.}},
  issn         = {{1542-3565}},
  keywords     = {{cohort study; colorectal cancer; epidemiology; nutrition}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{13--873}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Gastroenterology and Hepatology}},
  title        = {{A Prospective Diet-Wide Association Study for Risk of Colorectal Cancer in EPIC}},
  url          = {{http://dx.doi.org/10.1016/j.cgh.2021.04.028}},
  doi          = {{10.1016/j.cgh.2021.04.028}},
  volume       = {{20}},
  year         = {{2022}},
}