American Journal of Epidemiology Advance Access originally published online on May 9, 2007
American Journal of Epidemiology 2007 166(2):181-195; doi:10.1093/aje/kwm063
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ORIGINAL CONTRIBUTIONS |
Dietary Fatty Acids and Colorectal Cancer: A Case-Control Study
1 Public Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
2 Environmental and Occupational Medicine Department, University of Aberdeen, Aberdeen, United Kingdom
3 South East Scotland Genetic Service, Western General Hospital, Edinburgh, United Kingdom
4 Colon Cancer Genetics Group, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
Correspondence to Professor Harry Campbell, Public Health Sciences, College of Medicine and Vet Medicine, University of Edinburgh, Teviot Place, Edinburgh, Midlothian EH8 9AG, United Kingdom (e-mail: Harry.Campbell{at}ed.ac.uk).
Received for publication October 20, 2006. Accepted for publication January 22, 2007.
Fatty acid effects on colorectal cancer risk were examined in a national prospective case-control study in Scotland (1999–2006), including 1,455 incident cases and 1,455 matched controls. Three conditional logistic regression models adjusted for energy (residual method) and for other risk factors were applied in the whole sample and were stratified by sex, cancer site, age, and tumor staging. Total and trans-monounsaturated fatty acids and palmitic, stearic, and oleic acids were dose-dependently associated with colorectal cancer risk, but these effects did not persist after further energy adjustment. Significant dose-dependent reductions in risk were associated with increased consumption of omega-3 polyunsaturated fatty acids (highest vs. lowest quartile of intake: odds ratio = 0.63, 95% confidence interval: 0.50, 0.80; p < 0.0005 for trend) and of eicosapentaenoic (odds ratio = 0.59, 95% confidence interval: 0.47, 0.75; p < 0.0005 for trend) and docosahexaenoic (odds ratio = 0.63, 95% confidence interval: 0.50, 0.80; p < 0.0005 for trend) acids. These associations persisted after including energy with the nutrient-energy-adjusted term or total fatty acid intake (energy adjusted). The observed different effects of different types of fatty acids underline the importance of type of fat in the etiology and prevention of colorectal cancer.
case-control studies; colorectal neoplasms; fatty acids; fatty acids, omega-3; fatty acids, unsaturated; logistic models; Scotland; stearic acids
Abbreviations: CI, confidence interval; MUFA, monounsaturated fatty acid; OR, odds ratio; PUFA, polyunsaturated fatty acid
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