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American Journal of Epidemiology Vol. 154, No. 12 : 1143-1149
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


NUTRITIONAL EPIDEMIOLOGY

Prospective Study of Major Dietary Patterns and Colorectal Cancer Risk in Women

Paul Terry1,4, Frank B. Hu2, Holger Hansen3 and Alicja Wolk1

1 Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden.
2 Department of Nutrition, Harvard School of Public Health, Boston, MA.
3 Department of Community Medicine, University of Connecticut Health Center, Farmington, CT.
4 Current affiliation: Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.

ABSTRACT

A number of prospective cohort studies have examined the relations of individual dietary variables to risk of colorectal cancer. Few studies have addressed the broader eating patterns that reflect many dietary exposures working together. Using data from a prospective study of 61,463 women, with an average follow-up period of 9.6 years (between 1987 and 1998) and 460 incident cases of colorectal cancer, the authors conducted a factor analysis to identify and examine major dietary patterns in relation to colorectal cancer risk. Using proportional hazards regression to estimate relative risks, the authors found no clear association between a "Western," "healthy," or "drinker" dietary pattern and colorectal cancer risk. However, the data suggested that consuming low amounts of foods that constitute a "healthy" dietary pattern may be associated with increased risks of colon and rectal cancers. An inverse association with the "healthy" dietary pattern was found among women under age 50 years, although the number of cancers in this age group was limited and interpretation of this finding should be cautious. In this age group, relative risks for women in increasing quintiles of the "healthy" dietary pattern, compared with the lowest quintile, were 0.74 (95% confidence interval (CI): 0.41, 1.31), 0.69 (95% CI: 0.39, 1.24), 0.59 (95% CI: 0.32, 1.07), and 0.45 (95% CI: 0.23, 0.88) (p for trend = 0.03). The role of overall eating patterns in predicting colorectal cancer risk requires further investigation.

cohort studies; colorectal neoplasms; diet; factor analysis; statistical

Abbreviations: CI, confidence interval


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