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American Journal of Epidemiology Advance Access originally published online on September 21, 2006
American Journal of Epidemiology 2006 164(11):1085-1093; doi:10.1093/aje/kwj324
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Dietary Patterns and Risk of Colorectal Tumors: A Cohort of French Women of the National Education System (E3N)

E Kesse, F Clavel-Chapelon and MC Boutron-Ruault

From the Inserm, ERI20, Equipe E3N, Institut Gustave Roussy, Villejuif Cedex, France

Correspondence to Dr. M. C. Boutron-Ruault, Inserm, Equipe E3N, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France (e-mail: boutron{at}igr.fr).

Little is known about the dietary patterns associated with colorectal tumors along the adenoma-carcinoma sequence. Scores for dietary patterns were obtained by factor analysis in women from the French cohort of the European Prospective Investigation into Cancer and Nutrition (1993–2000). Their association with colorectal tumors was investigated in 516 adenoma cases (175 high-risk adenomas) and 4,804 polyp-free women and in 172 colorectal cancer cases and 67,312 cancer-free women. The authors identified four dietary patterns: "healthy" (vegetables, fruit, yogurt, sea products, and olive oil); "Western" (potatoes, pizzas and pies, sandwiches, sweets, cakes, cheese, cereal products, processed meat, eggs, and butter); "drinker" (sandwiches, snacks, processed meat, and alcoholic beverages); and "meat eaters" (meat, poultry, and margarine). For quartile 4 versus quartile 1, an increased risk of adenoma was observed with high scores of the Western pattern (multivariate relative risk (RR) = 1.39, 95% confidence interval: 1.00, 1.94; ptrend = 0.03) and the drinker pattern (RR = 1.42, 95% confidence interval: 1.10, 1.83; ptrend = 0.01). The meat-eaters pattern was positively associated with colorectal cancer risk (for quartile 4 vs. quartile 1: RR = 1.58, 95% confidence interval: 0.98, 2.53; ptrend = 0.02). Dietary patterns that reflect a Western way of life are associated with a higher risk of colorectal tumors.

adenoma; cohort studies; colorectal neoplasms; diet; risk; women

Abbreviations: E3N, Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale; EPIC, European Prospective Investigation into Cancer and Nutrition; RR, relative risk


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