Inverse associations of dietary fiber and menopausal hormone therapy with colorectal cancer risk in the Multiethnic Cohort Study

被引:27
作者
Park, Song-Yi [1 ]
Wilkens, Lynne R. [1 ]
Kolonel, Laurence N. [2 ]
Henderson, Brian E. [3 ]
Le Marchand, Loic [1 ]
机构
[1] Univ Hawaii, Ctr Canc, Canc Epidemiol Program, 701 Ilalo St, Honolulu, HI 96813 USA
[2] Univ Hawaii, Off Publ Hlth Studies, Honolulu, HI 96822 USA
[3] Univ Southern Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
关键词
colorectal cancer; dietary fiber; menopausal hormone therapy; multiethnic population; ESTROGEN PLUS PROGESTIN; REPLACEMENT THERAPY; ADENOMA RECURRENCE; AMERICAN WOMEN; SEX-HORMONES; HAWAII; COLON;
D O I
10.1002/ijc.30172
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In the Multiethnic Cohort Study, we previously reported that dietary fiber intake was inversely associated with colorectal cancer risk in men only. In women, the inverse relationship was weaker and appeared to be confounded by menopausal hormone therapy (MHT). We re-examined this observation with a greatly increased power. Using Cox proportional hazards models, we analyzed data from 187,674 participants with 4,692 cases identified during a mean follow-up period of 16 years. In multivariable-adjusted models, dietary fiber intake was inversely associated with colorectal cancer risk in both sexes: HR50.73, 95% CI: 0.61-0.89 for highest vs. lowest quintile, p(trend)=0.0020 in men and HR=0.76, 95% CI: 0.62-0.91, p(trend)=0.0067 in women. Postmenopausal women who ever used MHT had a 19% lower risk of colorectal cancer (95% CI: 0.74-0.89) compared with MHT never users. In a joint analysis of dietary fiber and MHT, dietary fiber intake was associated with a lower colorectal cancer risk in MHT never users (HR=0.75, 95% CI: 0.59-0.95, p(trend)=0.045), but did not appear to further decrease the colorectal cancer risk of MHT ever users (p(trend)=0.11). Our results support the overall protective roles of dietary fiber and MHT against colorectal cancer and suggest that dietary fiber may not lower risk further among women who ever used MHT. If confirmed, these results would suggest that MHT and dietary fiber may share overlapping mechanisms in protecting against colorectal cancer.
引用
收藏
页码:1241 / 1250
页数:10
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