Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Jun;152(8):1944-1953.e1.
doi: 10.1053/j.gastro.2017.02.015. Epub 2017 Feb 27.

Dietary Patterns and Risk of Colorectal Cancer: Analysis by Tumor Location and Molecular Subtypes

Raaj S Mehta  1 , Mingyang Song  2 , Reiko Nishihara  3 , David A Drew  1 , Kana Wu  4 , Zhi Rong Qian  5 , Teresa T Fung  6 , Tsuyoshi Hamada  5 , Yohei Masugi  5 , Annacarolina da Silva  5 , Yan Shi  5 , Wanwan Li  5 , Mancang Gu  5 , Walter C Willett  7 , Charles S Fuchs  8 , Edward L Giovannucci  9 , Shuji Ogino  10 , Andrew T Chan  11
Affiliations
Comparative Study

Dietary Patterns and Risk of Colorectal Cancer: Analysis by Tumor Location and Molecular Subtypes

Raaj S Mehta et al. Gastroenterology. 2017 Jun.

Abstract

Background & aims: Western and prudent dietary patterns have been associated with higher and lower risks of colorectal cancer (CRC), respectively. However, little is known about the associations between dietary patterns and specific anatomic subsites or molecular subtypes of CRC.

Methods: We used multivariable Cox proportional hazards models to examine the associations between Western and prudent dietary patterns and CRC risk in the Health Professionals Follow-up Study and Nurses' Health Study.

Results: After up to 32 years of follow-up of 137,217 men and women, we documented 3260 cases of CRC. Among individuals from whom subsite data were available, we observed 1264 proximal colon, 866 distal colon, and 670 rectal tumors. Western diet was associated with an increased incidence of CRC (Ptrend < .0001), with a relative risk (RR) of 1.31 (95% CI, 1.15-1.48, comparing the highest to lowest quartile). The association of Western diet with CRC was evident for tumors of the distal colon (RR, 1.55; 95% CI, 1.22-1.96; Ptrend = .0004) and rectum (RR, 1.35; 95% CI, 1.03-1.77; Ptrend = .01) but not proximal colon (RR, 1.11; 95% CI, 0.91-1.35; Ptrend = .51) when we comparing extreme quartiles. In contrast, for the prudent pattern, we observed a RR of 0.86 for overall CRC (95% CI, 0.77-0.95; Ptrend = .01), with similar trends at anatomic subsites. However, the trend appeared stronger among men than women. Among 1285 cases (39%) with tissue available for molecular profiling, Western diet appeared to be more strongly associated with some CRC molecular subtypes (no mutations in KRAS [KRAS wildtype] or BRAF [BRAF wildtype], no or a low CpG island methylator phenotype, and microsatellite stability), although formal tests for heterogeneity did not produce statistically significant results.

Conclusions: Western dietary patterns are associated with an increased risk of CRC, particularly distal colon and rectal tumors. Western dietary patterns also appear more strongly associated with tumors that are KRAS wildtype, BRAF wildtype, have no or a low CpG island methylator phenotype, and microsatellite stability. In contrast, prudent dietary patterns are associated with a lower risk of CRC that does not vary according to anatomic subsite or molecular subtype.

Keywords: Colon Cancer Risk; Molecular Epidemiology; Processed Meat; Red Meat.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Andrew T. Chan served as a consultant for Bayer Healthcare, Aralez Pharmaceuticals, Pfizer Inc., and PLx Pharma. This study was not funded by Bayer Healthcare, Aralez Pharmaceuticals, Pfizer Inc., or PLx Pharma. No other conflict of interest exists. The other authors declare that they have no conflicts of interest.

Comment in

References

    1. Song M, Garrett WS, Chan AT. Nutrients, Foods, and Colorectal Cancer Prevention. Gastroenterology. 2015;148(6):1244–60. e16. - PMC - PubMed
    1. Fung TT, Brown LS. Dietary Patterns and the Risk of Colorectal Cancer. Curr Nutr Rep. 2013;2(1):48–55. - PMC - PubMed
    1. Willett W. Nutritional Epidemiology. Oxford University Press; 2012.
    1. Magalhaes B, Peleteiro B, Lunet N. Dietary patterns and colorectal cancer: systematic review and meta-analysis. Eur J Cancer Prev. 2012;21(1):15–23. - PubMed
    1. Wu K, Hu FB, Fuchs C, Rimm EB, Willett WC, Giovannucci E. Dietary patterns and risk of colon cancer and adenoma in a cohort of men (United States) Cancer Causes Control. 2004;15(9):853–62. - PubMed

Publication types

MeSH terms