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Br J Nutr. 2016 Jul;116(2):316-25. doi: 10.1017/S0007114516001859. Epub 2016 May 19.

Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition.

Author information

1
1Imperial College London,London W2 1PG,UK.
2
2Section for Epidemiology,Department of Public Health,Aarhus University,Bartholins Allé 2 - Building 1260,DK-8000 Aarhus C,Denmark.
3
6International Agency for Research on Cancer (WHO-IARC),150 Cours Albert Thomas,69372 Lyon CEDEX 08,France.
4
7Department of Epidemiology,Rollins School of Public Health,Emory University,201 Dowman Drive, Atlanta, GA 30322,USA.
5
8Division of Human Nutrition (Bode 62),PO Box 8129,6700 EV Wageningen,The Netherlands.
6
10UiT The Arctic University of Norway,Postboks 6050, Langnes, 9037 Tromsø,Norway.
7
13Danish Cancer Society Research Center,Strandboulevarden 49, DK-2100 København Ø,Denmark.
8
14Center for Research in Epidemiology and Population Health (CESP),U1018,Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology,Institut National de la Santé et de la Recherche Médicale,F-94805 Villejuif,France.
9
17German Cancer Research Center (DKFZ),Division of Cancer Epidemiology,Im Neuenheimer Feld 280, 69120 Heidelberg,Germany.
10
18Department of Epidemiology,German Institute of Human Nutrition (DIfE),Arthur-Scheunert-Allee 114-116, 14558 Bergholz-Rehbrücke,Germany.
11
19Hellenic Health Foundation,Kaisareias 13 & Alexandroupoleos, GR-115 27, Athens,Greece.
12
22ISPO - Cancer Research and Prevention Institute,Clinical and Descriptive Epidemiology Unit,Via delle Oblate 2, 50141,Florence, Italy.
13
23Epidemiology and Prevention Unit,Fondazione IRCCS Istituto Nazionale dei Tumouri,Via Giacomo Venezian 1, 20133 Milan,Italy.
14
24Cancer Registry and Histopathology Unit,'Civic-M.P.Arezzo' Hospital,ASP, Via Dante No. 109, Ragusa 97100,Italy.
15
25Molecular and Genetic Epidemiology Unit,Human Genetics Foundation (HuGeF),Via Nizza 52, 10126 Torino,Italy.
16
26Dipartimento di Medicina Clinica e Chirurgia,Federico II University,Via Pansini, 5-80131 - Naples,Italy.
17
28Department of Community Medicine, Faculty of Health Sciences,University of Tromsø - The Arctic University of Norway,Postboks 6050 Langnes, 9037 Tromsø,Norway.
18
32Unit of Nutrition, Environment and Cancer,Catalan Institute of Oncology,Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona,Spain.
19
33Public Health Directorate,Asturias, Ciriaco Miguel Vigil St 9,Oviedo 33006,Spain.
20
34Escuela Andaluza de Salud Pública,Instituto de Investigación Biosanitaria ibs,Hospitales Universitarios de Granada/Universidad de Granada,Cuesta del Observatorio, 4, Campus Universitario de Cartuja,Granada 18080,Spain.
21
36Basque Regional Health Department,Public Health Direction and Biodonostia Research Institute - CIBERESP,Avenida de Navarra, 4, 20013 Donostia-San Sebastián,Spain.
22
35CIBER de Epidemiología y Salud Pública (CIBERESP),Melchor Fernández Almagro,3-5, Madrid 28029,Spain.
23
40Department of Clinical Sciences,Division of Oncology and Pathology,Lund University,Box 117, SE-221 00 Lund,Sweden.
24
41Diabetes and Cardiovascular Disease - Genetic Epidemiology,Department of Clinical Sciences,Lund University,Box 117, SE-221 00 Lund,Sweden.
25
42Department of Odontology,Umeå University, SE-901 87 Umeå,Sweden.
26
43Department of Pathology,Umeå University, SE-901 87 Umeå,Sweden.
27
44Cancer Epidemiology Unit,Nuffield Department of Population Health, University of Oxford,Richard Doll Building, Oxford OX3 7LF,UK.
28
45Department of Public Health and Primary Care,University of Cambridge, Addenbrooke's Hospital, Hills Rd,Cambridge CB2 0SP,UK.
29
46Medical Research Council Epidemiology Unit,University of Cambridge, Institute of Metabolic Science,Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ,UK.

Abstract

Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.

KEYWORDS:

CRC colorectal cancer; Cancer survival; Cohorts; Colorectal cancers; Diets; EPIC European Prospective Investigation into Cancer and Nutrition; European Prospective Investigation into Cancer and Nutrition; HR hazard ratio; SSB sugar-sweetened beverages

PMID:
27193442
PMCID:
PMC5570524
DOI:
10.1017/S0007114516001859
[Indexed for MEDLINE]
Free PMC Article

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