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J Natl Cancer Inst. 2014 Jan;106(1):djt352. doi: 10.1093/jnci/djt352. Epub 2013 Dec 7.

Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and incidence of colorectal cancer.

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Affiliations of authors: Danish Cancer Society Research Center, Copenhagen, Denmark (CK, AO, JC, AT); Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden (RL, PÅ); Department of Community Medicine, University of Tromsø, Tromsø, Norway (GS, EW, TB, LAÅ); Department of Public Health, Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (SL); Department of Gastroenterology and Hepatology (ML, VKD, PDS, BB) and Department of Epidemiology, Julius Center for Health Sciences and Primary Care (PHP), University Medical Center Utrecht, Utrecht, The Netherlands; Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine Berlin-Buch, Berlin, Germany (TP); Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark (KO); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805, Villejuif, France (M-CB-R, GF, VC); Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (M-CB-R, GF, VC); IGR, F-94805, Villejuif, France (M-CB-R, GF, VC); German Cancer Research Center, DKFZ, Division of Cancer Epidemiology, Heidelberg, Germany (TK, JC-C); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (HB); Hellenic Health Foundation, Athens, Greece (ATR, CB, DT); WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (ATR, CB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT); Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy (DP); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (VK); Cancer Registry and His



Few studies have investigated the association between whole-grain intake and colorectal cancer. Because whole-grain intake estimation might be prone to measurement errors, more objective measures (eg, biomarkers) could assist in investigating such associations.


The association between alkylresorcinols, biomarkers of whole-grain rye and wheat intake, and colorectal cancer incidence were investigated using prediagnostic plasma samples from colorectal cancer case patients and matched control subjects nested within the European Prospective Investigation into Cancer and Nutrition. We included 1372 incident colorectal cancer case patients and 1372 individual matched control subjects and calculated the incidence rate ratios (IRRs) for overall and anatomical subsites of colorectal cancer using conditional logistic regression adjusted for potential confounders. Regional differences (Scandinavia, the Mediterranean, Central Europe) were also explored.


High plasma total alkylresorcinol concentration was associated with lower incidence of distal colon cancer; the adjusted incidence rate ratio of distal colon cancer for the highest vs lowest quartile of plasma total alkylresorcinols was 0.48 (95% confidence interval [CI] = 0.28 to 0.83). An inverse association between plasma total alkylresorcinol concentrations and colon cancer was found for Scandinavian participants (IRR per doubling = 0.83; 95% CI = 0.70 to 0.98). However, plasma total alkylresorcinol concentrations were not associated with overall colorectal cancer, proximal colon cancer, or rectal cancer. Plasma alkylresorcinols concentrations were associated with colon and distal colon cancer only in Central Europe and Scandinavia (ie, areas where alkylresorcinol levels were higher).


High concentrations of plasma alkylresorcinols were associated with a lower incidence of distal colon cancer but not with overall colorectal cancer, proximal colon cancer, and rectal cancer.

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