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A colorectal cancer diet quality index is inversely associated with colorectal cancer in the Malmö diet and cancer study

Vulcan, Alexandraa; Ericson, Ulrikab; Manjer, Jonasc; Ohlsson, Bodila

European Journal of Cancer Prevention: November 2019 - Volume 28 - Issue 6 - p 463–471
doi: 10.1097/CEJ.0000000000000486
Research Papers: Gastrointestinal Cancer
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The World Cancer Research Fund International has concluded strong evidence for that high intake of dairy products and foods containing dietary fiber and low intake of processed meat are associated with decreased risk of colorectal cancer (CRC). As food items are consumed together, it is important to study dietary patterns. The aim of the present study was to examine the association between an a priori constructed dietary index and incident CRC and between intake of processed meat, fiber, and dairy products and CRC. In the Malmö Diet and Cancer study cohort, 923 cases of CRC were identified, during 502 136 person-years of follow-up. A Colorectal Diet Quality Index (CDQI) was constructed regarding intakes of processed meat, fiber, and dairy products in relation to CRC. Higher index indicated a higher dietary quality. Higher CDQI was associated with lower risk of CRC [hazard ratios (HR): 0.57 for highest compared with lowest quintile; 95% confidence interval (CI): 0.43, 0.75; P<0.001]. Intake of dairy products was inversely associated with risk of CRC [HR for highest vs. lowest quintile was 0.77 (CI: 0.62, 0.96); P = 0.008], as was dietary fiber [HR for highest vs. lowest quintile was 0.77 (CI: 0.61, 0.98); P = 0.043]. High intake of processed meat was associated with CRC [HR for highest vs. lowest quintile was 1.31; CI: 1.05, 1.63; P = 0.012]. High adherence to a predefined CRC-specific diet quality index was inversely associated with the risk of CRC and gave a stronger association with CRC, than when analyzing the components of the CDQI individually.

aDepartment of Clinical Sciences, Division of Internal Medicine

bDepartment of Clinical Sciences, Division of Surgery, Skåne University Hospital

cDepartment of Diabetes and Cardiovascular Disease, Genetic Epidemiology, Lund University, Malmö, Sweden

Received 28 June 2018 Accepted 8 October 2018

Correspondence to Alexandra Vulcan, PhD, Skåne University Hospital Malmö, Jan Waldenströms Gata 14, pl 2, 205 02 Malmö, Sweden Tel: + 46 4033 2388; fax: +46 4033 7300; e-mail: alexandra.vulcan@med.lu.se

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