Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies

Y. Park, D.J. Hunter, D. Spiegelman, L. Bergkvist, F. Berrino, P.A. van den Brandt, J.E. Buring, G.A. Colditz, J.L. Freudenheim, C.S. Fuchs, E. Giovannucci, R.A. Goldbohm, S. Graham, L. Harnack, A.M. Hartman, Stephanie A. Smith-Warner*

*Corresponding author for this work

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Abstract

Context Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants From 13 prospective cohort studies included in the Pooling Project of Prospective Studies of Diet and Cancer, 725 628 men and women were followed up for 6 to 20 years across studies. Study- and sex-specific relative risks (RRs) were estimated with the Cox proportional hazards model and were subsequently pooled using a random-effects model. Main Outcome Measure Incident colorectal cancer. Results During 6 to 20 years of follow-up across studies, 8081 colorectal cancer cases were identified. For comparison of the highest vs lowest study- and sex-specific quintile of dietary fiber intake, a significant inverse association was found in the age-adjusted model (pooled RR=0.84; 95% confidence interval [CI], 0.77-0.92). However, the association was attenuated and no longer statistically significant after adjusting for other risk factors (pooled multivariate RR=0.94; 95% Cl, 0.86-1.03). In categorical analyses compared with dietary fiber intake of 10 to
Original languageEnglish
Pages (from-to)2849-2857
JournalJAMA-Journal of the American Medical Association
Volume294
DOIs
Publication statusPublished - 1 Jan 2005

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