PURPOSE: Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women's Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. METHODS: The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50-79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). RESULTS: During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5-Q1 1.22; 95 % CI 1.05, 1.43; p trend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5-Q1 1.35; 95 % CI 1.05, 1.67; p trend = 0.01) but not distal colon cancer (HRQ5-Q1 0.84; 95 % CI 0.61, 1.18; p trend = 0.63) or rectal cancer (HRQ5-Q1 1.20; 95 % CI 0.84, 1.72; p trend = 0.65). CONCLUSION: Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
PURPOSE:Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women's Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. METHODS: The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50-79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). RESULTS: During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5-Q1 1.22; 95 % CI 1.05, 1.43; p trend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5-Q1 1.35; 95 % CI 1.05, 1.67; p trend = 0.01) but not distal colon cancer (HRQ5-Q1 0.84; 95 % CI 0.61, 1.18; p trend = 0.63) or rectal cancer (HRQ5-Q1 1.20; 95 % CI 0.84, 1.72; p trend = 0.65). CONCLUSION: Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
Authors: J David Curb; Anne McTiernan; Susan R Heckbert; Charles Kooperberg; Janet Stanford; Michael Nevitt; Karen C Johnson; Lori Proulx-Burns; Lisa Pastore; Michael Criqui; Sandra Daugherty Journal: Ann Epidemiol Date: 2003-10 Impact factor: 3.797
Authors: Nitin Shivappa; Anna E Prizment; Cindy K Blair; David R Jacobs; Susan E Steck; James R Hébert Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-08-25 Impact factor: 4.254
Authors: Dora Romaguera; Anne-Claire Vergnaud; Petra H Peeters; Carla H van Gils; Doris S M Chan; Pietro Ferrari; Isabelle Romieu; Mazda Jenab; Nadia Slimani; Françoise Clavel-Chapelon; Guy Fagherazzi; Florence Perquier; Rudolf Kaaks; Birgit Teucher; Heiner Boeing; Anne von Rüsten; Anne Tjønneland; Anja Olsen; Christina C Dahm; Kim Overvad; José Ramón Quirós; Carlos A Gonzalez; María José Sánchez; Carmen Navarro; Aurelio Barricarte; Miren Dorronsoro; Kay-Tee Khaw; Nicholas J Wareham; Francesca L Crowe; Timothy J Key; Antonia Trichopoulou; Pagona Lagiou; Christina Bamia; Giovanna Masala; Paolo Vineis; Rosario Tumino; Sabina Sieri; Salvatore Panico; Anne M May; H Bas Bueno-de-Mesquita; Frederike L Büchner; Elisabet Wirfält; Jonas Manjer; Ingegerd Johansson; Göran Hallmans; Guri Skeie; Kristin Benjaminsen Borch; Christine L Parr; Elio Riboli; Teresa Norat Journal: Am J Clin Nutr Date: 2012-05-16 Impact factor: 7.045
Authors: Terryl J Hartman; Binbing Yu; Paul S Albert; Martha L Slattery; Electra Paskett; James Walter Kikendall; Frank Iber; Brenda K Brewer; Arthur Schatzkin; Elaine Lanza Journal: Cancer Epidemiol Biomarkers Prev Date: 2005-10 Impact factor: 4.254
Authors: Simin Liu; JoAnn E Manson; Julie E Buring; Meir J Stampfer; Walter C Willett; Paul M Ridker Journal: Am J Clin Nutr Date: 2002-03 Impact factor: 7.045
Authors: Alaa Rostom; Catherine Dubé; Gabriela Lewin; Alexander Tsertsvadze; Nicholas Barrowman; Catherine Code; Margaret Sampson; David Moher Journal: Ann Intern Med Date: 2007-03-06 Impact factor: 25.391
Authors: Nitin Shivappa; Susan E Steck; Thomas G Hurley; James R Hussey; Yunsheng Ma; Ira S Ockene; Fred Tabung; James R Hébert Journal: Public Health Nutr Date: 2013-10-10 Impact factor: 4.022
Authors: Daria M McMahon; James B Burch; James R Hébert; James W Hardin; Jiajia Zhang; Michael D Wirth; Shawn D Youngstedt; Nitin Shivappa; Steven J Jacobsen; Bette Caan; Stephen K Van Den Eeden Journal: Ann Epidemiol Date: 2018-11-02 Impact factor: 3.797
Authors: Nitin Shivappa; James R Hébert; Valentina Rosato; Marta Rossi; Maurizio Montella; Diego Serraino; Carlo La Vecchia Journal: Nutr Cancer Date: 2017-07-18 Impact factor: 2.900
Authors: Li Liu; Reiko Nishihara; Zhi Rong Qian; Fred K Tabung; Daniel Nevo; Xuehong Zhang; Mingyang Song; Yin Cao; Kosuke Mima; Yohei Masugi; Yan Shi; Annacarolina da Silva; Tyler Twombly; Mancang Gu; Wanwan Li; Tsuyoshi Hamada; Keisuke Kosumi; Kentaro Inamura; Jonathan A Nowak; David A Drew; Paul Lochhead; Katsuhiko Nosho; Kana Wu; Molin Wang; Wendy S Garrett; Andrew T Chan; Charles S Fuchs; Edward L Giovannucci; Shuji Ogino Journal: Gastroenterology Date: 2017-09-01 Impact factor: 22.682
Authors: Nitin Shivappa; James R Hébert; Valentina Rosato; Marta Rossi; Massimo Libra; Maurizio Montella; Diego Serraino; Carlo La Vecchia Journal: Urology Date: 2016-09-29 Impact factor: 2.649
Authors: Nitin Shivappa; James R Hébert; Antonella Zucchetto; Maurizio Montella; Massimo Libra; Werner Garavello; Marta Rossi; Carlo La Vecchia; Diego Serraino Journal: Nutr Cancer Date: 2016-08-26 Impact factor: 2.900