Jiali Zheng1,2,3, Fred K Tabung4, Jiajia Zhang1, E Angela Murphy5, Nitin Shivappa1,2,6, Judith K Ockene7, Bette Caan8, Candyce H Kroenke8, James R Hébert1,2,6, Susan E Steck9,10. 1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC, 29208, USA. 2. Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. 3. Division of Cancer Prevention and Population Sciences, Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 4. Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, 43210, USA. 5. Department of Pathology, Immunology and Microbiology, University of South Carolina School of Medicine, Columbia, SC, 29208, USA. 6. Connecting Health Innovations, LLC, Columbia, SC, 29201, USA. 7. Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA. 8. Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA. 9. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC, 29208, USA. ssteck@sc.edu. 10. Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. ssteck@sc.edu.
Abstract
PURPOSE: Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative. METHODS: The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII)® scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent. RESULTS: After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HRT1vsT3 = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1. CONCLUSIONS: Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.
PURPOSE: Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative. METHODS: The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII)® scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent. RESULTS: After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HRT1vsT3 = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1. CONCLUSIONS: Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.
Entities:
Keywords:
Cohort study; Colorectal cancer survival; Dietary pattern; Post-cancer diagnosis; Postmenopausal women
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