A Prospective Diet-Wide Association Study for Risk of Colorectal Cancer in EPIC.

Abstract

This study is a comprehensive diet-wide association study (DWAS) aimed at identifying dietary factors associated with colorectal cancer (CRC) risk in a large cohort. Previous research on the link between diet and CRC risk has shown inconsistent results, so the goal of this study was to clarify the associations between several dietary exposures and CRC risk. The study assessed 92 food and nutrient intakes in 386,792 participants, 5,069 of whom developed incident CRC. Multiple comparisons were corrected for using the false discovery rate, and the findings were replicated in the Netherlands Cohort Study (NLCS). Additionally, the study examined gene-nutrient interactions based on known CRC-associated genetic loci. The results revealed 20 associations between dietary exposures and CRC risk. Some of the factors found to be positively associated with CRC risk included alcohol, liquor/spirits, wine, beer/cider, soft drinks, and pork. In contrast, milk, cheese, calcium, phosphorus, magnesium, potassium, riboflavin, vitamin B6, beta carotene, fruit, fiber, nonwhite bread, banana, and total protein intakes were inversely associated with CRC risk. Thirteen of these associations were replicated in the NLCS, and a meta-analysis of these replicated associations provided further insights. For example, alcohol, liquor/spirits, wine, and beer/cider were positively associated with CRC risk, whereas milk, cheese, and several nutrients such as calcium, phosphorus, magnesium, and riboflavin were inversely associated with the risk of developing CRC. However, no significant gene-nutrient interactions were found after adjusting for multiple comparisons. The findings from this study confirm the positive association between alcohol and CRC risk and suggest that higher intakes of dairy products, calcium, and certain nutrients may be protective against CRC.