TY - JOUR
T1 - Intake of dietary fruit, vegetables, and fiber and risk of colorectal cancer according to molecular subtypes
T2 - A pooled analysis of 9 studies
AU - Hidaka, Akihisa
AU - Harrison, Tabitha A.
AU - Cao, Yin
AU - Sakoda, Lori C.
AU - Barfield, Richard
AU - Giannakis, Marios
AU - Song, Mingyang
AU - Phipps, Amanda I.
AU - Figueiredo, Jane C.
AU - Zaidi, Syed H.
AU - Toland, Amanda E.
AU - Amitay, Efrat L.
AU - Berndt, Sonja I.
AU - Borozan, Ivan
AU - Chan, Andrew T.
AU - Gallinger, Steven
AU - Gunter, Marc J.
AU - Guinter, Mark A.
AU - Harlid, Sophia
AU - Hampel, Heather
AU - Jenkins, Mark A.
AU - Lin, Yi
AU - Moreno, Victor
AU - Newcomb, Polly A.
AU - Nishihara, Reiko
AU - Ogino, Shuji
AU - Obon-Santacana, Mireia
AU - Parfrey, Patrick S.
AU - Potter, John D.
AU - Slattery, Martha L.
AU - Steinfelder, Robert S.
AU - Um, Caroline Y.
AU - Wang, Xiaoliang
AU - Woods, Michael O.
AU - van Guelpen, Bethany
AU - Thibodeau, Stephen N.
AU - Hoffmeister, Michael
AU - Sun, Wei
AU - Hsu, Li
AU - Buchanan, Daniel D.
AU - Campbell, Peter T.
AU - Peters, Ulrike
N1 - Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2021/10/15
Y1 - 2021/10/15
N2 - Protective associations of fruits, vegetables, and fiber intake with colorectal cancer risk have been shown in many, but not all epidemiologic studies. One possible reason for study heterogeneity is that dietary factors may have distinct effects by colorectal cancer molecular subtypes. Here, we investigate the association of fruit, vegetables, and fiber intake with four well-established colorectal cancer molecular subtypes separately and in combination. Nine observational studies including 9,592 cases with molecular subtypes for microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and somatic mutations in BRAF and KRAS genes, and 7,869 controls were analyzed. Both case-only logistic regression analyses and polytomous logistic regression analyses (with one control set and multiple case groups) were used. Higher fruit intake was associated with a trend toward decreased risk of BRAF-mutated tumors [OR 4th vs. 1st quartile ¼ 0.82 (95% confidence interval, 0.65-1.04)] but not BRAF-wildtype tumors [1.09 (0.97-1.22); P difference as shown in case-only analysis ¼ 0.02]. This difference was observed in case-control studies and not in cohort studies. Compared with controls, higher fiber intake showed negative association with colorectal cancer risk for cases with microsatellite stable/MSI-low, CIMP-negative, BRAF-wildtype, and KRAS-wildtype tumors (Ptrend range from 0.03 to 3.4e-03), which is consistent with the traditional adenoma-colorectal cancer pathway. These negative associations were stronger compared with MSI-high, CIMP-positive, BRAF-mutated, or KRAS-mutated tumors, but the differences were not statistically significant. These inverse associations for fruit and fiber intake may explain, in part, inconsistent findings between fruit or fiber intake and colorectal cancer risk that have previously been reported.
AB - Protective associations of fruits, vegetables, and fiber intake with colorectal cancer risk have been shown in many, but not all epidemiologic studies. One possible reason for study heterogeneity is that dietary factors may have distinct effects by colorectal cancer molecular subtypes. Here, we investigate the association of fruit, vegetables, and fiber intake with four well-established colorectal cancer molecular subtypes separately and in combination. Nine observational studies including 9,592 cases with molecular subtypes for microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and somatic mutations in BRAF and KRAS genes, and 7,869 controls were analyzed. Both case-only logistic regression analyses and polytomous logistic regression analyses (with one control set and multiple case groups) were used. Higher fruit intake was associated with a trend toward decreased risk of BRAF-mutated tumors [OR 4th vs. 1st quartile ¼ 0.82 (95% confidence interval, 0.65-1.04)] but not BRAF-wildtype tumors [1.09 (0.97-1.22); P difference as shown in case-only analysis ¼ 0.02]. This difference was observed in case-control studies and not in cohort studies. Compared with controls, higher fiber intake showed negative association with colorectal cancer risk for cases with microsatellite stable/MSI-low, CIMP-negative, BRAF-wildtype, and KRAS-wildtype tumors (Ptrend range from 0.03 to 3.4e-03), which is consistent with the traditional adenoma-colorectal cancer pathway. These negative associations were stronger compared with MSI-high, CIMP-positive, BRAF-mutated, or KRAS-mutated tumors, but the differences were not statistically significant. These inverse associations for fruit and fiber intake may explain, in part, inconsistent findings between fruit or fiber intake and colorectal cancer risk that have previously been reported.
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U2 - 10.1158/0008-5472.CAN-20-0168
DO - 10.1158/0008-5472.CAN-20-0168
M3 - Article
C2 - 32816852
AN - SCOPUS:85100395350
SN - 0008-5472
VL - 80
SP - 4578
EP - 4590
JO - Cancer research
JF - Cancer research
IS - 20
ER -