Annals of Oncology 13:369-373, 2002
© 2002 European Society for Medical Oncology
Macronutrients and colorectal cancer: a Swiss case-control study
1Registre Vaudois des Tumeurs, and Unité d’épidémiologie du cancer, Institut universitaire de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; 2Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milano; and Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milano, Italy
Received 22 June 2001; revised 1 October 2001; accepted 23 October 2001.
Background
A role of energy and various nutrients, including protein, sugar, saturated and unsaturated fats, in colorectal cancer risk has been suggested, but should be better defined.
Patients and methods
The association between dietary intake of various macronutrients and colorectal cancer risk was analysed using data from a case-control study conducted between 1992 and 2000 in the Swiss Canton of Vaud. The study comprised 286 case subjects (174 males, 112 females; median age 65 years) with incident, histologically confirmed colon (n = 149) or rectal (n = 137) cancer, and 550 control subjects (269 males, 281 females; median age 59 years) admitted to the same University Hospital for a wide spectrum of acute non-neoplastic conditions. Dietary habits were investigated using a validated food frequency questionnaire, including questions on 79 foods or recipes and on individual fat intake pattern. Multivariate odds ratios (OR) were obtained after allowance for age, sex, education, physical activity and energy intake.
Results
The risk of colon and rectal cancer increased with total energy intake (OR in highest and lowest tertile, 2.0 and 2.2, respectively). There was no significant relation with starches or proteins, a significant inverse relation with sugars (OR for the highest tertile, 0.5), a direct trend in risk of borderline significance for saturated fats (OR = 1.4 for the highest tertile), and significant inverse trends for monounsaturated (OR = 0.6) and polyunsaturated fats (OR = 0.6).
Conclusions
These findings confirm that energy intake is directly related to colorectal cancer risk, and that different types of fat may have different roles in colorectal carcinogenesis.
Key words: case-control study, colorectal carcinoma, diet, Switzerland
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