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Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival--results from the EPIC cohort study.

Abstract

BACKGROUND

We investigated whether prediagnostic reported intake of dairy products and dietary calcium is associated with colorectal cancer survival.

METHODS

Data from 3,859 subjects with colorectal cancer (42.1% male; mean age at diagnosis, 64.2 ± 8.1 years) in the European Investigation into Cancer and Nutrition cohort were analyzed. Intake of dairy products and dietary calcium was assessed at baseline (1992-2000) using validated, country-specific dietary questionnaires. Multivariable Cox regression models were used to calculate HR and corresponding 95% confidence intervals (CI) for colorectal cancer-specific death (n = 1,028) and all-cause death (n = 1,525) for different quartiles of intake.

RESULTS

The consumption of total dairy products was not statistically significantly associated with risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.17; 95% CI, 0.97-1.43) nor that of all-cause death (Q4 vs. Q1, 1.16; 95% CI, 0.98-1.36). Multivariable-adjusted HRs for colorectal cancer-specific death (Q4 vs. Q1) were 1.21 (95% CI, 0.99-1.48) for milk, 1.09 (95% CI, 0.88-1.34) for yoghurt, and 0.93 (95% CI, 0.76-1.14) for cheese. The intake of dietary calcium was not associated with the risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.01; 95% CI, 0.81-1.26) nor that of all-cause death (Q4 vs. Q1, 1.01; 95% CI, 0.84-1.21).

CONCLUSIONS

The prediagnostic reported intake of dairy products and dietary calcium is not associated with disease-specific or all-cause risk of death in patients diagnosed with colorectal cancer.

IMPACT

The impact of diet on cancer survival is largely unknown. This study shows that despite its inverse association with colorectal cancer risk, the prediagnostic intake of dairy and dietary calcium does not affect colorectal cancer survival.

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  • Authors+Show Affiliations

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    Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands. v.k.dik@umcutrecht.nl.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

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    Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands.

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    Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, Georgia.

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    International Agency for Research on Cancer (IARC-WHO), Lyon, France.

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    International Agency for Research on Cancer (IARC-WHO), Lyon, France.

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    Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.

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    Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.

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    Danish Cancer Society Research Center, Copenhagen, Denmark.

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    Danish Cancer Society Research Center, Copenhagen, Denmark.

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    Nutrition, Hormones, and Women's Health team, Inserm Center for Research in Epidemiology and Population Health (CESP), Villejuif, France. Paris South University, Villejuif, France. Institut Gustave Roussy, Villejuif, France.

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    Nutrition, Hormones, and Women's Health team, Inserm Center for Research in Epidemiology and Population Health (CESP), Villejuif, France. Paris South University, Villejuif, France. Institut Gustave Roussy, Villejuif, France.

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    Nutrition, Hormones, and Women's Health team, Inserm Center for Research in Epidemiology and Population Health (CESP), Villejuif, France. Paris South University, Villejuif, France. Institut Gustave Roussy, Villejuif, France.

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    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

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    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

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    Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany.

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    Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany.

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    Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.

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    Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

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    Hellenic Health Foundation, Athens, Greece.

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    Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.

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    Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. HuGeF Foundation, Turin, Italy.

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    Cancer Registry and Histopathology Unit, "Civile M.P. Arezzo" Hospital, Ragusa, Italy.

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    Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

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    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.

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    Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland.

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    Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.

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    Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

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    Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastian, Spain. CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.

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    CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Granada, Spain.

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    Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, ICO-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.

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    CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. Navarre Public Health Institute, Pamplona, Spain.

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    CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain.

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    Public Health Directorate, Asturias, Spain.

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    Department of Clinical Sciences, Division of Pathology, Lund University, Skåne University Hospital, Lund, Sweden.

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    Department of Plastic Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden.

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    Arctic Research Centre, Umeå University, Umeå, Sweden. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

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    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

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    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

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    University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom.

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    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

    Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.

    Source

    MeSH

    Calcium, Dietary
    Cohort Studies
    Colorectal Neoplasms
    Dairy Products
    Europe
    Female
    Humans
    Male
    Middle Aged
    Survival Analysis

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24917183

    Citation

    Dik, Vincent K., et al. "Prediagnostic Intake of Dairy Products and Dietary Calcium and Colorectal Cancer Survival--results From the EPIC Cohort Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 23, no. 9, 2014, pp. 1813-23.
    Dik VK, Murphy N, Siersema PD, et al. Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival--results from the EPIC cohort study. Cancer Epidemiol Biomarkers Prev. 2014;23(9):1813-23.
    Dik, V. K., Murphy, N., Siersema, P. D., Fedirko, V., Jenab, M., Kong, S. Y., ... Bueno-de-Mesquita, H. B. (2014). Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival--results from the EPIC cohort study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 23(9), pp. 1813-23. doi:10.1158/1055-9965.EPI-14-0172.
    Dik VK, et al. Prediagnostic Intake of Dairy Products and Dietary Calcium and Colorectal Cancer Survival--results From the EPIC Cohort Study. Cancer Epidemiol Biomarkers Prev. 2014;23(9):1813-23. PubMed PMID: 24917183.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival--results from the EPIC cohort study. AU - Dik,Vincent K, AU - Murphy,Neil, AU - Siersema,Peter D, AU - Fedirko,Veronika, AU - Jenab,Mazda, AU - Kong,So Y, AU - Hansen,Camilla P, AU - Overvad,Kim, AU - Tjønneland,Anne, AU - Olsen,Anja, AU - Dossus,Laure, AU - Racine,Antoine, AU - Bastide,Nadia, AU - Li,Kuanrong, AU - Kühn,Tilman, AU - Boeing,Heiner, AU - Aleksandrova,Krasimira, AU - Trichopoulou,Antonia, AU - Trichopoulos,Dimitrios, AU - Barbitsioti,Antonia, AU - Palli,Domenico, AU - Contiero,Paolo, AU - Vineis,Paolo, AU - Tumino,Rosaria, AU - Panico,Salvatore, AU - Peeters,Petra H M, AU - Weiderpass,Elisabete, AU - Skeie,Guri, AU - Hjartåker,Anette, AU - Amiano,Pilar, AU - Sánchez,María-José, AU - Fonseca-Nunes,Ana, AU - Barricarte,Aurelio, AU - Chirlaque,María-Dolores, AU - Redondo,Maria-Luisa, AU - Jirström,Karin, AU - Manjer,Jonas, AU - Nilsson,Lena M, AU - Wennberg,Maria, AU - Bradbury,Kathryn E, AU - Khaw,Kay-Tee, AU - Wareham,Nicholas, AU - Cross,Amanda J, AU - Riboli,Elio, AU - Bueno-de-Mesquita,H Bas, Y1 - 2014/06/10/ PY - 2014/6/12/entrez PY - 2014/6/12/pubmed PY - 2015/7/2/medline SP - 1813 EP - 23 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 23 IS - 9 N2 - BACKGROUND: We investigated whether prediagnostic reported intake of dairy products and dietary calcium is associated with colorectal cancer survival. METHODS: Data from 3,859 subjects with colorectal cancer (42.1% male; mean age at diagnosis, 64.2 ± 8.1 years) in the European Investigation into Cancer and Nutrition cohort were analyzed. Intake of dairy products and dietary calcium was assessed at baseline (1992-2000) using validated, country-specific dietary questionnaires. Multivariable Cox regression models were used to calculate HR and corresponding 95% confidence intervals (CI) for colorectal cancer-specific death (n = 1,028) and all-cause death (n = 1,525) for different quartiles of intake. RESULTS: The consumption of total dairy products was not statistically significantly associated with risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.17; 95% CI, 0.97-1.43) nor that of all-cause death (Q4 vs. Q1, 1.16; 95% CI, 0.98-1.36). Multivariable-adjusted HRs for colorectal cancer-specific death (Q4 vs. Q1) were 1.21 (95% CI, 0.99-1.48) for milk, 1.09 (95% CI, 0.88-1.34) for yoghurt, and 0.93 (95% CI, 0.76-1.14) for cheese. The intake of dietary calcium was not associated with the risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.01; 95% CI, 0.81-1.26) nor that of all-cause death (Q4 vs. Q1, 1.01; 95% CI, 0.84-1.21). CONCLUSIONS: The prediagnostic reported intake of dairy products and dietary calcium is not associated with disease-specific or all-cause risk of death in patients diagnosed with colorectal cancer. IMPACT: The impact of diet on cancer survival is largely unknown. This study shows that despite its inverse association with colorectal cancer risk, the prediagnostic intake of dairy and dietary calcium does not affect colorectal cancer survival. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/24917183/Prediagnostic_intake_of_dairy_products_and_dietary_calcium_and_colorectal_cancer_survival__results_from_the_EPIC_cohort_study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=24917183 DB - PRIME DP - Unbound Medicine ER -