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Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies.

Abstract

Use of dietary supplements is rising in countries where colorectal cancer is prevalent. We conducted a systematic literature review and meta-analyses of prospective cohort studies on dietary supplement use and colorectal cancer risk. We identified relevant studies in Medline, Embase and Cochrane up to January 2013. Original and peer-reviewed papers on dietary supplement use and colorectal cancer, colon cancer, or rectal cancer incidence were included. "Use-no use"(U-NU), "highest-lowest"(H-L) and "dose-response"(DR) meta-analyses were performed. Random-effects models were used to estimate summary estimates. In total, 24 papers were included in the meta-analyses. We observed inverse associations for colorectal cancer risk and multivitamin (U-NU: RR = 0.92; 95% CI: 0.87,0.97) and calcium supplements (U-NU: RR = 0.86; 95% CI: 0.79,0.95; H-L: RR = 0.80; 95% CI: 0.70,0.92; DR: for an increase of 100 mg/day, RR = 0.96; 95% CI: 0.94,0.99). Inconsistent associations were found for colon cancer risk and supplemental vitamin A and vitamin C, and for colorectal cancer risk and supplemental vitamin D, vitamin E, garlic and folic acid. Meta-analyses of observational studies suggest a beneficial role for multivitamins and calcium supplements on colorectal cancer risk, while the association with other supplements and colorectal cancer risk is inconsistent. Residual confounding of lifestyle factors might be present. Before recommendations can be made, an extensive assessment of dietary supplement use and a better understanding of underlying mechanisms is needed.

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  • Authors+Show Affiliations

    ,

    Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.

    , , , , , , ,

    Source

    International journal of cancer 136:10 2015 May 15 pg 2388-401

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Calcium, Dietary
    Colorectal Neoplasms
    Databases as Topic
    Dietary Supplements
    Female
    Humans
    Male
    Middle Aged
    Prospective Studies
    Risk Factors
    Vitamins
    Young Adult

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    25335850

    Citation

    Heine-Bröring, Renate C., et al. "Dietary Supplement Use and Colorectal Cancer Risk: a Systematic Review and Meta-analyses of Prospective Cohort Studies." International Journal of Cancer, vol. 136, no. 10, 2015, pp. 2388-401.
    Heine-Bröring RC, Winkels RM, Renkema JM, et al. Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies. Int J Cancer. 2015;136(10):2388-401.
    Heine-Bröring, R. C., Winkels, R. M., Renkema, J. M., Kragt, L., van Orten-Luiten, A. C., Tigchelaar, E. F., ... Kampman, E. (2015). Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies. International Journal of Cancer, 136(10), pp. 2388-401. doi:10.1002/ijc.29277.
    Heine-Bröring RC, et al. Dietary Supplement Use and Colorectal Cancer Risk: a Systematic Review and Meta-analyses of Prospective Cohort Studies. Int J Cancer. 2015 May 15;136(10):2388-401. PubMed PMID: 25335850.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies. AU - Heine-Bröring,Renate C, AU - Winkels,Renate M, AU - Renkema,Jacoba M S, AU - Kragt,Lea, AU - van Orten-Luiten,Anne-Claire B, AU - Tigchelaar,Ettje F, AU - Chan,Doris S M, AU - Norat,Teresa, AU - Kampman,Ellen, Y1 - 2014/11/11/ PY - 2014/04/18/received PY - 2014/09/19/accepted PY - 2014/10/23/entrez PY - 2014/10/23/pubmed PY - 2015/5/13/medline KW - colorectal cancer KW - dietary supplements KW - epidemiology KW - meta-analysis KW - nutrition KW - review SP - 2388 EP - 401 JF - International journal of cancer JO - Int. J. Cancer VL - 136 IS - 10 N2 - Use of dietary supplements is rising in countries where colorectal cancer is prevalent. We conducted a systematic literature review and meta-analyses of prospective cohort studies on dietary supplement use and colorectal cancer risk. We identified relevant studies in Medline, Embase and Cochrane up to January 2013. Original and peer-reviewed papers on dietary supplement use and colorectal cancer, colon cancer, or rectal cancer incidence were included. "Use-no use"(U-NU), "highest-lowest"(H-L) and "dose-response"(DR) meta-analyses were performed. Random-effects models were used to estimate summary estimates. In total, 24 papers were included in the meta-analyses. We observed inverse associations for colorectal cancer risk and multivitamin (U-NU: RR = 0.92; 95% CI: 0.87,0.97) and calcium supplements (U-NU: RR = 0.86; 95% CI: 0.79,0.95; H-L: RR = 0.80; 95% CI: 0.70,0.92; DR: for an increase of 100 mg/day, RR = 0.96; 95% CI: 0.94,0.99). Inconsistent associations were found for colon cancer risk and supplemental vitamin A and vitamin C, and for colorectal cancer risk and supplemental vitamin D, vitamin E, garlic and folic acid. Meta-analyses of observational studies suggest a beneficial role for multivitamins and calcium supplements on colorectal cancer risk, while the association with other supplements and colorectal cancer risk is inconsistent. Residual confounding of lifestyle factors might be present. Before recommendations can be made, an extensive assessment of dietary supplement use and a better understanding of underlying mechanisms is needed. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/25335850/full_citation L2 - https://doi.org/10.1002/ijc.29277 DB - PRIME DP - Unbound Medicine ER -