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Diet Quality Indexes and Colorectal Cancer Risk: the Multiethnic Cohort Study
Author(s) -
Park SongYi,
Boushey Carol,
Wilkens Lynne,
Haiman Christopher,
Le Marchand Loïc
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.168.8
Subject(s) - medicine , dash , hazard ratio , demography , colorectal cancer , mediterranean diet , confidence interval , proportional hazards model , prospective cohort study , cohort , population , cohort study , lower risk , body mass index , gerontology , cancer , environmental health , sociology , computer science , operating system
Healthy eating patterns assessed by diet quality indexes have been related to lower risk of colorectal cancer. Previous studies have been performed mostly among whites. We investigated the associations between four diet quality indexes, the Healthy Eating Index 2010 (HEI‐2010), the Alternative Healthy Eating Index 2010 (AHEI‐2010), the alternate Mediterranean diet (aMED) score, and the Dietary Approaches to Stop Hypertension (DASH) score, and colorectal cancer risk in a multiethnic population. We performed a prospective analysis using data from 190,949 adults aged 45–75 years who enrolled the Multiethnic Cohort Study by completing a self‐administered questionnaire in 1993–1996. Participants were African Americans, Native Hawaiians, Japanese Americans, Latinos and whites living in Hawaii and California. During an average 16 years of follow‐up, 4,770 invasive colorectal cancer cases were identified. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (95% CIs). Both in men and women, all four scores were inversely associated with risk of colorectal cancer adjusting for age and race/ethnicity in a dose‐dependent manner. In multivariate models, further adjustment for covariates slightly weakened the associations, especially in women, and the associations with the AHEI‐2010 and aMED score were no longer statistically significant. Tests for heterogeneity did not show statistically significant differences in the associations between men and women (P's for heterogeneity > 0.13). In men, the risk reductions were greater for the HEI‐2010 (HR=0.69, 95% CI: 0.59–0.80 for quintile 5 vs. 1), AHEI‐2010 (HR=0.75, 95% CI: 0.65–0.85), and DASH score (HR=0.75, 95% CI: 0.66–0.86) than for the aMED score (HR=0.84, 95% CI: 0.73–0.97). Associations were stronger for the left colon and rectum than for the right colon for all indexes. The inverse associations were less strong in African Americans than in the other four racial/ethnic groups for all four indexes. Our findings support that high diet quality is associated with a lower risk of colorectal cancer in most racial/ethnic subgroups. Support or Funding Information This work was supported by the National Institutes of Health (U01 CA164973, NCI HHSN261201200423P, P30 CA071789).