TY - JOUR
T1 - Calcium intake and colorectal cancer risk
T2 - Results from the nurses' health study and health professionals follow-up study
AU - Zhang, Xuehong
AU - Keum, Nana
AU - Wu, Kana
AU - Smith-Warner, Stephanie A.
AU - Ogino, Shuji
AU - Chan, Andrew T.
AU - Fuchs, Charles S.
AU - Giovannucci, Edward L.
N1 - Publisher Copyright:
© 2016 UICC
PY - 2016/11/15
Y1 - 2016/11/15
N2 - The relationship between calcium intake and colorectal cancer (CRC) risk remains inconclusive. We conducted this study to evaluate whether the association between calcium intake and CRC risk differs by anatomic subsite and determine the dose–response relationship for this association, as well as assess when in carcinogenesis calcium may play a role. We assessed calcium intake every 4 years and followed 88,509 women (1980–2012) in the Nurses' Health Study and 47,740 men (1986–2012) in the Health Professionals Follow-Up Study. We documented 3,078 incident CRC cases. Total calcium intake (≥1,400 vs. <600 mg/d) was associated with a statistically significant lower risk of colon cancer (multivariable relative risk: 0.78, 95%CI: 0.65–0.95). Similar results were observed by different sources of calcium (from all foods or dairy products only). The inverse association was linear and suggestively stronger for distal colon cancer (0.65, 0.43–0.99) than for proximal colon cancer (0.94, 0.72–1.22, p-common effects = 0.14). Additionally, when comparing different latencies, the overall pattern suggested that the inverse association appeared to be stronger with increasing latency and was strongest for intakes 12–16 years before diagnosis. Comparing total calcium intakes of ≥1,400 vs. <600 mg/d for intake 12–16 y before diagnosis, the pooled RR (95% CIs) of CRC was 0.76 (0.64–0.91). Higher calcium intake was associated with a lower risk of developing colon cancer, especially for distal colon cancer. Overall inverse association was linear and did not differ by intake source. Additionally, calcium intake approximately 10 years before diagnosis appeared to be associated with a lower risk of CRC.
AB - The relationship between calcium intake and colorectal cancer (CRC) risk remains inconclusive. We conducted this study to evaluate whether the association between calcium intake and CRC risk differs by anatomic subsite and determine the dose–response relationship for this association, as well as assess when in carcinogenesis calcium may play a role. We assessed calcium intake every 4 years and followed 88,509 women (1980–2012) in the Nurses' Health Study and 47,740 men (1986–2012) in the Health Professionals Follow-Up Study. We documented 3,078 incident CRC cases. Total calcium intake (≥1,400 vs. <600 mg/d) was associated with a statistically significant lower risk of colon cancer (multivariable relative risk: 0.78, 95%CI: 0.65–0.95). Similar results were observed by different sources of calcium (from all foods or dairy products only). The inverse association was linear and suggestively stronger for distal colon cancer (0.65, 0.43–0.99) than for proximal colon cancer (0.94, 0.72–1.22, p-common effects = 0.14). Additionally, when comparing different latencies, the overall pattern suggested that the inverse association appeared to be stronger with increasing latency and was strongest for intakes 12–16 years before diagnosis. Comparing total calcium intakes of ≥1,400 vs. <600 mg/d for intake 12–16 y before diagnosis, the pooled RR (95% CIs) of CRC was 0.76 (0.64–0.91). Higher calcium intake was associated with a lower risk of developing colon cancer, especially for distal colon cancer. Overall inverse association was linear and did not differ by intake source. Additionally, calcium intake approximately 10 years before diagnosis appeared to be associated with a lower risk of CRC.
KW - calcium
KW - calcium supplement
KW - colorectal cancer
KW - distal colon cancer
KW - latency
KW - prospective cohort
KW - repeated assessments
UR - http://www.scopus.com/inward/record.url?scp=84986579048&partnerID=8YFLogxK
U2 - 10.1002/ijc.30293
DO - 10.1002/ijc.30293
M3 - Article
C2 - 27466215
AN - SCOPUS:84986579048
SN - 0020-7136
VL - 139
SP - 2232
EP - 2242
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 10
ER -