alcohol intake physical activity intake, consumption of red and processed meat , fish and shell fish, fruits and vegetables 560/ Incidence, colon, ≥ 0.846 vs < 0.734 1.52 (1.12 to Ptrend:0.002 292/ Incidence, rectal, men ≥ 103 vs < 86 1.93 (1.19 to 3.13) Ptrend:0.16 291/ Incidence, rectal, women 1.20 (0.81 to Ptrend:0.17 MacInnis, 2006 COL40751 Australia MCCS, Prospective Cohort, Age: 27-75 years, W 212/ 24 072 10.4 years Cancer registry, medical records Measured Incidence, cancer Per 0.1 unit increase 1.31 (1.08-1.58) Country of birth, education level, HRT use ≥ 0.80 vs < 0.75 1.7 (1.1-2.4) MacInnis, 2006 COL40627 Australia MCCS, Prospective Cohort, Age: 27-75 years, M/W 229/ 41 114 10.3 Cancer registry Measured Incidence, rectal cancer Q 3 vs Q 1 1.30 (0.9-1.8) Per 0.1 unit 1.24 (1.02-1.51) 134/ Incidence, rectal cancer, men Per 0.1 unit 1.18 (0.90-1.55) Q 3 vs Q 1 1.25 (0.80-1.80) 95/ Per 0.1 unit 1.31 (1.0-1.72)
W, Registered nurses history of specific cancer, postmenopausal hormone use, red meat intake Giovannucci, 1995 COL00110 USA HPFS, Prospective Cohort, Age: 40-75 years, M 117/ 31 055 6 years Self-reported Incidence, cancer, 65% who completed 1987 questionnaire ≥0.99 vs ≤0.89 3.41 (1.52-7.66) Ptrend:0.01 Age, alcohol consumption, aspirin use, dietary fiber intake, energy intake, family history of specific cancer, folate intake, history endoscopic screening, methionine intake, physical activity, previous polyp diagnosis, red meat intake, smoking habits Mid-point categories
Table 337 Waist to hip ratio and colorectal cancer risk. Main characteristics of studies excluded from the CUP SLR dose-response Author, Year, WCRF Code, Country name, characteristics Cases/ Study size Follow-up Case ascertainment Exposure assessment Outcome Comparison RR (95%CI) Ptrend Adjustment factors Inclusion/ exclusion reasons Kabat, 2015 COL41034 USA WHI, Prospective Cohort, Age: 50-79 years, 1 908/ 143 901 12.7 years Self-report verified by medical record and pathology report Measured Incidence, colorectal cancer 1.65 (1.40-1.93) Age, alcohol, aspirin use, smoking, HRT use, diabetes, educational level, ethnicity, family history of colorectal No specific quintile ranges Heo, 2015 COL41057 USA WHI, Prospective Cohort, Age: 50-79 years, W Postmenopausal 1 904/ 144 701 12 years Self-report verified by medical record and pathology report Measured Incidence, colorectal cancer per 1 score 1.12 (1.08-1.16) Age, alcohol, aspirin use, diabetes, educational level, ethnicity, family history of colorectal cancer, folate intake, height, hormone use, physical activity, randomisation, red meat intake, smoking Exposure is z-WHR ≥0.75 vs ≤0.74 1.18 (1.07-1.30) Brändstedt, 2014 COL41022 Sweden MDCS, Prospective Cohort, Age: 44-74 years, M/W 26/ 28 098 18 Cancer registry Incidence, colorectal cancer, men braf mutated ≥0.9 vs ≤0.8 1.20 (0.43-3.34) Ptrend:0.697 Gene interaction data analysis
Hartz, 2012 COL40901 USA WHI, Prospective Cohort, Age: 50-79 W, Postmenopausal 1 181/ 141 652 8 Measured Incidence, colon cancer per 1 sd units 1.14 Age, alcohol, BMI, educational level, Income, physical activity, race, region, smoking, treatment allocation No specific increment Lee, 2009 COL40764 China SWHS, Prospective Cohort, Age: 40-70 years, W 394/ 73 224 7.4 years Cancer registry and death certificates and participant contact Incidence, colorectal cancer ≥0.84 vs ≤0.77 1.20 (0.90-1.60) Ptrend:0.27 Age, energy intake Superseded by Li, 2013 COL40937 Gunter, 2008 COL40737 USA WHI, Case-cohort study, Age:50-79 years 438/ 1 247 Self-reported verified by medical record Examined at baseline Incidence, colorectal cancer 0.85 vs 0.74 1.47 (1.04-2.09) Ptrend: 0.01 Age Superseded by 2013 COL40965 Ahmed, 2006 COL40617 USA ARIC, Prospective Cohort, Age: 45-64 years, M/W 107/ 14 109 11.5 years Cancer registry & hospital surveillance Measured Incidence, colorectal cancer, men ≥1 vs ≤0.92 2.38 (1.30-4.20) Used in HvsL analysis only McCarl, 2006 COL40633 USA IWHS, Prospective Cohort, Age: 55-69 years, W 954/ 35 197 15 SEER registry Incidence, colorectal cancer ≥0.91 vs ≤0.75 1.46 (1.19-1.80) Age Superseded by Oxentenko, 2010 COL40849
years Bostick, 1994 COL00079 USA IWHS, Prospective Cohort, Age: 55-69 W 212/ 35 216 167 447 SEER Self-reported Incidence, colon cancer ≥0.91 vs ≤0.76 1.25 (0.83-1.88) Ptrend:0.30 Age, energy intake, height, parity, vitamin a supplement, vitamin intake, vitamin e intake age Superseded by Folsom, 2000 COL01688 Bostick, 1993 COL00483 USA IWHS, Prospective Cohort, Age: 55-69 years, W 212/ 35 216 167 447 SEER Self-reported Incidence, cancer 0.84 Mean exposure reported Bostick, 1993 COL01450 USA IWHS, Prospective Cohort, Age: 55-69 years, W 212/ 35 216 167 447 SEER Self-reported Incidence, colon cancer Mean exposure reported Schoen, 1990 COL00183 USA Cardiovascular Health Study, Prospective Cohort, Age: >65 102/ 5 849 Hospital record Measured Incidence, cancer Q4 vs Q1 2.6 (1.4-4.8) Age, sex, physical activity Used in HvsL analysis
344Height and colorectal cancer risk. Main characteristics of studies included in the CUP SLR dose-response meta-analysis Author, Year, WCRF Code, Country Study name, characteristics Cases/ size Follow-up Case ascertainment Exposure assessment Outcome Comparison RR (95%CI) Ptrend Adjustment factors Missing data derived for analyses Boursi, 2014 COL41032 UK THIN, Nested Case Control, Age: 40- M/W 5 617/ 15122 controls Medical records Medical records Incidence, colorectal cancer, men > 179 vs < 170 cm Alcohol, BMI, colonoscopy, connective tissues disease, diabetes, heart disease, NSAID use, smoking Mid-point categories Per 10 cm increase 1.1 (1.05-1.15) 4 361/ 11725 controls Incidence, colorectal cancer, women >165 vs <156 cm 1.25 (1.12-1.39) Per 10 cm increase 1.16 (1.1-1.23) Kabat, 2014 COL41031 USA NIH-AARP, Prospective Cohort, Age: 50-71 years, M/W, Retired 1 311/ 481 197 10.5 Cancer registry and national death Index Self-reported height Incidence, colon cancer, women per 10 cm 1.19 (1.10-1.29) Age, age at menarche, alcohol, BMI, colonoscopy, educational level, family history of cancer, physical activity, race, smoking 2 860/ Self-reported height Incidence, cancer, men 1.10 (1.05-1.16) 1 427/ Self-reported height Incidence, rectal cancer, men 1.09 (1.02-1.17) 591/ Self-reported height Incidence, rectal cancer, women 1.12 (0.99-1.26) Kabat, 2013 COL40979 USA WHI, Prospective Cohort, Age: 50-79 years, 1 516/ 144 701 12 years Cancer registry and national death Index Self-reported height Incidence, colorectal cancer 1.19 (1.10-1.28) 1 904/ 144 701 Incidence, colon cancer 1.18 (1.08-1.29)
W ethnicity, family history of colorectal cancer, folate intake, HRT use, pack-years of cigarette smoking, physical activity, randomisation, red meat 12 years 257/ 481 197 10.5 years Incidence, rectal cancer 1.37 (1.1-1.7) Kabat, 2013 COL40945 Canada CNBSS, Prospective Cohort, Age: 40-59 years, W 1 096/ 88 256 16.2 years Record linkages to cancer database and to the national mortality database Height and weight measured at the Initial examination. Incidence, colorectal cancer per 10 cm 1.13 (1.02-1.24) Age, BMI, hormone replacement therapy, menopausal status, oral contraceptive use, pack yrs of smoking, of education 769/ Incidence, colon cancer per 10 cm 1.12 (1.00-1.26) 338/ Incidence, rectal cancer per 10 cm 1.15 (0.97-1.37) Walter, 2013 COL40999 USA VITAL, Prospective Cohort, 491/ 65 038 7.3 years Cancer registry Questionnaire Incidence, colorectal cancer per 5 inch 1.12 (0.94-1.32) Age, sex, race Increment converted to 5 cm
Age: 50-76 years, M/W Green, 2011 COL40879 UK MWS, Prospective Cohort, Age: 56 W 6 281/ 1 297 124 9.4 Cancer registry Questionnaire Incidence, colon cancer per 10 cm 1.25 (1.17-1.32) Age, age at first child birth, age at menarche, alcohol, BMI, parity, region, smoking, status, strenuous exercise Hughes, 2011 COL40895 Netherlands NLCS, Prospective Cohort, Age: 55-69 M/W 1 211/ 120 852 16.3 Cancer registry Self-reported height and Incidence, colorectal cancer, men 183-200 vs cm 0.80 (0.60-1.08) Ptrend:0.16 1 211/ Incidence, colorectal cancer, men per 5 cm 0.96 (0.89-1.04) 1 106/ Incidence, colorectal cancer, women 171-186 vs cm 1.32 (1.03-1.71) Ptrend:0.05 1 106/ Incidence, colorectal cancer, women per 5 cm 1.09 (1.01-1.17)
459/ Incidence, proximal colon cancer, women 171-186 vs cm 1.19 (0.84-1.70) Ptrend:0.67 459/ Incidence, proximal colon cancer, women per 5 cm 1.04 (0.95-1.15) 427/ Incidence, distal cancer, men 183-200 vs cm 0.97 (0.63-1.48) Ptrend:0.70 427/ Incidence, distal colon cancer, men per 5 cm 0.99 (0.89-1.11) 327/ Incidence, proximal colon cancer, men 183-200 vs cm 0.90 (0.59-1.37) Ptrend:0.66 327/ Incidence, proximal cancer, men per 5 cm 1.01 (0.90-1.13) 327/ Incidence, distal colon cancer, women 171-186 vs cm 1.53 (1.03-2.27) Ptrend:0.05 327/ Incidence, distal cancer, women per 5 cm 1.11 (0.99-1.24) 205/ Incidence, cancer, 171-186 vs cm 1.49 0.98, 2.27 160
Age: 40-64 years, M/W, adults residence, BMI, occupation, physical activity, salary, smoking habits 1007/ Incidence, colon cancer, women ≥171.1 vs ≤164.5 cm 1.21 (1.01-1.46) Per 5 cm 1.08 (1.01-1.15) 2281/ Incidence, rectal cancer, men ≥158.1 vs ≤151 cm 1.16 (1.03-1.31) Per 5 cm 1.06 (1.01-1.1) 892/ Incidence, rectal cancer, women 0.92 (0.75-1.12) Per 5 cm 1.00 (0.94-1.08) Bowers, 2006 COL40699 Finland ATBC, Prospective Cohort, Age: 58 M, Smokers 410/ 28 983 14.1 years Cancer registry Measured by trained staff Incidence, colorectal cancer 179-200 vs cm 0.90 (0.64-1.27) Ptrend:0.17 Age, number of cigarettes smoked, weight Mid-point categories 227/ Incidence, colon cancer 0.82 (0.78-1.53) 183/ Incidence, rectal cancer 1.02 (0.61-1.7) Pischon, 2006 COL01985 Europe EPIC, Prospective Cohort, Age: 25-70 421/ 368 277 2 254 727 person-years Population registries Self-reported questionnaires Incidence, cancer, women ≥180.5 vs <167 cm 1.79 (1.3-2.46)
COL40751 Australia MCCS, Prospective Cohort, Age: 27-75 years, W 24 072 10.4 years Incidence, cancer Age, sex, country of birth, HRT use Person-years of follow up ≥161 vs ≤155 cm 1.1 (0.8-1.5) MacInnis, 2004 COL00373 Australia MCCS, Prospective Cohort, Age: 27-75 years, M 153/ 16 566 145 433 Person years Cancer registry Incidence, colon cancer Per 10 cm 1.43 (1.12-1.83) Age, sex, country of >177.4 vs <167.5 cm 1.9 (1.1-3.1) Engeland, 2005 COL01941 Norway NCC, Prospective Cohort, Age: 20-74 years, M/W 22 987/ 1 999 978 23 years Health survey, cancer registry, death registry Height and weight measured by trained Incidence, colorectal cancer, men ≥180 vs <160 cm 1.14 (1.10-1.18) 24 130/ Incidence, colorectal cancer, ≥170 vs <150 cm 1.14 (1.09-1.19) 13 805/ Incidence, cancer, men ≥180 vs <160 cm 1.18 (1.13-1.23) 16 638/ Incidence, colon cancer, women ≥170 vs <150 cm 1.18 (1.12-1.24) 9 182/ Incidence, rectal cancer, men ≥180 vs <160 cm 1.08 (1.03-1.14)
years Age: 20-69 years, M/W 99/ Incidence, cancer, women 1.08 (0.8-1.47) 169 Incidence, colon cancer, men 1.02 (0.82-1.25) 55/ Incidence, colon cancer, women 0.88 (0.59-1.32) Bostick, 1994 COL00079 USA IWHS, Prospective Cohort, Age: 55-69 years, W 212/ 35 216 167 447 SEER Incidence, colon cancer ≥67 vs ≤63 inch 1.23 (0.83-1.84) Age, energy intake, parity, vitamin a supplement, vitamin E intake Albanes, 1988 COL00495 USA NHANES I Age: 25-74 years, M/W 62/ 12 554 10 years Hospital records, death certificate Measured Incidence, colorectal cancer, men Q4 vs Q1 2.1 (1.00-4.5) Age 67/ Incidence, colorectal cancer, women 1.6 (0.8-3.0) Hebert, 1997 COL00430 USA PHS Age: 40-84 years M 341/ 22 071 12 years Medical records Self-reported Incidence, colorectal cancer ≥73 vs <68inch 1.53 (1.04-2.25) Age, BMI, Aspirin use, smoking, alcohol consumption, physical activity Incidence, colon cancer 1.70 (1.08-2.66)
Incidence, right colon, women ≥159 vs ≤151 cm 1.04 (0.80-1.36) Incidence, colon cancer, women ≥159 vs ≤151 cm 1.24 (1.04-1.47) Simons, 2014 COL41029 Netherlands NLCS, Case Cohort, Age: 55-69 years 204/ Cancer registry Questionnaire Incidence, colorectal cancer, 2 genes methylated Q 3 vs Q 1 1.23 (0.84-1.79) Ptrend:0.28 Age, sex, physical activity, weight Gene methylation data Incidence, colorectal cancer, Igfbp 2 genes methylated per 5 cm 1.05 (0.93-1.19) Semmens, 2013 COL40929 Japan Life Span Prospective Cohort, M/W 1 142/ 56 064 Cancer registry Self-reported Incidence, cancer Q 3 vs Q 1 1.24 (1.05-1.47) Age, sex, city attained age Participants are atomic bomb survivors Incidence, cancer per 10 cm 1.10 (0.99-1.22) 577/ Incidence, colon cancer, women 153-155 vs ≤149 cm 1.27 (0.99-1.63) 565/ Incidence, cancer, men 164-168 vs ≤160 cm 1.23 (0.97-1.55) 565/ Incidence, cancer, men per 10 cm 1.06 (0.92-1.23)
Hughes, 2012 COL40943 Netherlands NLCS, Case Cohort, Age: 55-69 years, M/W 561/ 4 654 7.3 years Cancer registry and pathology database Height (cm) and body weight (kg) were Incidence, colorectal cancer, braf wildtype per 5 cm 1.08 (1.01-1.15) Sex, ethnicity Gene interaction data Hughes, 2012 COL40944 Australia MCCS, Prospective Cohort, Age: 27-75 years, M/W 495/ 40 154 Cancer registry/death records/national death Index Measured Incidence, colorectal cancer, per 5 cm 1.07 (0.99-1.15) Sex, ethnicity Gene interaction data Cnattingius, 2009 COL40776 Sweden STC, Prospective Cohort, Age: 248/ 2 337 33 year Population cancer registries Questionnaire Incidence, colorectal cancer Q4 vs Q2 1.00 (0.70-1.44) Age Used in HvsL analysis only Whitley, 2009 COL40677 Boyd Orr Cohort 59/ 2 642 59 years Cancer registry and death certificates Measured Incidence/ mortality, colorectal cancer Per 1 SD 1.06 (0.84-1.33) Age, sex Childhood stature The level of increment is not specified Lundqvist, 2007 COL40692 Sweden, Finland Sweden, Finland Co-twin study, 1975, Prospective Cohort, Age: 44 years, M/W 717/ 68 149 25.2 years National cancer registers Measured, BMI & height Incidence, colon cancer Highest vs lowest 1.12 (1.00-1.50) Age, county of residence, diabetes, educational physical activity, smoking status Used in HvsL analysis only 479/ Incidence, rectal cancer 1.00 (0.70-1.20)
McCarl, 2006 COL40633 USA IWHS, Prospective Cohort, Age: 55-69 W 954/ 35 197 15 years SEER registry Incidence, colorectal cancer ≥67 vs <62 inch 1.42 (1.17-1.72) Age Superseded by Oxentenko, 2010 COL40849 Norat, 2005 COL01698 Europe EPIC, Prospective Cohort, Age:21-83 Years M/W 1 329 /478 040 2 279 075 person years Cancer registry Incidence, colorectal cancer Mean exposure reported Pischon, 2006 used COL01985 Giovannucci, 2004 COL00615 USA HPFS, Prospective Cohort, Age:40-75 Years M 494/ 47 690 12 years Cancer registry Incidence, colon cancer Per 9 inch 1.68 (1.18-2.38) Age, race, smoking status, alcohol consumption Wei, 2004 Used COL00581 Tamakoshi, 2004 COL00551 JACC, Prospective Cohort, Age: 40-79 years M/W 249/ 74 320 1 016 485 Person Cancer registry Self-reported Incidence, colon cancer, men ≥165 vs <161 cm 1.58 (0.91-2.73) Age, race, smoking status, alcohol consumption, meat, intake, green leafy vegetables intake, family history of cancer Mortality Incidence, colon cancer, women ≥153 vs <150 1.38 (0.77-2.48)
Colangelo, 2002 COL00383 USA CHA Detection Project in Industry, Prospective Cohort, Age: ≥ 40 years 191/ 35 582 866 926 National Death Index Height and weight were measured Mortality, colorectal cancer, men Per 7 cm 1.24 (1.07-1.43) Age, race, education, sex Mortality 126/ Mortality, colorectal cancer, women 0.95 (0.79-1.16) Davey Smith, 2000 COL00390 Scotland The Renfrew/Paisley General Population Study, Prospective Cohort, Age: 45-64 years 201/ 15 393 20 years Area residency list Measured Mortality, colorectal cancer Per -10 cm 0.7 (0.56-0.88) Age, social class, deprivation category Mortality Robsahm, 1999 COL00180 Norway NSPT, Prospective Cohort, Age: M/W / 112 2852 Incidence, colon cancer, men Q5 vs Q1 1.37 (1.27-1.49) Used in HvsL only Incidence, colon cancer, women 1.35 (1.26-1.45) Incidence, rectal cancer, men 1.17 (1.06-1.29) Incidence, rectal cancer, women 1.18 (1.06-1.03)
Tangrea, 1997 COL00267 Finland ATBC, Nested Case Control, Age: 50-69 years, M, Smokers 146/ Population registries Incidence, colorectal cancer Age, clinic site, date of blood drawn No RR reported Gaard, 1997 COL00163 Norway NHSCD, Prospective Cohort, Age: M/W 292/ 62 173 Incidence, cancer, men Highest vs lowest 0.89 (0.48-1.61) Used in HvsL analysis only Incidence, colon cancer, women 0.83 (0.43-1.64) 106 (M+W) Incidence, rectal cancer, men 1.44 (0.67-3.12) Incidence, rectal cancer, women 0.91 (0.36-2.29) Giovannucci, 1995 COL00110 USA HPFS, Prospective Cohort, Age: 40-75 M 203/ 31 055 6 years Self-reported verified by medical record and The National Death Index Incidence, colon cancer, colon cancer ≥73 vs <69 cm 1.76 (1.13-2.74) Age, alcohol consumption, energy intake, family history of specific cancer, physical activity, smoking habits, aspirin use, dietary fibre intake, folate Superseded by Wei, 2004 COL00581
intake, history endoscopic screening, history polyp diagnosis, methione intake, red meat intake Chyou, 1994 COL00086 USA HHP, Prospective Cohort, M, Japanese ancestry 289/ 7 945 19 years Selective service draft registration file Incidence, cancer Mean exposure 86.9 cm Mean exposure reported 108/ Incidence, rectal cancer 86.7 cm Suadicani, 1993 COL01085 Denmark Copenhagen CVD Prospective Cohort, Age: M 93/ 5429 Incidence, rectal cancer 178-198 vs cm 0.32 (0.11-1.00) Used in HvsL analysis only Le Marchand, 1992 COL00676 USA HHCS, Prospective Cohort, Age: M 203/ 3 501 Incidence, rectal cancer Q3 vs Q1 0.8 (0.5-1.3) Used in HvsL analysis only Chute, 1991 COL00475 USA NHS, Prospective Cohort, 191/ 118 404 8 years Self-reported verified by medical record Self-reported Incidence, colon cancer ≥168 vs <161 1.6 (1.1-2.5)
Age: 30-55 W, nurses and The National Death Index 49/ Incidence, rectal cancer 1.2 (0.6-2.6) Tartter, 1984 COL01088 USA New York Mount Sinai Medical Centre Study, Prospective Cohort, M/W 63/ 279 Hospital Recurrence, colorectal cancer Recurrence No RR reported
B . Randomized controlled trials with colorectal adenomas as primary endpoint published after the 2007 WCRF Expert Report (Only the most recent publication of a or that with the larger number of cases is shown). Pattern of diet ( Low fat, high fruits and vegetables) Author, Year, Country Study name Study name, characteristics Cases Treatment/ control Case Outcome Treatment/ comparison RR (95%CI) Ptrend Sansbury, 2009 Polyp Prevention USA Randomised Control 947 control group, 958 intervention group Age at least 35- years, M/W with at one histologically confirmed colorectal adenoma identified 4 years follow-up 65/347 Full colonoscopies at baseline, their 1-year visit, and the end of the intervention, about 4 years after Adenoma recurrence intervention (20% energy intake from fats, at least 18 g of fibre and 3.5 servings of fruits and vegetables per 1,000 kcal) vs no intervention 0.65 0.92) 7/66 Advanced adenoma 0.44 (0.18- 1.05)
Author, Year, Country name Study name, Cases Treatment/ control Case Outcome Treatment/ comparison RR (95%CI) Ptrend Gao, 2013 China 980 men and women (> 50 years) confirmed no adenoma by colonoscopy in past 5 years Average 37.8 months of follow-up 64/132 Colonoscopy examination (Colorectal adenoma occurrence was primary outcome) Any adenoma 1 mg/day folic acid supplement or treatment without folic acid 0.74 (0.65-0.85) 42/78 |Left colon adenoma 0.40 (0.33-0.49) 16/29 Right colon adenoma 0.77 (0.55-1.09) 8/22 Advanced adenoma 0.67 (0.58-0.76) Figuereido, 2009 US, Canada, UK Aspirin/Folate Polyp Prevention Study (AFPPS) NHS/HPFS Prevention Study, United Kingdom Colorectal Adenoma Prevention (ukCAP) Pooled analyses of 3 trials: 1,324 participants treatment, 1,308 placebo Up to 3.5 years of treatment 343/339 Large bowel endoscopy and pathology review Adenoma recurrence 0.5 or 1.0 mg/ day of folic acid or placebo 0.98 (0.82–1.17) P=0.81 105/97 Advanced lesions 1.06 (0.81–1.39) P=0.65 Jaszewski, 2008 USA 49 treated, 45 placebo 49/45 Colonoscopy Any adenoma 5 mg/day acid for 3 Lower number of adenomas/ patient in the intervention
3 year years vs placebo group (0.36 ± 0.69) compared to placebo group (0.82 ± 1.17) P=0.02 5.6.3 Calcitriol, acetylsalicylic acid, and calcium carbonate Author, Year, Country name Study name, characteristics Cases Treatment/ control Case Outcome Treatment/ comparison RR (95%CI) Ptrend Pommergaard, 2015 Europe, USA, Russia, Men and aged 40-75 years with previous adenoma, 209 assigned to 0.5 μg calcitriol, 75 mg acetylsalicylic acid, and 1250 mg calcium carbonate each day for 3 years, 218 with placebo 52/58 colonoscopy 3 years Adenoma recurrence assessed Treatment vs placebo 0.94 (0.60–1.48)
5.6.3 Calcium and Vitamin D Author, Year, Country Study name Study name, characteristics Treatment/ control Case Outcome Treatment/ comparison RR (95%CI) Ptrend Baron, 2015 USA Calcium Polyp Prevention Study Patients with past diagnosed adenomas and no known colorectal polyps remaining after complete colonoscopy Partial 2x2 factorial design: 2259 participants to receive daily vitamin D3 (1000 IU), calcium as carbonate (1200 mg), both, or neither 438/442 Colonoscopy was anticipated to be performed after 3 or 5 years Adenomas (primary end point) Vitamin D vs no Vitamin D 0.99 (0.89–1.09) 345/362 Calcium vs no calcium 0.95 (0.85–1.06) 259/259 Calcium and Vit D vs calcium alone 1.01 (0.88–1.15) 174/183 Calcium and Vitamin D vs placebo 0.93 (0.80–1.08)
14.2.4 Influence of updated studies in the overall results We will do influence-analyses to assess the effect of each updated study on the summary risk estimates8 . References 1. World Cancer Research Fund/ American Institute for Cancer Research. Systematic Literature Review – Support Resource. In : Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective.Washington DC: AICR , 2007 2. Cancer Research Fund/ American Institute for Cancer Research. Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective.page 305 Washington DC: AICR , 2007 3. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188 4. N Orsini, R Bellocco and S Greenland, Generalized least squares for trend estimation of summarized dose-response data, Stata J 6 (2006), pp. 40–57 5. Chêne G, Thompson SG. Methods for summarizing the risk associations of variables in epidemiologic studies in a consistent form.Am J Epidemiol. 1996;144(6):610-21. 6. JP Higgins and SG Thompson, Quantifying heterogeneity in a meta-analysis, Stat Med 21 (2002), pp. 1539–1558. 7. Bekkering GE et al. How much of the data published in observational studies of the association between diet and colorectal or bladder cancer is usable for meta-analysis? Am J Epidemiol (2008);167(9):1017-26. 8. A Tobias, Assessing the influence of a single in meta-analysis, Stata Tech Bull 47 (1999), pp. 15–17. Continuous update of the WCRF-AICR report on diet and cancer Protocol: Colorectal cancer
Pyridoxic acid (vit B6) Phytoestrogen: Genistein, Daidzein Chemical food contaminants Polychlorinated biphenyls (PCBs) Phytochemicals 4-pyridoxic acid (vit B6) in 24-h urine Nitrosamines Xanthurenic acid in 24-h urine Arsenic Ferritin Saliva Other dietary lipids: Cholesterol, Triglycerides Erythrocyte Linoleic acid Selenium Superoxide dismutase Cadmium Minerals: Zinc, Copper Monounsaturated fatty acids n-3 fatty acids: EPA (Eicosapentaenoic), DHA (Docosahexaenoic) n-6 fatty acids (other than linoleic acid) Polyunsaturated fatty acids, Saturated fatty acids Glutathione peroxidase Measured in Include Exclude Plasma Vit D Vit E: alpha-tocopherol, gamma Vit C Provit A carotenoids: Carotene, B-carotene Nonprovit A carotenoids: Lycopene, Cryptoxanthin (B-), zeaxanthin, Lutein Selenium, Selenoprotein Folate, Iron: ferritin Alkaline phosphatase Minerals: Zinc, Copper, caeruloplasmin Other dietary lipids: Cholesterol, Triglycerides, LDL, HDL
COL40725 Flood A 2005 Prospective Cohort BCDDP Women colorectal cancer New Yes Yes exposure values + PY per quantile rectum cancer New Yes Yes exposure values + nb of cases and PY per quantile colon cancer New Yes Yes distal cancer New Yes Yes proximal colon cancer New Yes Yes COL01690 Lin 2005 Prospective Cohort Health Study colorectal cancer Yes (Dose ; Hvs.L) Yes Yes exposure values + PY per quantile COL01843 2005 Prospective Cohort EPIC-E3N Women colorectal cancer New No No Results from Jenab 2010 are more recent COL00053 Koh 2004 Nested Case Control Singapore Chinese Health study Mixed colorectal cancer Yes (Dose No No No result COL00581 Wei E.K. 2004 Prospective Cohort health professionals follow-up study Men colon cancer Yes (Hvs.L) No Yes Missing PY==>even if less recent, the result from COL00156 is retained rectum cancer Yes (Hvs.L) No Yes COL00581 Wei E.K. 2004 Prospective Cohort Nurses' Health Study Cohort Women colon cancer Yes (Hvs.L) No Yes Missing PY==>even if less recent, the result from COL00131 is retained rectum cancer Yes (Hvs.L) No Yes COL00366 McCulloug h 2003 Prospective Cohort Cancer Prevention Study II Nutrition Cohort Men/Women colorectal cancer Yes (Dose ; Hvs.L) Yes Yes Mid- exposure values + PY per quantile Men proximal colon cancer Yes (Dose ; Hvs.L) No Yes Missing PY Men distal cancer Yes (Dose ; Hvs.L) No Yes Men colon cancer Yes (Dose ; Hvs.L) No Yes Men rectum cancer Yes (Dose ; Hvs.L) No Yes COL00560 2002 Prospective Cohort Sweden screening cohort study Women colorectal cancer Yes (Dose ; Hvs.L) Yes Yes PY per quantile colon cancer Yes (Dose ; Hvs.L) Yes Yes proximal colon Yes (Dose ; Hvs.L) Yes Yes
COL00774 Wu 1987 Prospective Cohort Leisure World Cohort Men colorectal cancer Yes (Hvs.L) No Yes Missing data for exposure ("tertiles" without any dose precision) Women colorectal cancer Yes (Hvs.L) No Yes COL01383 Heilbrun 1986 Nested Case Control Honolulu Heart program Men colon cancer Reviewed in text No No No result COL01050 Garland 1985 Prospective Cohort Western Electric Health study Men colorectal cancer Yes (Hvs.L) No No Missing data (RR 95%CI) Total no. of articles = 35 Total no. of individual cohort studies = 22 no. of individual cohort studies included = 16 (10 & 14 in CRC/COL; 8 & 8 in COL; 6 & 6 in REC; 3 & 3 in PRO; 3 & 5 in DIS; dose- response and H vs. L meta- analysis respectively) no. of studies included = 13 in CRC; 10 in COL; 8 in REC; 4 in PRO; 4 in DIS Total no. of studies included = 17 in CRC; 11 in COL; 10 in REC; 5 in PRO; 7 in DIS
menopausal - family history of CRC performed as only one new study was identified included in a H vs. L analysis COL00209 Zheng W. et al 1998 Prospective Cohort Iowa Women's Health Women - Post- menopausal rectum cancer Reviewed in text No No Data format not sufficient for a dose-response meta-analysis; H vs. L analysis not performed as only one new study was identified Can be included in a H vs. L analysis COL00155 Kampman 1994 Case Cohort The Netherlands Cohort No Sub-Group colorectal cancer Yes (Hvs.L) No Yes Data format not sufficient for a dose-response meta-analysis COL01450 Bostick 1993 Prospective Cohort Iowa Women's Health Study Women cancer Yes (Hvs.L) No No Superseded by Sellers et al, 1998, COL01974 on the highest versus lowest analysis; dose-response meta-analysis not performed as only one new study was identified Can be included in a dose-response meta-analysis ; overall results were on women instead of subgroup by family history of colorectal cancer as in Sellers et al., 1998, COL01974 Total no. of articles = 11 Total no. of individual cohort studies = 9 Total no. of individual cohort studies included = 6 (6 CRC/COL and 3 COL in H vs. L meta-analysis) - Total no. of studies included = 7 in CRC; 1 in COL