TY - JOUR
T1 - Pre- and post-diagnostic dairy intake in relation to recurrence and all-cause mortality in people with stage I-III colorectal cancer
AU - van Lanen, Anne-Sophie
AU - Kok, Dieuwertje E.
AU - Wesselink, Evertine
AU - Winkels, Renate M.
AU - van Halteren, Henk K.
AU - de Wilt, Johannes H. W.
AU - Kampman, Ellen
AU - van Duijnhoven, Fränzel J. B.
N1 - Funding Information: This work was supported by Wereld Kanker Onderzoek Fonds (WKOF) & World Cancer Research Fund International (WCRF International) as well as by funding (2014/1179, IIG_FULL_2021_022 and IIG_FULL_2021_023) obtained from the Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant programme; Alpe d’Huzes/Dutch Cancer Society (UM 2012–5653, UW 2013–5927, UW 2015–7946); and ERA-NET on Translational Cancer Research (TRANSCAN: Dutch Cancer Society (UW2013-6397, UW2014-6877) and the Netherlands Organization for Health Research and Development (ZonMw), the Netherlands) and the Regio Deal Foodvalley (162135). The funders had no role in the design of the study; the collection, analysis and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication. Funding Information: The authors would like to thank all participants, the involved co-workers in the participating hospitals, and the COLON investigators at Wageningen University & Research. Also, the authors would like to thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry. Publisher Copyright: © 2023, The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - Purpose: Higher dairy consumption is associated with a lower risk of colorectal cancer (CRC), but no studies thus far have investigated its relation with recurrence in CRC. Few studies have investigated total dairy in relation to mortality in CRC, and yielded inconsistent results. Methods: In this prospective cohort study, people newly diagnosed with stage I-III CRC filled out a food frequency questionnaire at diagnosis (n = 1812) and six months after diagnosis (n = 1672). We examined associations between pre- and post-diagnostic intake of total dairy, low-fat dairy, high-fat dairy, milk, yoghurt, and cheese with recurrence and all-cause mortality using multivariable Cox proportional hazard models and restricted cubic splines (RCS). Results: A total of 176 recurrences and 301 deaths occurred during a median follow-up of 3.0 and 5.9 years, respectively. Before diagnosis, a higher low-fat dairy intake was associated with a lower risk of recurrence (HR Q4vsQ1: 0.42, 95% CI 0.26–0.67; P RCS: 0.008) and all-cause mortality (HR Q4vsQ1: 0.58, 95% CI 0.41–0.81; P RCS < 0.001), whereas a higher high-fat dairy consumption tended to be associated with an increased all-cause mortality risk (HR Q4vsQ1: 1.41, 95% CI 0.98–2.01; P RCS: 0.030). After diagnosis, only the associations between low- and high-fat dairy in relation to all-cause mortality remained. Conclusions: This study demonstrated that higher pre- and post-diagnostic intakes of low-fat dairy were associated with a reduced all-cause mortality risk in people with stage I-III CRC, whereas higher intakes of high-fat dairy were associated with an increased all-cause mortality risk. Also, a higher pre-diagnostic low-fat dairy intake was associated with a reduced risk of recurrence. Trial registration: Clinical Trials.gov identifier: NCT03191110.
AB - Purpose: Higher dairy consumption is associated with a lower risk of colorectal cancer (CRC), but no studies thus far have investigated its relation with recurrence in CRC. Few studies have investigated total dairy in relation to mortality in CRC, and yielded inconsistent results. Methods: In this prospective cohort study, people newly diagnosed with stage I-III CRC filled out a food frequency questionnaire at diagnosis (n = 1812) and six months after diagnosis (n = 1672). We examined associations between pre- and post-diagnostic intake of total dairy, low-fat dairy, high-fat dairy, milk, yoghurt, and cheese with recurrence and all-cause mortality using multivariable Cox proportional hazard models and restricted cubic splines (RCS). Results: A total of 176 recurrences and 301 deaths occurred during a median follow-up of 3.0 and 5.9 years, respectively. Before diagnosis, a higher low-fat dairy intake was associated with a lower risk of recurrence (HR Q4vsQ1: 0.42, 95% CI 0.26–0.67; P RCS: 0.008) and all-cause mortality (HR Q4vsQ1: 0.58, 95% CI 0.41–0.81; P RCS < 0.001), whereas a higher high-fat dairy consumption tended to be associated with an increased all-cause mortality risk (HR Q4vsQ1: 1.41, 95% CI 0.98–2.01; P RCS: 0.030). After diagnosis, only the associations between low- and high-fat dairy in relation to all-cause mortality remained. Conclusions: This study demonstrated that higher pre- and post-diagnostic intakes of low-fat dairy were associated with a reduced all-cause mortality risk in people with stage I-III CRC, whereas higher intakes of high-fat dairy were associated with an increased all-cause mortality risk. Also, a higher pre-diagnostic low-fat dairy intake was associated with a reduced risk of recurrence. Trial registration: Clinical Trials.gov identifier: NCT03191110.
KW - All-cause mortality
KW - Colorectal cancer
KW - High-fat dairy
KW - Low-fat dairy
KW - Recurrence
KW - Yoghurt
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85163762755&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37393586
UR - http://www.scopus.com/inward/record.url?scp=85163762755&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00394-023-03201-0
DO - https://doi.org/10.1007/s00394-023-03201-0
M3 - Article
C2 - 37393586
SN - 1436-6207
VL - 62
SP - 2891
EP - 2904
JO - European Journal of Nutrition
JF - European Journal of Nutrition
IS - 7
ER -