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  • Intake of dietary fibre and lifetime non-steroidal anti-inflammatory drug (NSAID) use and the incidence of colorectal polyps in a population screened for colorectal cancer

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Cancer Biology
Epidemiology and Global Health
Cancer risk
Intake of dietary fibre and lifetime non-steroidal anti-inflammatory drug (NSAID) use and the incidence of colorectal polyps in a population screened for colorectal cancer
  1. Eileen Shaw1,
  2. Matthew T Warkentin1,
  3. S Elizabeth McGregor2,3,4,
  4. Susanna Town5,
  5. Robert J Hilsden2,5,
  6. Darren R Brenner1,2,3
  1. 1 Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
  2. 2 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3 Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  4. 4 Population, Public and Indigenous Health, Alberta Health Services, Calgary, Alberta, Canada
  5. 5 Forzani and MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta, Canada
  1. Correspondence to Dr Darren R Brenner, Department of Cancer Epidemiology and Prevention Research CancerControl Alberta, Alberta Health Services Holy Cross Centre, Calgary, Alberta T2S 3C3, Canada; Darren.Brenner{at}albertahealthservices.ca

Abstract

Background There is suggestive evidence that increased intake of dietary fibre and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are generally associated with decreased colorectal cancer risk. However, the effects on precursors of colorectal cancer, such as adenomatous polyps, are mixed. We present the associations between dietary fibre intake and NSAID use on the presence and type of colorectal polyps in a screening population.

Methods A cross-sectional study of 2548 individuals undergoing colonoscopy at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Canada) was conducted. Dietary fibre intake and NSAID use were assessed using the Diet History Questionnaire I or II and the Health and Lifestyle Questionnaire. Colorectal outcomes were documented as a polyp or high-risk adenomatous polyp (HRAP; villous histology, high-grade dysplasia, ≥10 mm or ≥3 adenomas). Crude and ORs and 95% CIs were estimated using unconditional logistic regression.

Results There were 1450 negative colonoscopies and 1098 patients with polyps, of which 189 patients had HRAPs. Total dietary fibre intake was associated with a decreased presence of HRAPs (OR=0.50, 95% CI: 0.29 to 0.86) when comparing the highest to lowest quartiles and was observed with both soluble (OR=0.51, 95% CI: 0.30 to 0.88) and insoluble (OR=0.51, 95% CI: 0.30 to 0.86) fibres. Ever use of NSAIDs was also inversely associated with HRAPs (OR=0.65, 95% CI: 0.47 to 0.89), observed with monthly (OR=0.60, 95% CI: 0.37 to 0.95) and daily (OR=0.53, 95% CI: 0.32 to 0.86) use.

Conclusions Dietary fibre intake and NSAID use were associated with a decreased risk of having a HRAP at screening.

  • cancer epidemiology
  • diet
  • lifestyle
  • prevention
  • screening

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/jech-2016-208606

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    Footnotes

    • Contributors SEM and RJH were responsible for the conception and design of the original study and data collection from the Forzani & MacPhail Colon Cancer Screening Centre. ST collected the data. DRB conceived the idea and design of the present analysis. ES and MTW carried out the analysis of the data. ES wrote the manuscript. SEM, RJH and DRB contributed to meaningful discussion and critical review of the manuscript. All authors have read and approved the final manuscript.

    • Funding This work was supported by a Career Development Award in Prevention Research (no 703917) from the Canadian Cancer Society held by DRB.

    • Competing interests None declared.

    • Ethics approval Health Research Ethics Board of Alberta.

    • Provenance and peer review Not commissioned; externally peer reviewed.