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

BackgroundThere 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....

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Published in:Journal of epidemiology and community health (1979) 2017-10, Vol.71 (10), p.961-969
Main Authors: Shaw, Eileen, Warkentin, Matthew T, McGregor, S Elizabeth, Town, Susanna, Hilsden, Robert J, Brenner, Darren R
Format: Article
Language:English
Subjects:
Anti-inflammatory agents
Aspirin
Cancer Biology
Cancer risk
Cancer screening
Colon cancer
Colonoscopy
Colorectal cancer
Colorectal carcinoma
Dietary fiber
Dietary intake
Drug dosages
Drug use
Dysplasia
Ethnicity
Histology
Inflammation
Medical screening
Meta-analysis
Nonsteroidal anti-inflammatory drugs
Pathology
Polyps
Population
Population studies
Tumors
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Summary:BackgroundThere 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.MethodsA 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.ResultsThere 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.ConclusionsDietary fibre intake and NSAID use were associated with a decreased risk of having a HRAP at screening.
ISSN:0143-005X
1470-2738
DOI:10.1136/jech-2016-208606