Associations between dietary and lifestyle risk factors and colorectal cancer in the Scottish population

Evropi Theodoratou*, Susan M. Farrington, Albert Tenesa, Geraldine McNeill, Roseanne Cetnarskyj, Emmanouil Korakakis, Farhat V. N. Din, Mary E. Porteous, Malcolm G. Dunlop, Harry Campbell

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Colorectal cancer (CRC) accounts for 9.7% of all cancer cases and for 8% of all cancer-related deaths. Established risk factors include personal or family history of CRC as well as lifestyle and dietary factors. We investigated the relationship between CRC and demographic, lifestyle, food and nutrient risk factors through a case-control study that included 2062 patients and 2776 controls from Scotland. Forward and backward stepwise regression was applied and the stability of the models was assessed in 1000 bootstrap samples. The variables that were automatically selected to be included by the forward or backward stepwise regression and whose selection was verified by bootstrap sampling in the current study were family history, dietary energy, high-energy snack foods', eggs, juice, sugar-sweetened beverages and white fish (associated with an increased CRC risk) and NSAIDs, coffee and magnesium (associated with a decreased CRC risk). Application of forward and backward stepwise regression in this CRC study identified some already established as well as some novel potential risk factors. Bootstrap findings suggest that examination of the stability of regression models by bootstrap sampling is useful in the interpretation of study findings. High-energy snack foods' and high-energy drinks (including sugar-sweetened beverages and fruit juices) as risk factors for CRC have not been reported previously and merit further investigation as such snacks and beverages are important contributors in European and North American diets.

Original languageEnglish
Pages (from-to)8-17
Number of pages10
JournalEuropean Journal of Cancer Prevention
Volume23
Issue number1
DOIs
Publication statusPublished - Jan 2014

Keywords

  • bootstrap sampling
  • colorectal cancer
  • risk factors
  • stepwise regression
  • food-frequency questionnaire
  • low-dose aspirin
  • colon-cancer
  • coffee consumption
  • prospective cohort
  • magnesium intake
  • adenomatous polyps
  • primary prevention
  • randomized trial
  • alcohol intake

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