(22-02-13) B vitamin intakes and incidence of colorectal cancer: results from the Women's Health Initiative Observational

Study cohort1,2,3,4
1. Stefanie Zsch?bitz,
2. Ting-Yuan David Cheng,
3. Marian L Neuhouser,
4. Yingye Zheng,
5. Roberta M Ray,
6. Joshua W Miller,
7. Xiaoling Song,
8. David R Maneval,
9. Shirley AA Beresford,
10. Dorothy Lane,
11. James M Shikany, and
12. Cornelia M Ulrich
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Author Affiliations
1. 1From the Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, MLN, XS, SAAB, and CMU); the Division of Preventive Oncology, National Center for Tumor Diseases, Heidelberg, Germany (SZ and CMU); the Biostatistics and Biomathematics Program (YZ) and the WHI Clinical Coordinating Center (MLN and RMR), Fred Hutchinson Cancer Research Center, Seattle, WA; the Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, CA (JWM); the Food Science and Human Nutrition Department, University of Florida, Gainesville, FL (DRM); the Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, MLN, and SAAB); Stony Brook University Medical Center, Stony Brook, NY (DL); and the Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL (JMS).
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Author Notes
? ↵2 SZ and T-YDC contributed equally to this work.
? ↵3 Supported by NIH grants R01 CA120523 and N01WH22110.
? ↵4 Address correspondence and requests for reprints to CM Ulrich, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120 Heidelberg, Germany. E-mail: [email protected].
Abstract
Background: The role of one-carbon metabolism nutrients in colorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake.
Objective: We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake.
Design: A total of 88,045 postmenopausal women were recruited during 1993?1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95% CIs were estimated by Cox proportional hazards models.
Results: Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95% CI: 0.66, 0.97 and HR: 0.80; 95% CI: 0.66, 0.99, respectively) and total intakes of riboflavin (HR: 0.81; 95% CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01).
Conclusions: Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in postmenopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk

Source: Am J Clin Nutr February 2013vol. 97 no. 2 332-343

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