Fiber Intake and Survival After Colorectal Cancer Diagnosis.

JAMA Oncol
Authors
Keywords
Abstract

Importance: Although high dietary fiber intake has been associated with a lower risk of colorectal cancer (CRC), it remains unknown whether fiber benefits CRC survivors.

Objective: To assess the association of postdiagnostic fiber intake with mortality.

Design, Setting, and Participants: A total of 1575 health care professionals with stage I to III CRC were evaluated in 2 prospective cohorts, Nurses' Health Study and Health Professionals Follow-up Study. Colorectal cancer-specific and overall mortality were determined after adjusting for other potential predictors for cancer survival. The study was conducted from December 23, 2016, to August 23, 2017.

Exposures: Consumption of total fiber and different sources of fiber and whole grains assessed by a validated food frequency questionnaire between 6 months and 4 years after CRC diagnosis.

Main Outcomes and Measures: Hazard ratios (HRs) and 95% CIs of CRC-specific and overall mortality after adjusting for other potential predictors for cancer survival.

Results: Of the 1575 participants, 963 (61.1%) were women; mean (SD) age was 68.6 (8.9) years. During a median of 8 years of follow-up, 773 deaths were documented, including 174 from CRC. High intake of total fiber after diagnosis was associated with lower mortality. The multivariable HR per each 5-g increment in intake per day was 0.78 (95% CI, 0.65-0.93; P = .006) for CRC-specific mortality and 0.86 (95% CI, 0.79-0.93; P 

Conclusions and Relevance: Higher fiber intake after the diagnosis of nonmetastatic CRC is associated with lower CRC-specific and overall mortality. Increasing fiber consumption after diagnosis may confer additional benefits to patients with CRC.

Year of Publication
2018
Journal
JAMA Oncol
Volume
4
Issue
1
Pages
71-79
Date Published
2018 Jan 01
ISSN
2374-2445
DOI
10.1001/jamaoncol.2017.3684
PubMed ID
29098294
PubMed Central ID
PMC5776713
Links
Grant list
R35 CA197735 / CA / NCI NIH HHS / United States
R01 CA118553 / CA / NCI NIH HHS / United States
P01 CA087969 / CA / NCI NIH HHS / United States
U01 CA167552 / CA / NCI NIH HHS / United States
K24 DK098311 / DK / NIDDK NIH HHS / United States
UM1 CA186107 / CA / NCI NIH HHS / United States
R01 CA169141 / CA / NCI NIH HHS / United States
UM1 CA167552 / CA / NCI NIH HHS / United States
P50 CA127003 / CA / NCI NIH HHS / United States
UL1 TR001863 / TR / NCATS NIH HHS / United States
R01 CA202704 / CA / NCI NIH HHS / United States
P01 CA055075 / CA / NCI NIH HHS / United States
R01 CA151993 / CA / NCI NIH HHS / United States
U01 CA176726 / CA / NCI NIH HHS / United States
R01 CA137178 / CA / NCI NIH HHS / United States
R01 CA176272 / CA / NCI NIH HHS / United States