Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome

Rowena Chau, Seyedeh Ghazaleh Dashti, Driss Ait Ouakrim, Daniel D. Buchanan, Mark Clendenning, Christophe Rosty, Ingrid M. Winship, Joanne P. Young, Graham G. Giles, Finlay A. Macrae, Alex Boussioutas, Susan Parry, Jane C. Figueiredo, A. Joan Levine, Dennis J. Ahnen, Graham Casey, Robert W. Haile, Steven Gallinger, Loïc Le Marchand, Stephen N ThibodeauNoralane Morey Lindor, Polly A. Newcomb, John D. Potter, John A. Baron, John L. Hopper, Mark A. Jenkins, Aung Ko Win

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND: People with a DNA mismatch repair (MMR) gene mutation have a substantially elevated risk of colorectal cancer (CRC) but the modifiers of this risk are not well established. We investigated the association between dietary supplement intake and CRC risk for carriers.

METHODS: This study included 1966 (56% female) carriers of an MMR gene mutation (719 MLH1, 931 MSH2, 211 MSH6 and 105 PMS2) who were recruited from the USA, Canada, Australia and New Zealand into the Colon Cancer Family Registry between 1997 and 2012. Information on lifestyle factors including supplement intake was collected at the time of recruitment. Using Cox proportional hazards regression weighted to correct for ascertainment bias, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between self-reported multivitamin, calcium and folic acid supplement intake and CRC risk.

RESULTS: Of 744 carriers with CRC, 18%, 6% and 5% reported intake of multivitamin, calcium and folic acid supplements for at least 1 month, respectively, compared with 27%, 11% and 10% of 1222 carriers without CRC. After adjusting for identified confounding variables, a decreased CRC risk was associated with multivitam inintake for at least 3 years (HR 0.47, 95% CI 0.32-0.69) and calcium intake for at least 3 years(HR 0.42, 95% CI 0.23-0.74), compared with never users. There was no evidence of an association between folic acid supplement intake and CRC risk (P = 0.82).

CONCLUSION: Intake of multivitamin and calcium supplements might be associated with a decreased risk of CRC for MMR gene mutation carriers.

Original languageEnglish (US)
Pages (from-to)940-953
Number of pages14
JournalInternational Journal of Epidemiology
Volume45
Issue number3
DOIs
StatePublished - Jun 1 2016

Fingerprint

Hereditary Nonpolyposis Colorectal Neoplasms
Folic Acid
Colorectal Neoplasms
Calcium
DNA Mismatch Repair
Confidence Intervals
Mutation
Genes
Confounding Factors (Epidemiology)
Dietary Supplements
New Zealand
Colonic Neoplasms
Canada
Registries
Life Style

Keywords

  • calcium
  • Colorectal cancer
  • DNA mismatch repair
  • folic acid
  • Lynch syndrome
  • multivitamin

ASJC Scopus subject areas

  • Epidemiology

Cite this

Chau, R., Dashti, S. G., Ait Ouakrim, D., Buchanan, D. D., Clendenning, M., Rosty, C., ... Win, A. K. (2016). Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome. International Journal of Epidemiology, 45(3), 940-953. https://doi.org/10.1093/ije/dyw036

Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome. / Chau, Rowena; Dashti, Seyedeh Ghazaleh; Ait Ouakrim, Driss; Buchanan, Daniel D.; Clendenning, Mark; Rosty, Christophe; Winship, Ingrid M.; Young, Joanne P.; Giles, Graham G.; Macrae, Finlay A.; Boussioutas, Alex; Parry, Susan; Figueiredo, Jane C.; Levine, A. Joan; Ahnen, Dennis J.; Casey, Graham; Haile, Robert W.; Gallinger, Steven; Le Marchand, Loïc; Thibodeau, Stephen N; Lindor, Noralane Morey; Newcomb, Polly A.; Potter, John D.; Baron, John A.; Hopper, John L.; Jenkins, Mark A.; Win, Aung Ko.

In: International Journal of Epidemiology, Vol. 45, No. 3, 01.06.2016, p. 940-953.

Research output: Contribution to journalArticle

Chau, R, Dashti, SG, Ait Ouakrim, D, Buchanan, DD, Clendenning, M, Rosty, C, Winship, IM, Young, JP, Giles, GG, Macrae, FA, Boussioutas, A, Parry, S, Figueiredo, JC, Levine, AJ, Ahnen, DJ, Casey, G, Haile, RW, Gallinger, S, Le Marchand, L, Thibodeau, SN, Lindor, NM, Newcomb, PA, Potter, JD, Baron, JA, Hopper, JL, Jenkins, MA & Win, AK 2016, 'Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome', International Journal of Epidemiology, vol. 45, no. 3, pp. 940-953. https://doi.org/10.1093/ije/dyw036
Chau, Rowena ; Dashti, Seyedeh Ghazaleh ; Ait Ouakrim, Driss ; Buchanan, Daniel D. ; Clendenning, Mark ; Rosty, Christophe ; Winship, Ingrid M. ; Young, Joanne P. ; Giles, Graham G. ; Macrae, Finlay A. ; Boussioutas, Alex ; Parry, Susan ; Figueiredo, Jane C. ; Levine, A. Joan ; Ahnen, Dennis J. ; Casey, Graham ; Haile, Robert W. ; Gallinger, Steven ; Le Marchand, Loïc ; Thibodeau, Stephen N ; Lindor, Noralane Morey ; Newcomb, Polly A. ; Potter, John D. ; Baron, John A. ; Hopper, John L. ; Jenkins, Mark A. ; Win, Aung Ko. / Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome. In: International Journal of Epidemiology. 2016 ; Vol. 45, No. 3. pp. 940-953.
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abstract = "BACKGROUND: People with a DNA mismatch repair (MMR) gene mutation have a substantially elevated risk of colorectal cancer (CRC) but the modifiers of this risk are not well established. We investigated the association between dietary supplement intake and CRC risk for carriers.METHODS: This study included 1966 (56{\%} female) carriers of an MMR gene mutation (719 MLH1, 931 MSH2, 211 MSH6 and 105 PMS2) who were recruited from the USA, Canada, Australia and New Zealand into the Colon Cancer Family Registry between 1997 and 2012. Information on lifestyle factors including supplement intake was collected at the time of recruitment. Using Cox proportional hazards regression weighted to correct for ascertainment bias, we estimated hazard ratios (HRs) and 95{\%} confidence intervals (CIs) for associations between self-reported multivitamin, calcium and folic acid supplement intake and CRC risk.RESULTS: Of 744 carriers with CRC, 18{\%}, 6{\%} and 5{\%} reported intake of multivitamin, calcium and folic acid supplements for at least 1 month, respectively, compared with 27{\%}, 11{\%} and 10{\%} of 1222 carriers without CRC. After adjusting for identified confounding variables, a decreased CRC risk was associated with multivitam inintake for at least 3 years (HR 0.47, 95{\%} CI 0.32-0.69) and calcium intake for at least 3 years(HR 0.42, 95{\%} CI 0.23-0.74), compared with never users. There was no evidence of an association between folic acid supplement intake and CRC risk (P = 0.82).CONCLUSION: Intake of multivitamin and calcium supplements might be associated with a decreased risk of CRC for MMR gene mutation carriers.",
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AU - Chau, Rowena

AU - Dashti, Seyedeh Ghazaleh

AU - Ait Ouakrim, Driss

AU - Buchanan, Daniel D.

AU - Clendenning, Mark

AU - Rosty, Christophe

AU - Winship, Ingrid M.

AU - Young, Joanne P.

AU - Giles, Graham G.

AU - Macrae, Finlay A.

AU - Boussioutas, Alex

AU - Parry, Susan

AU - Figueiredo, Jane C.

AU - Levine, A. Joan

AU - Ahnen, Dennis J.

AU - Casey, Graham

AU - Haile, Robert W.

AU - Gallinger, Steven

AU - Le Marchand, Loïc

AU - Thibodeau, Stephen N

AU - Lindor, Noralane Morey

AU - Newcomb, Polly A.

AU - Potter, John D.

AU - Baron, John A.

AU - Hopper, John L.

AU - Jenkins, Mark A.

AU - Win, Aung Ko

PY - 2016/6/1

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N2 - BACKGROUND: People with a DNA mismatch repair (MMR) gene mutation have a substantially elevated risk of colorectal cancer (CRC) but the modifiers of this risk are not well established. We investigated the association between dietary supplement intake and CRC risk for carriers.METHODS: This study included 1966 (56% female) carriers of an MMR gene mutation (719 MLH1, 931 MSH2, 211 MSH6 and 105 PMS2) who were recruited from the USA, Canada, Australia and New Zealand into the Colon Cancer Family Registry between 1997 and 2012. Information on lifestyle factors including supplement intake was collected at the time of recruitment. Using Cox proportional hazards regression weighted to correct for ascertainment bias, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between self-reported multivitamin, calcium and folic acid supplement intake and CRC risk.RESULTS: Of 744 carriers with CRC, 18%, 6% and 5% reported intake of multivitamin, calcium and folic acid supplements for at least 1 month, respectively, compared with 27%, 11% and 10% of 1222 carriers without CRC. After adjusting for identified confounding variables, a decreased CRC risk was associated with multivitam inintake for at least 3 years (HR 0.47, 95% CI 0.32-0.69) and calcium intake for at least 3 years(HR 0.42, 95% CI 0.23-0.74), compared with never users. There was no evidence of an association between folic acid supplement intake and CRC risk (P = 0.82).CONCLUSION: Intake of multivitamin and calcium supplements might be associated with a decreased risk of CRC for MMR gene mutation carriers.

AB - BACKGROUND: People with a DNA mismatch repair (MMR) gene mutation have a substantially elevated risk of colorectal cancer (CRC) but the modifiers of this risk are not well established. We investigated the association between dietary supplement intake and CRC risk for carriers.METHODS: This study included 1966 (56% female) carriers of an MMR gene mutation (719 MLH1, 931 MSH2, 211 MSH6 and 105 PMS2) who were recruited from the USA, Canada, Australia and New Zealand into the Colon Cancer Family Registry between 1997 and 2012. Information on lifestyle factors including supplement intake was collected at the time of recruitment. Using Cox proportional hazards regression weighted to correct for ascertainment bias, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between self-reported multivitamin, calcium and folic acid supplement intake and CRC risk.RESULTS: Of 744 carriers with CRC, 18%, 6% and 5% reported intake of multivitamin, calcium and folic acid supplements for at least 1 month, respectively, compared with 27%, 11% and 10% of 1222 carriers without CRC. After adjusting for identified confounding variables, a decreased CRC risk was associated with multivitam inintake for at least 3 years (HR 0.47, 95% CI 0.32-0.69) and calcium intake for at least 3 years(HR 0.42, 95% CI 0.23-0.74), compared with never users. There was no evidence of an association between folic acid supplement intake and CRC risk (P = 0.82).CONCLUSION: Intake of multivitamin and calcium supplements might be associated with a decreased risk of CRC for MMR gene mutation carriers.

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KW - Colorectal cancer

KW - DNA mismatch repair

KW - folic acid

KW - Lynch syndrome

KW - multivitamin

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