@article{eb6417c1521d466d9775479e4d0739f9,
title = "Multivitamin, calcium and folic acid supplements and the risk of colorectal cancer in Lynch syndrome",
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.",
keywords = "Calcium, Colorectal cancer, DNA mismatch repair, Folic acid, Lynch syndrome, Multivitamin",
author = "Rowena Chau and Dashti, {Seyedeh Ghazaleh} and Ouakrim, {Driss Ait} and Buchanan, {Daniel D.} and Mark Clendenning and Christophe Rosty and Ingrid MWinship and Young, {Joanne P.} and Giles, {Graham G.} and Macrae, {Finlay A.} and Alex Boussioutas and Susan Parry and Figueiredo, {Jane C.} and Levine, {A. Joan} and Ahnen, {Dennis J.} and Graham Casey and Haile, {Robert W.} and Steven Gallinger and Marchand, {Loic Le} and Thibodeau, {Stephen N.} and Lindor, {Noralane M.} and Newcomb, {Polly A.} and Potter, {John D.} and Baron, {John A.} and Hopper, {John L.} and Jenkins, {Mark A.} and Win, {Aung Ko}",
note = "Funding Information: The authors thank all study participants of the Colon Cancer Family Registry and stafffor their contributions to this project. This work was supported by grant UM1 CA167551 from the National Cancer Institute and through cooperative agreements with the following Colon Cancer Family Registry centres: Australasian Colorectal Cancer Family Registry (U01 CA074778 and U01/U24 CA097735); Mayo Clinic Cooperative Family Registry for Colon Cancer Studies (U01/U24 CA074800); Ontario Familial Colorectal Cancer Registry (U01/U24 CA074783); Seattle Colorectal Cancer Family Registry (U01/U24 CA074794); University of Hawaii Colorectal Cancer Family Registry (U01/U24 CA074806); and USC Consortium Colorectal Cancer Family Registry U01/U24 CA074799). Seattle CCFR research was also supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Centre, which was funded by control nos. N01-CN-67009 (1996-2003) and N01-PC-35142 (2003-2010) and contract no. HHSN2612013000121 (2010-17) from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute, with additional support from the Fred Hutchinson Cancer Research Centre. The collection of cancer incidence data for the State of Hawaii used in this study was supported by the Hawaii Department of Health as part of the state-wide cancer reporting programme mandated by: Hawaii Revised Statutes; and the National Cancer Institute's Surveillance, Epidemiology and End Results Program (SEER) under control nos. N01-PC-67001 (1996-2003) and N01-PC-35137 (2003-2010) and contract nos. HHSN26120100037C (2010-2013) and HHSN261201300009I (2010_current) awarded to the University of Hawaii. The ideas and opinions expressed herein are those of the author(s), and endorsement by the State of Hawaii, Department of Health, the National Cancer Institute, SEER Program or their contractors and subcontractors is not intended nor should be inferred. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the state-wide cancer reporting programme mandated by: California Health and Safety Code Section 103885; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers forDisease Control and Prevention's National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s), and endorsement by the State of California, Department of Public Health the National Cancer Institute and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred. This work was also supported by Centre for Research Excellence grant APP1042021 and programme grant APP1074383 from the National Health and Medical Research Council (NHMRC), Australia. AKW is an NHMRC Early Career Fellow. MAJ is an NHMRC Senior Research Fellow. JLH is a NHMRC Senior Principal Research Fellow. DDB is a University of Melbourne Research at Melbourne Accelerator Program (R@MAP) Senior Research Fellow. The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centres in the Colon Cancer Family Registry (CCFR), nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government or the CCFR. Authors had full responsibility for the design of the study, the collection of the data, the analysis and interpretation of the data, the decision to submit the manuscript for publication and the writing of the manuscript. Publisher Copyright: {\textcopyright} The Author 2016.",
year = "2016",
month = jun,
doi = "10.1093/ije/dyw036",
language = "English (US)",
volume = "45",
pages = "940--953",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",
number = "3",
}