Table 4.

Associations (HRs, 95% CIs) between WCRF/AICR diet scores (in quintiles and continuously) and risk of colorectal cancer outcomes among men in the HPFS and women in the NHS

Q1Q2Q3Q4Q5ContinuousaP trendbP heterogeneityc
Mean (SD) score
 Men0.33 (0.05)0.43 (0.02)0.50 (0.02)0.58 (0.03)0.71 (0.07)
 Women0.38 (0.05)0.48 (0.02)0.54 (0.02)0.60 (0.02)0.71 (0.06)
Total colorectal cancer
 Men
  No. of cases245219227234226
  Age-adjusted1.00 (ref)0.80 (0.67–0.96)0.77 (0.64–0.92)0.72 (0.60–0.86)0.67 (0.56–0.80)0.82 (0.75–0.89)<0.0001
  MV-adjustedd1.00 (ref)0.84 (0.70–1.02)0.83 (0.69–1.00)0.78 (0.65–0.94)0.74 (0.61–0.90)0.86 (0.79–0.94)0.001
Women0.06
  No. of cases241276259272250
  Age-adjusted1.00 (ref)0.97 (0.81–1.15)0.93 (0.78–1.10)0.87 (0.73–1.04)0.79 (0.66–0.95)0.90 (0.83–0.97)0.004
  MV-adjustede1.00 (ref)1.02 (0.85–1.21)1.01 (0.84–1.21)0.99 (0.82–1.18)0.93 (0.77–1.12)0.97 (0.89–1.04)0.38
Total colon cancer
 Men
  No. of cases195177167189179
  Age-adjusted1.00 (ref)0.81 (0.66–1.00)0.70 (0.57–0.87)0.72 (0.58–0.88)0.66 (0.54–0.82)0.81 (0.74–0.90)<0.0001
  MV-adjustedd1.00 (ref)0.85 (0.69–1.05)0.76 (0.61–0.94)0.78 (0.63–0.96)0.73 (0.59–0.91)0.85 (0.77–0.94)0.002
Women0.04
  No. of cases185210211215202
  Age-adjusted1.00 (ref)0.95 (0.78–1.16)0.96 (0.79–1.17)0.88 (0.72–1.08)0.82 (0.67–1.00)0.91 (0.84–0.99)0.03
  MV-adjustede1.00 (ref)1.01 (0.83–1.23)1.06 (0.87–1.30)1.01 (0.82–1.23)0.97 (0.79–1.20)0.99 (0.90–1.08)0.75
Proximal colon cancer
 Men
  No. of cases7767729485
  Age-adjusted1.00 (ref)0.77 (0.56–1.08)0.76 (0.55–1.05)0.89 (0.65–1.20)0.77 (0.56–1.06)0.92 (0.80–1.06)0.26
  MV-adjustedd1.00 (ref)0.79 (0.57–1.11)0.80 (0.58–1.12)0.94 (0.69–1.29)0.84 (0.61–1.17)0.96 (0.83–1.12)0.61
Women0.64
  No. of cases106133139133135
  Age-adjusted1.00 (ref)1.05 (0.81–1.35)1.08 (0.84–1.40)0.92 (0.71–1.19)0.92 (0.71–1.19)0.94 (0.84–1.04)0.23
  MV-adjustede1.00 (ref)1.12 (0.86–1.44)1.20 (0.92–1.55)1.04 (0.80–1.36)1.07 (0.82–1.40)1.01 (0.90–1.12)0.92
Distal colon cancer
 Men
  No. of cases8371596058
  Age-adjusted1.00 (ref)0.80 (0.58–1.10)0.61 (0.44–0.86)0.54 (0.38–0.75)0.53 (0.38–0.75)0.71 (0.61–0.83)<0.0001
  MV-adjustedd1.00 (ref)0.85 (0.61–1.17)0.67 (0.47–0.94)0.59 (0.42–0.83)0.60 (0.42–0.85)0.76 (0.64–0.89)0.0008
 Women0.05
  No. of cases7467687861
  Age-adjusted1.00 (ref)0.77 (0.55–1.07)0.80 (0.57–1.11)0.85 (0.62–1.18)0.67 (0.47–0.94)0.88 (0.76–1.01)0.07
  MV-adjustede1.00 (ref)0.80 (0.57–1.12)0.87 (0.62–1.21)0.97 (0.70–1.36)0.79 (0.55–1.13)0.95 (0.82–1.10)0.49
Rectal cancer
 Men
  No. of cases5042604547
  Age-adjusted1.00 (ref)0.76 (0.50–1.14)1.01 (0.69–1.48)0.71 (0.47–1.07)0.69 (0.46–1.04)0.83 (0.69–0.99)0.04
  MV-adjustedd1.00 (ref)0.81 (0.53–1.23)1.11 (0.75–1.63)0.80 (0.53–1.22)0.79 (0.52–1.20)0.88 (0.72–1.06)0.17
 Women0.95
  No. of cases5666485748
  Age-adjusted1.00 (ref)1.01 (0.71–1.45)0.80 (0.54–1.17)0.83 (0.57–1.21)0.70 (0.47–1.04)0.84 (0.71–0.98)0.03
  MV-adjustede1.00 (ref)1.05 (0.73–1.51)0.85 (0.57–1.25)0.92 (0.63–1.36)0.80 (0.53–1.21)0.89 (0.75–1.06)0.20
  • aPer one interquartile range increase in the WCRF/AICR lifestyle score.

  • bP value for the continuous WCRF/AICR lifestyle score.

  • cPheterogeneity between NHS and HPFS for the continuous WCRF/AICR lifestyle score.

  • dAdjusted for total energy intake (kcal/day, quintiles), NSAID/aspirin use [≥2 pills/week vs. <2 pills/week (ref)], family history of colorectal cancer [yes vs. no (ref)], previous colorectal cancer screening via colonoscopy or sigmoidoscopy [yes vs. no (ref)], history of polyps [yes vs. no (ref)], smoking [never smoker (ref), >0–<10, ≥10–<20, ≥20–<30, ≥30–<40, ≥40–<50, ≥50 pack-years], multivitamin use [regular use vs. nonuse (ref)], supplemental calcium intake [none (ref), >0-<200, ≥200–<400, ≥400–<600, ≥600 mg/day], young adult body mass index [<25 (ref), ≥25–<27.5, ≥27.5–<30, ≥30 kg/m2], and physical activity (MET-hours/wk, quintiles).

  • eAdjusted for same as multivariable models in men + menopausal status [postmenopausal vs. not (ref)], and postmenopausal hormone use [never use (ref), past use, current use].