Fish Intake and Risk for Incident, Sporadic Colorectal Adenomatous Polyps Open Access

Chi, Fangzhou (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/8s45q913h?locale=en
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Abstract

Background: Previous studies have investigated an association between fish intake and risk for colorectal cancer, but a possible relationship between fish consumption and the precursor of colorectal cancer, adenomatous polyps, is unknown.

Purpose: To investigate an association between fish intake and risk of incident, sporadic colorectal adenomatous polyps, alone and according to other risk factors.

Methods: This case-control study was part of the Minnesota Cancer Prevention Research Unit (CPRU) program. Cases (n = 564) were patients aged 30 to 74 years with pathology-confirmed adenomatous polyps of the colon or rectum. Two control groups were recruited: colonoscopy-negative controls (n = 1,202) were colonoscopy/sigmoidoscopy-confirmed polyp-free participants, and community (CM) controls (n = 535) were subjects randomly selected from the state driver's license registry and frequency-matched to the cases on age, sex, and zip code. Data on dietary intake were collected using a modified, 153-item Willett food frequency questionnaire prior to colonoscopy.

Results: The multivariate-adjusted odds ratios and 95% confidence intervals (CI) for the second through the fourth quartiles of fish intake were, respectively, 1.29 (95% CI 0.91, 4.82), 0.88 (95% CI 0.62, 1.23), and 1.28 (95% CI 0.87, 4.88) in comparison with the colonoscopy-negative controls, and were similar to those in relation to the community controls. The association did not differ substantially according to other risk factors.

Conclusions: These results do not support the hypothesis that greater fish intake may reduce risk for incident, sporadic colorectal adenoma, although a possible modest U-shaped association cannot be ruled out.

Table of Contents

CHAPTER I: BACKGROUND AND LITERATURE REVIEW............................. 1

Introduction ..................................................................................... 1

Descriptive epidemiology ..................................................................... 1

Analytic epidemiology ......................................................................... 2

Molecular basis of colorectal cancer ...................................................... 4

Association between fish intake and colorectal cancer (biological

plausibility) ....................................................................................... 8

CHAPTER II: MANUSCRIPT ................................................................ 10

Abstract ......................................................................................... 10

Introduction .................................................................................... 12

Materials and Methods ........................................................................ 14

Results ........................................................................................... 16

Discussion ....................................................................................... 17

References ...................................................................................... 23

Tables of Results .............................................................................. 33

CHAPTER III: SUMMARY AND FUTURE DIRECTIONS .............................. 37

APPENDICES ................................................................................... 39

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