Dietary Fatty Acids and Recurrence of Colorectal Adenomas in a European Intervention Trial

Abstract

Epidemiological studies have provided inconsistent data about the role of dietary fatty acids in colorectal cancer, and few studies have addressed their role in colorectal adenoma. The aim of the study was to assess the risk of overall adenoma recurrence associated with dietary consumption of total fat, subtypes of fat, and specific fatty acids (oleic acid, linoleic acid, α-linolenic acid). The study sample was composed of 523 patients with confirmed adenomas at the index colonoscopy, 35 to 75 yr old, who completed the European fiber-calcium intervention trial and had an initial dietary assessment using a qualitative and quantitative food questionnaire. The overall 3-yr recurrence rate was 22.6% (118 out of 523 patients). There were no significant associations between overall adenoma recurrence and either total fat, subtypes of fat, or specific fatty acids. However, polyunsaturated fatty acids and linoleic acid were both moderately but significantly associated with distal and multiple recurrence. No significant associations were observed with recurrence of proximal or advanced adenomas. Our findings do not support the hypothesis of strong associations between dietary fatty acids and recurrence of colorectal adenomas. The hypothesis of a differential role of specific fatty acids according to colorectal subsites deserves further investigation.

ACKNOWLEDGMENTS

N. Methy carried out the statistical analysis, the interpretation of results, and wrote the first draft of the article. C. Binquet was involved in the statistical analysis and the writing of the article. M. C. Boutron-Ruault and B. Paillot were involved in the study design, the collection of data, and the revision of the article. J. Faivre was the principal investigator who initiated and coordinated the running of the trial and contributed to the revision of the report. C. Bonithon-Kopp coordinated the collection of data, oversaw statistical analysis, interpretation of results, and the writing of the article. We thank all dieticians for their participation in this study. Other European Cancer Prevention Study Group investigators (countries and names in alphabetical order) are the following: Belgium, M. Buset; Denmark, C. Fenger and O Kronborg; France, C. Belghiti, B. Crespon, F. Doyon, J. Estève, A. M. Justum, J. L. Legoux, C. Milan, F. Piard, P. Pienkowski, and J. F. Seitz; Germany, W. Matek, R. W. Owen, U. Räth, F. Richter, J. Rudi, and I. Wankmüller; Ireland, M. Buckley and C. O'Morain; Israel, P. Rozen; Italy, R. Andreatta, A. Giacosa, B. Omazzi, A. Prada, G. C. Sturniolo, and A. Zambelli; Portugal, H. Salhandra De Oliveira and L. Santos; Spain, J. Boadas, E. Cabeza, A. Obrador, and J. Pujol; and the United Kingdom, M. Hill, C. Marks, and G. Kerr. None of the authors have conflict of interest. The study was supported by grants from the Europe Against Cancer Programme, the Association Contre le Cancer (Brussels), the Association Luxembourgeoise Contre le Cancer, Inserm (France, Grant 91-1002), the French Ministry of Health (PHRC), the Deutsches Krebsforschungzentrum, the Danish Cancer Society, the FISS (Spain), Hospital Supplies (Ireland), the University of Coimbra (Portugal), and Istituto Tumori Genova (Italy). The calcium and its placebo treatment were provided by Sandoz France. The fiber and its placebo treatment were provided by Reckitt and Coleman (United Kingdom).

Notes

^a Abbreviation is as follows: BMI, body mass index.

^b n = 118.

^c n = 405.

^d Data missing for 5 subjects.

^e Data missing for 28 subjects.

^f Data missing for 3 subjects.

^a Abbreviations are as follows: OR, odds ratio; CI, confidence interval.

^b Adjusted for gender, age, total energy intake, and treatment group.

^c P value when the variable of interest is considered as a continuous covariable.

^d dAdjusted for gender, age, total energy intake, treatment group, multiple adenomas, and proximal adenomas at inclusion.

^a Abbreviations are as follows: OR, odds ratio; CI, confidence interval.

^b n = 59.

^c n = 78.

^d n = 40.

^e Adjusted for gender, age, total energy intake, treatment group, multiple adenomas, and proximal adenomas at inclusion.

^f P value when the variable of interest is considered as a continuous covariable.

^g Adjusted for gender, age, total energy intake, treatment group and multiple adenomas at inclusion.