Dietary patterns and colorectal cancer recurrence and survival: a cohort study

Zhu, Yun and Wu, Hao and Wang, Peizhong P. and Savas, Sevtap and Woodrow, Jennifer and Wish, Tyler and Jin, Rong and Green, Roger C. and Woods, Michael O. and Roebothan, Barbara and Buehler, Sharon and Dicks, Elizabeth and McLaughlin, John R. and Campbell, Peter T. and Parfrey, Patrick S. (2013) Dietary patterns and colorectal cancer recurrence and survival: a cohort study. BMJ Open, 3. ISSN 2044-6055

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Abstract

Objective: To examine the association between dietary patterns and colorectal cancer (CRC) survival. Design: Cohort study. Setting: A familial CRC registry in Newfoundland. Participants: 529 newly diagnosed CRC patients from Newfoundland. They were recruited from 1999 to 2003 and followed up until April 2010. Outcome measure: Participants reported their dietary intake using a food frequency questionnaire. Dietary patterns were identified with factor analysis. Multivariable Cox proportional hazards models were employed to estimate HR and 95% CI for association of dietary patterns with CRC recurrence and death from all causes, after controlling for covariates. Results: Disease-free survival (DFS) among CRC patients was significantly worsened among patients with a high processed meat dietary pattern (the highest vs the lowest quartile HR 1.82, 95% CI 1.07 to 3.09). No associations were observed with the prudent vegetable or the high-sugar patterns and DFS. The association between the processed meat pattern and DFS was restricted to patients diagnosed with colon cancer (the highest vs the lowest quartile: HR 2.29, 95% CI 1.19 to 4.40) whereas the relationship between overall survival (OS) and this pattern was observed among patients with colon cancer only (the highest vs the lowest quartile: HR 2.13, 95% CI 1.03 to 4.43). Potential effect modification was noted for sex (p value for interaction 0.04, HR 3.85 for women and 1.22 for men). Conclusions: The processed meat dietary pattern prior to diagnosis is associated with higher risk of tumour recurrence, metastasis and death among patients with CRC.

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