Colorectal cancer in the Linxian China Nutrition Intervention Trial: Risk factors and intervention results

• Published in: PloS one Vol. 16; no. 9; p. e0255322
• Main Authors: Keskin, Havva, Wang, Shao-Ming, Etemadi, Arash, Fan, Jin-Hu, Dawsey, Sanford M, Abnet, Christian C, Qiao, You-Lin, Taylor, Philip R
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 15-09-2021; Public Library of Science (PLoS)
• Subjects: Alcohol; Ascorbic acid; Biology and Life Sciences; Body mass index; Cancer; Care and treatment; Carotene; Cigarettes; Colorectal cancer; Colorectal carcinoma; Developed countries; Diet; Dietary supplements; Epidemiology; Esophagus; Family medical history; Food consumption; Gender; Genetics; Intervention; Medicine and Health Sciences; Metabolism; Molybdenum; Mortality; Nutrition; Placebos; Population; Questionnaires; Requirements; Riboflavin; Risk analysis; Risk factors; Selenium; Social Sciences; Tobacco; Tocopherol; Urban populations; Vitamin A; Vitamins; Water consumption; Water use; Womens health; β-Carotene; China; Beijing China; Istanbul Turkey; Turkey; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255322

Colorectal cancer (CRC) is among the most common cancers in economically developed countries and developing world. While dietary factors are associated with risk of CRC in the West and urban China, little is known about risk or protective factors in rural China. The Linxian General Population Nutrition Intervention Trial (NIT) cohort was established over 30 years ago to test whether daily multivitamin/mineral supplements could reduce the incidence and mortality of esophageal/gastric cardia cancer. The cohort included a total of 29,553 healthy participants 40-69 years old who were randomly assigned to supplements or placebos via a 2.sup.4 fractional factorial study design. We examined risk factors for the development of CRC as well as the effects of four different nutritional factors (Factor A: retinol, zinc; B: riboflavin, niacin; C: ascorbic acid, molybdenum; D: selenium, alpha-tocopherol, beta-carotene,) on CRC incidence following 5.25 years of supplementation in this randomized, placebo-controlled intervention trial. CRC risk increased with age and height as well as piped water usage, family history of CRC, and consumption of foods cooked in oil, eggs, and fresh fruits. No effect on CRC was seen for any of these four intervention factors tested in both genders, but CRC was reduced 37% in females who received Factor D (selenium/alpha-tocopherol/beta-carotene) (RR = 0.63, 95% CI = 0.43-0.92, P = 0.016) compared to females who did not receive Factor D. In this undernourished rural Chinese population, CRC risk factors in this Chinese cohort showed both similarities and differences compared to Western and urban Asian Chinese populations. Intervention results suggested a potential benefit for women supplemented with selenium/alpha-tocopherol/beta-carotene.