ABSTRACT

Background:
Diabetes has been associated with colorectal cancer (CRC). We aimed at evaluating whether adherence to a diabetes risk reduction diet (DRRD) could favorably influence the risk of CRC.
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Methods:
Data came from a multicentric Italian case-control study including 1,953 histologically confirmed CRC cases and 4,154 hospital controls admitted for acute non-neoplastic diseases. Diet was assessed through a validated and reproducible food frequency questionnaire. The DRRD score was computed assigning higher values for higher consumption of cereal fiber, fruit, coffee, nuts and a higher polyunsaturated/saturated fats ratio and for lower glycemic index and lower consumption of red/processed meat and sweetened beverage and fruit juice. The odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of CRC according to the DRRD score were obtained using logistic regression models adjusting for total energy intake and other major confounders.

Results:
The DRRD was inversely related to CRC risk. The ORs of CRC were 0.77 (95% CI = 0.67-0.89) for the third versus first score tertile (p trend <0.001) and 0.92 (95% CI = 0.87-0.96) for a 3-point increment in the score. Inverse associations were observed for colon and rectal cancer and were consistent in strata of sex, age and other major covariates.

Conclusion:
A higher adherence to a DRRD was inversely associated with CRC risk.

Impact:
Given the high incidence and mortality rates of CRC, adherence to a DRRD can have relevant prevention and public health implications.

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