© 2003 by Oxford University Press
Journal of the National Cancer Institute, Vol. 95, No. 12, 914-916,
June 18, 2003
© 2003 Oxford University Press
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Glycemic Load, Carbohydrate Intake, and Risk of Colorectal Cancer in Women: A Prospective Cohort Study
Affiliations of authors: P. D. Terry, T. E. Rohan, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; M. Jain, Integrated Policy and Planning Division, Ontario Ministry of Health and Long-Term Care, and Department of Public Health Sciences, University of Toronto, Toronto, Canada; A. B. Miller, Department of Public Health Sciences, University of Toronto, and Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany; G. R. Howe, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Correspondence to: Paul D. Terry, Ph.D., M.P.H., National Institute of Environmental Health Sciences, Epidemiology Branch, P.O. Box 12233 MD A3–05, Research Triangle Park, NC 27709–2233 (e-mail: terry2{at}niehs.nih.gov).
ABSTRACT
Mounting evidence suggests that high circulating levels of insulin might be associated with increased colorectal cancer risk. The glycemic effects of diets high in refined starch may increase colorectal cancer risk by affecting insulin and/or insulin-like growth factor-I levels. We examined the association between dietary intake and colorectal cancer risk in a cohort of 49 124 women participating in a randomized, controlled trial of screening for breast cancer in Canada. Linkages to Canadian mortality and cancer databases yielded data on mortality and cancer incidence up to December 31, 2000. During an average 16.5 years of follow-up, we observed 616 incident cases of colorectal cancer (436 colon cancers, 180 rectal cancers). Rate ratios for colorectal cancer for the highest versus the lowest quintile level were 1.05 (95% confidence interval [CI] = 0.73 to 1.53; Ptrend = .94) for glycemic load, 1.01 (95% CI = 0.68 to 1.51; Ptrend = .66) for total carbohydrates, and 1.03 (95% CI = 0.73 to 1.44; Ptrend = .71) for total sugar. Our data do not support the hypothesis that diets high in glycemic load, carbohydrates, or sugar increase colorectal cancer risk.
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