Diet, Fibers, and Colon Cancer

  • Jean Faivre
  • Claude Bonithon-Kopp
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 472)

Abstract

Epidemiological studies of colorectal cancer, particularly studies of time trends, of migrants, and of religious groups, indicate that environmental factors are of overwhelming importance in determining the incidence of the disease in the population. Of the possible environmental factors important in colorectal cancer carcinogenesis, diet has been the focus of attention. Recent advances have shown that genetic constitution is also important in determining susceptibility to the disease. This implies that colorectal cancer can be caused by an interaction between dietary factors and genetic predisposition. Among the dietary components that have been linked to decreased risk of colorectal cancer is the high intake of dietary fibre. The hypothesis of a fibre-depleted aetiology for colorectal cancer was particularly put forward by Burkitt.1 This was based on the careful clinical observations of the difference in patterns of diseases between Western and traditional African societies. He noted the rarity of colorectal cancer in African countries compared to the west and found that African diets were higher in dietary fibre and lower in refined carbohydrates than west European diets. Results from laboratory animal studies and from analytical epidemiological studies provide evidence that a high fibre intake decreases the risk of colorectal cancer. However, some studies have failed to support the theory of a fibre-depleted diet as a causative factor in the aetiology of colorectal cancer. The objective of this review is to present the evidence for and against the protective role of dietary fibre against colorectal cancer.

Keywords

Colorectal Cancer Dietary Fibre Wheat Bran Natl Cancer Inst Colorectal Adenoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Burkitt D.P. (1971) Epidemiology of cancer of the colon and rectum. Cancer 28: 3–13.PubMedCrossRefGoogle Scholar
  2. 2.
    Trowel H. (1974) Definition of fibre. Lancet 1: 503.CrossRefGoogle Scholar
  3. 3.
    Bauer H.G., Asp N.G., Oste R., Dehlqvist A., and Fredlund P.E. (1979) Effect of dietary fiber on the induction of colorectal tumors and fecal (3-glucuronidase activity in the rat. Cancer Res 39: 3752–6.PubMedGoogle Scholar
  4. 4.
    Bauer H.G., Asp N.G., Dahlgvist A., Fredlund P.E., Nyman M., and Oste R. (1981) Effect of two kinds of pectin and guar gum on 1,2-dimethylhydrazine initiation of colon tumors and on fecal 3glucuronidase activity in the rat. Cancer Res 41: 2518–23.PubMedGoogle Scholar
  5. 5.
    Casteleden W.M. (1977) Prolonged survival and decrease in intestinal tumors in dimethyhydrazinetreated rats fed a chemically defined diet. Br J Cancer 35: 491–5.CrossRefGoogle Scholar
  6. 6.
    Freeman H.J., Spiller G.A., and Kim Y.S. (1978) A double-blind study on the effect of purified cellulose dietary fiber on 1,2-dimethylhydrazine-induced rat colonic neoplasia. Cancer Res 38: 2912–17.PubMedGoogle Scholar
  7. 7.
    Jacobs L.R. (1983) Enhancement of rat colon carcinogenesis by wheat bran consumption during the stage of 1,2-dimethylhydrazine administration. Cancer Res 43: 4057–61.PubMedGoogle Scholar
  8. 8.
    Klurfeld D.M. (1987) The role of dietary fiber in gastrointestinal diseases. J Am Diet Assoc 87: 1172–7PubMedGoogle Scholar
  9. 9.
    Reddy B.S., Mori H., and Nicolais N. (1981) Effect of dietary wheat bran an dehydrated citrus fiber on azoxymethane-induced intestinal carcinogenesis in Fischer 344 rats. J Natl cancer Inst 66: 553–7.PubMedGoogle Scholar
  10. 10.
    Watanabe K., Reddy B.S., Weisburger J.H., and Krichevsky D. (1979) Effect of dietary alfalfa, pectin, and wheat bran on azoxymethane or methylnitrosourea-induced colon carcinogenesis in F344 rats. J Natl Cancer Inst 63: 141–5.PubMedGoogle Scholar
  11. 11.
    Jacobs L.R. and Lupton J.R. (1986) Relationship between colonic luminal pH, cell proliferation and colon carcinogenesis in 1,2-dimethylhydrazine treated rats fed high fiber diets. Cancer Res 46: 1727–34.PubMedGoogle Scholar
  12. 12.
    Nigro N.D., Bull A.W., Klopfer B.A., Pak M.S., and Campbell R.L. (1979) Effect of dietary fiber on azoxymethane-induced intestinal carcinogenesis in rats. J Natl Cancer Inst 62: 1097–102.PubMedGoogle Scholar
  13. 13.
    Prizont R. (1987) Absence of large bowel tumors in rats injected with 1,2-dimethylhydrazine and fed high dietary cellulose. Dig Dis Sci 32: 1418–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Ward J.M., Yamamoto R.S., and Weisburger J.H. (1973) Cellulose dietary bulk and azoxymethaneinduced intestinal cancer. J Natl Cancer Inst 51: 713–15.PubMedGoogle Scholar
  15. 15.
    Wilpart M. and Roberfroid M. (1987) Intestinal carcinogenesis and dietary fibers: the influence of cellulose or fybogel chronically given after exposure to DMH. Nutr Cancer 10: 39–51.PubMedCrossRefGoogle Scholar
  16. 16.
    Barnes D.S., Clapp N.K., Scott D.A., Oberst D.L., and Berry S.S. (1983) Effect of wheat, rice, corn, and soybean bran on 1,2-dimethylhydrazine induced large bowel tumorigenesis in F344rats. Nutr Cancer 5: 1–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Freeman H.J., Spiller G.A., and Kim Y.S. (1980) A double-blind study on the effect o differing purified cellulose and pectin fiber diets on 1,2-dimethylhydrazine-induced rat colonic neoplasia. Cancer Res 40: 2661–5.PubMedGoogle Scholar
  18. 18.
    Reddy B.S., Maeura Y., and Wayman M. (1983) Effect of dietary corn bran and autohydrolyzed lignin on 3,2-dimethyl-4-aminobiphenyl-induced intestinal carcinogenesi in male F344 rats. J Natl Cancer Inst 71: 419–23.PubMedGoogle Scholar
  19. 19.
    Abraham R., Barbolt T.A., and Rodgers J.B. (1980) Inhibition by bran of the colonic cocarcinogenicity of ble salts in rat given dimethyhydrazine. Exp Mol Pathol 33: 133–43.PubMedCrossRefGoogle Scholar
  20. 20.
    Barbolt T.A. and Abraham R. (1978) The effect of bran on dimethylhydrazine-induced colon carcinogenesis in the rat. Proc Soc Exp Biol Med 157: 656–9.PubMedGoogle Scholar
  21. 21.
    Barbolt R.A. and Abraham R. (1980) Dose response, sex difference and the effect of bran in dimethylhydrazine induced intestinal tumorigenesis in rats. Toxicol Appl Pharmacol 55: 417–22.PubMedCrossRefGoogle Scholar
  22. 22.
    Cruse J.P., Lewin M.R., and Clark C.G. (1978) Failure of bran to protect against experimental colon cancer in rats. Lancet 2: 1278–80.PubMedCrossRefGoogle Scholar
  23. 23.
    Fleiszer D., Murray D., Macfarlan J., and Brown R. (1978) Protective effect of dietary fibre against chemically-induced bowel tumours in rats. Lancet 2: 552–3.PubMedCrossRefGoogle Scholar
  24. 24.
    Wilson R.B., Hutcheson D.P., and Widemanf V. (1977) Dimethylhydrazine induced colon tumors in rats fed diets containing beef fat or corn oil with and without wheat bran. Am J Clin Nutr 30: 176–81.PubMedGoogle Scholar
  25. 25.
    Reddy B.S. and Mori H. (1981) Effect of dietary wheat bran and dehydrated citrus fiber on 3,2dimethyl-4-aminobiphenyl-induced intestinal carcinogenesis in F344 rats. Carcinogenesis 2: 21–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Nauss K.M., Locnishar M., Sondergaard D., and Newberne P.M. (1984) Lack of effect of dietary fat on N-nitrosomethyl urea induced colon tumorigenesis in rats. Carcinogenesis 5: 255–60.PubMedCrossRefGoogle Scholar
  27. 27.
    Modan B., Barell V., and Lubin F. (1975) Low-fiber intake as an etiologic factor in cancer of the colon. J Natl Cancer Inst 55: 15–18.PubMedGoogle Scholar
  28. 28.
    Kune S., Kune G.M., and Watson F. (1987) Case-control study of dietary etiological factors: the Melbourne Colorectal Cancer Study. Nutr Cancer 9: 43–56.PubMedCrossRefGoogle Scholar
  29. 29.
    Tuyns A.J., Haelterman M., and Kaaks R. (1987) Colorectal cancer and the intake of nutrients: oligosaccharides are a risk factor, fats are not: a case-control study in Belgium. Nutr Cancer 11: 189–204.CrossRefGoogle Scholar
  30. 30.
    West D.W., Slattery M.L., Robison L.M., Schuman K.L., Ford M.H., Mahoney A.W., et al. (1989) Dietary intake and colon cancer: sex-and anatomic site-specific associations. Am J Epidemiol 128: 989–99.Google Scholar
  31. 31.
    Benito E., Stiggelbout A., Bosch F.X., Obrador A., Kaldor J., Mullet M., et al. (1991) Nutritional factors in colorectal cancer risk: a case-control study in Majorca. Int J Cancer 49: 161–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Whittemore A.S., Wu-Williams A H, Lee M., Zheng S., Gallagher R.E, Jiao D.A. et al. (1990) Diet, physical activity, and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst 82: 915–26.PubMedCrossRefGoogle Scholar
  33. 33.
    Freudenheim J., Graham S., Marshall J.R., Haughey B.P., and Wilkinson G. (1990) A case-control study of diet and rectal cancer in Western New-York. Am J Epidemiol 131: 612–24.PubMedGoogle Scholar
  34. 34.
    Young T. and Wolf D.A. (1988) Case-control study of proximal and distal colon cancer and diet in Winconsin. Int J Cancer 42: 167–75.PubMedCrossRefGoogle Scholar
  35. 35.
    Bidoli E., Franceschi S., Talamini R., Barra S., and La Vecchia C. (1992) Food consumption and cancer of the colon and rectum in North-Eastern Italy. Int J Cancer 50: 223–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Iscovich J.M., Liabbe K.A., Castelleto R., Calzona A., Bernedo A., Chopita N.A. et al. (1992) Colon cancer in Argentina. I. Risk from intake of dietary items. Int J Cancer 51: 851–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Meyer T. and White E. (1993) Alcohol and nutrients in relation to colon cancer in middle-aged adults. Am J Epidemiol 138: 225–36.PubMedGoogle Scholar
  38. 38.
    Arbman G., Axelson D., Ericsson-Begodsui A.B., Fredriksson M., Nilsson E., and Sjodahl R. (1992) Cereal fiber, calcium, and colorectal cancer. Cancer 69: 2042–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Dales L.G., Friedman G D., Ury H.K., Grossman S., and Williams S.R., (1979) A case-control study of relationship of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol 109: 132–44.PubMedGoogle Scholar
  40. 40.
    Miller A.B., Howe G.R., Jain M., Craib K.J.P., and Harrison L. (1983) Food items and food groups as risk factors in a case-control study of diet and colorectal cancer. Int J Cancer 32: 155–61.PubMedCrossRefGoogle Scholar
  41. 41.
    Macquart-Moulin G., Riboli E., Comte J., Charnay B., Berthezene P., and Day N. (1986) Case-control study on colorectal cancer and diet in Marseilles. Int J Cancer 38: 183–91.PubMedCrossRefGoogle Scholar
  42. 42.
    Peters R.K., Garabrant D.H., and Yu M.C. (1989) A case-control study of occupational and dietary factors in colorectal cancer in youn men by subsite. Cancer Res 49: 5459–68.PubMedGoogle Scholar
  43. 43.
    Lee H.P., Gourley L., Duffy S.W., Esteve J., Lee J., and Day N. (1989) Colorectal cancer and diet in an Asian population-case-control study among Singapore Chinese. Int J Cancer 43: 1007–16.PubMedCrossRefGoogle Scholar
  44. 44.
    Pickle L.W., Greene M.H., and Ziegler R.G. (1984) Colorectal cancer in rural Nebraska. Cancer Res 44: 363–9.PubMedGoogle Scholar
  45. 45.
    Bristol J.B., Emmett P.M., and Heaton K.W. (1985) Sugar, fat, and the risk of colorectal cancer. Br Med J 291: 1467–70.CrossRefGoogle Scholar
  46. 46.
    Gerhardsson de Verdier M., Hagman U., Steineck G., Rieger A., and Norell S.E. (1990) Diet, body mass, and colorectal cancer: a case-referent study. Int J Cancer 46: 832–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Faivre J., Boutron M.C., Senesse E, Couillault C., Belghiti C., and Meny B. (1997) Environmental and familial risk factors in relation to the colorectal adenoma-carcinoma sequence: results of a case-control study in Burgundy ( France ). Eur J Cancer Prey 6: 127–31.Google Scholar
  48. 48.
    Martinez I., Torres R., and Frias Z. (1981) Factors associated with adenocarcinomas of the large bowel in Puerto Rico. Rev Latinoam Oncol Clin 13: 13–20.Google Scholar
  49. 49.
    Potter J.D. and McMichael A.J. (1986) Diet and cancer of the colon and rectum: a case-control study. J Natl Cancer Inst 76: 557–69.PubMedGoogle Scholar
  50. 50.
    Howe G.R., Benito E., Castelleto R., Comte J., EstEve J., Gallagher R.P. et al. (1992) Dietary intake of fiber and decreased risk of cancers of the colon and rectum: evidence from the combined analysis of 13 case-control studies. Cancer Causes Control 84: 1887–96.Google Scholar
  51. 51.
    Trock B., Lanza E., and Greenwald P. (1990) Dietary fiber, vegetables, and colon cancer, critical review and meta-analyses of the epidemiological evidence. J Natl Cancer Inst 82: 650–61.PubMedCrossRefGoogle Scholar
  52. 52.
    Morgan J.W., Frazer G.F., Philips R.L., and Andress M.H. (1988) Dietary factors and colon cancer incidence among seventh day adventists. Am J Epidemiol 128: 918 (abstract).Google Scholar
  53. 53.
    Goldbohm R.A., Van-den-Brandt P.A., Van-t-Veer P., Brants H.A., Dorant E., Sturmans E. et al. (1994) A prospective cohort study on the relation between meat consumption and the risk of colon cancer. Cancer Res 54: 718–23.PubMedGoogle Scholar
  54. 54.
    Giovannucci E., Rimm E.B., Stampfer M.J., Colditz G.A., Ascherio A., and Willett W.C. (1994) Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res 54: 2390–7.PubMedGoogle Scholar
  55. 55.
    Gaard M.,Tretli S., and Loken E.B. (1996) Dietary factos and risk of colon cancer: a prospective study of 50,535 young Norwegian men and women. Eur J Cancer Prey 5: 445–54.Google Scholar
  56. 56.
    Willet W.C., Stampfer M.J., Colditz G.A., Rosner B.A., and Speizer F.E. (1990) Relation of meat fat and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 323: 1664–72.CrossRefGoogle Scholar
  57. 57.
    Steinmetz K.A., Kushi L.H., Bostick R.M., Folsom A.R., and Potter J.D. (1994) Vegetables, fruits, and colon cancer in the Iowa womenis health study. Am J Epidemiol 139: 1–15.PubMedGoogle Scholar
  58. 58.
    Fuchs C.S., Giovanucci E.L., Colditz G.A., Hunter D.J., Stampfer M.J., Rosner B., Speizer F.E., and Willett W.C. (199) Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 340: 169–76.Google Scholar
  59. 59.
    Heibrun L., Nomura A., Hankin J., and Stermmermann G.N. (1989) Diet and colorectal cancer with special reference to fiber intake. Int J Cancer 44: 1–6.CrossRefGoogle Scholar
  60. 60.
    Thun M.J., Calle E.E., Namboodiri M.M., Flanders W.D., Coates R.J., Byers T., et al. (1992) Riks factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst 84: 1491–500.PubMedCrossRefGoogle Scholar
  61. 61.
    Hill M.J., Morson B.C., and Bussey H.J.R. (1978) Aetiology of adenoma-carcinoma sequence in the large bowel. Lancet i: 245–7.Google Scholar
  62. 62.
    Hoff G., Moen E., Trygg K., Frolich W., Sauar J., Vatn M., Gjones E., and Larsen S. (1986) Epidemiology of polyps in the rectum and sigmoid colon. Evaluation of nutritional factors. Scand J Gastroenterol 21: 199–204.Google Scholar
  63. 63.
    Kune G.A., Kune S., Read A., Mac Gowan K., Penfold C., and Watson L.F. (1991) Colorectal polyps, diet, alcohol, and family history of colorectal cancer: a case-control study. Nutr Cancer 16: 25–30.PubMedCrossRefGoogle Scholar
  64. 64.
    Neugut A.I., Garbowski G.C., and Leew C. (1993) Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case-control study. Ann Intern Med 118: 91–5.Google Scholar
  65. 65.
    Sandler R.S., Lyles C.M., Peipins L.A., Mc Auliffe C.A., Woosley J.T., and Kupper L.L. (1993) Diet and risk of colorectal adenomas: macronutrients cholesterol and fiber. J Natl Cancer Inst 85: 884–91.PubMedCrossRefGoogle Scholar
  66. 66.
    Macquart-Moulin G., Riboli E., Cornee J., Kaas R., and Berthezene P. (1987) Colorectal polyps and diet: a case-control study in Marseilles. Int J Cancer 40: 179–88.PubMedCrossRefGoogle Scholar
  67. 67.
    Little J., Logan R.F.A., Hawtin P.G., Hardcastle J.D., and Turner I.D. (1993) Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme. Br J Cancer 67: 177–84.PubMedCrossRefGoogle Scholar
  68. 68.
    Giovanucci E., Stampfer M.J., and Colditz G. (1992) Relationship of diet to risk of colorectal cancer adenoma in men. J Natl Cancer Inst 84: 91–8.CrossRefGoogle Scholar
  69. 69.
    De Cosse 1J, Miller H.H., and Lesser M.L. (1989) Effect of wheat fiber and vitamin C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 81: 1290–7.Google Scholar
  70. 70.
    Mc Keown-Eyssen G., Holloway C., Jazmaji V., Britht-See E., Dion P, and Bruce W.R. (1988) A randomized trial of vitamins C and E in the prevention of recurrence of colorectal polyps. Cancer Res 48: 4701–5.Google Scholar
  71. 71.
    Mac Lennan R., Macrae F.A., Bain C., Battistutta D., Chapuis P, and Gratten H. (1995) Randomized trial of intake of fat, fiber, and beta carotene to prevent colorectal adenomas. J Natl Cancer Inst 87: 1760–6.CrossRefGoogle Scholar
  72. 72.
    Faivre J., Couillault C., Kronborg O., Rath U., Giacosa A., De Oliveira H., Obrador T., OlMorain C., and E.C.P. Colon Group (1997) Chemoprevention of metachronous adenomas of the large bowel: design and interim results of a randomized trial of calcium and fibre. Eur J Cancer Prey 6: 132–8.Google Scholar
  73. 73.
    Vargas P.A. and Alberts D.S. (1992) Primary prevention of colorectal cancer through dietary modification. Cancer 70: 1229–35.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Jean Faivre
    • 1
  • Claude Bonithon-Kopp
    • 1
  1. 1.Registre des Cancers Digestifs (Equipe Associèe INSERM-DGS, CRI 95-05)Facultè de MèdecineDijon CèdexFrance

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