Dietary supplement use and colorectal cancer risk: A systematic review and meta-analyses of prospective cohort studies

Renate C. Heine-Bröring, Renate M. Winkels, Jacoba M.S. Renkema, Lea Kragt, Anne Claire B. Van Orten-Luiten, Ettje F. Tigchelaar, Doris S.M. Chan, Teresa Norat, Ellen Kampman

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

Use of dietary supplements is rising in countries where colorectal cancer is prevalent. We conducted a systematic literature review and meta-analyses of prospective cohort studies on dietary supplement use and colorectal cancer risk. We identified relevant studies in Medline, Embase and Cochrane up to January 2013. Original and peer-reviewed papers on dietary supplement use and colorectal cancer, colon cancer, or rectal cancer incidence were included. "Use-no use"(U-NU), "highest-lowest"(H-L) and "dose-response"(DR) meta-analyses were performed. Random-effects models were used to estimate summary estimates. In total, 24 papers were included in the meta-analyses. We observed inverse associations for colorectal cancer risk and multivitamin (U-NU: RR = 0.92; 95% CI: 0.87,0.97) and calcium supplements (U-NU: RR = 0.86; 95% CI: 0.79,0.95; H-L: RR = 0.80; 95% CI: 0.70,0.92; DR: for an increase of 100 mg/day, RR = 0.96; 95% CI: 0.94,0.99). Inconsistent associations were found for colon cancer risk and supplemental vitamin A and vitamin C, and for colorectal cancer risk and supplemental vitamin D, vitamin E, garlic and folic acid. Meta-analyses of observational studies suggest a beneficial role for multivitamins and calcium supplements on colorectal cancer risk, while the association with other supplements and colorectal cancer risk is inconsistent. Residual confounding of lifestyle factors might be present. Before recommendations can be made, an extensive assessment of dietary supplement use and a better understanding of underlying mechanisms is needed.

Original languageEnglish (US)
Pages (from-to)2388-2401
Number of pages14
JournalInternational Journal of Cancer
Volume136
Issue number10
DOIs
StatePublished - May 15 2015

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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