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. 2011 Nov 10;343:d6617. doi: 10.1136/bmj.d6617

Table 2.

 Prospective studies of whole grain intake and incidence of colorectal cancer

Study, country Study name Follow-up period Study size, sex, age, No of cases* Diet assessment, No of items Exposure Quantity Relative risk (95% CI) Adjustment for confounders
Fung 201039, USA Nurses’ Health Study 1980-2006, 26 years 87 256 women, age 34-59, 1432 cases Validated food frequency questionnaire, 61-116 food items Whole grains Per serving/day 0.95 (0.89 to 1.02) Age, body mass index, alcohol, family history of colorectal cancer, physical activity, aspirin, colonoscopy, history of polyps, pack years of smoking, energy, multivitamins
Fung 201039, USA Health Professionals Follow-Up Study 1986-2006, 20 years 45 490 men, age 40-75, 1032 cases Validated food frequency questionnaire, about 140 food items Whole grains Per serving/day 0.94 (0.88 to 0.99) Age, body mass index, alcohol, family history of colorectal cancer, physical activity, aspirin, colonoscopy, history of polyps, pack years of smoking, energy, multivitamins
Egeberg 201038, Denmark The Diet Cancer and Health Cohort Study 1993-2006, 10.2 years 26 630 men and 29 189 women, age 50-64, 461 cases of colon cancer and 283 cases of rectal cancer Validated food frequency questionnaire, 192 food items Whole grains, colon cancer, men >160 v ≤75 g/day 0.61 (0.43 to 0.86) Age, body mass index, alcohol intake, school education, red and processed meat, HRT (women), leisure time physical activity
Whole grains, rectal cancer, men >160 v ≤75 g/day 0.88 (0.57 to 1.36)
Whole grains, colon cancer, women >160 v ≤75 g/day 0.92 (0.63 to 1.35)
Whole grains, rectal cancer, women >160 v ≤75 g/day 0.81 (0.50 to 1.30)
Schatzkin 200727, USA NIH-AARP Diet and Health Study 1995-2000, 5 years 291 988 men and 197 623 women, age 50-71, 2974 cases Validated food frequency questionnaire, 124 food items Whole grains 1.3 v 0.2 serv/1000 kcal/day 0.79 (0.70 to 0.89) Age, sex, physical activity, smoking, HRT (women), red meat, dietary calcium, dietary folate, energy
McCarl 200625, USA Iowa Women’s Health Study 1986-2000, 14 years 35 197 women, age 55-69, 954 cases Validated food frequency questionnaire, 127 food items Whole grains ≥19 v ≤3.5 servings/week 0.81 (0.66 to 0.99) Age
Larsson 200535, Sweden Swedish Mammography Cohort Study 1987-2004, 14.8 years 61 433 women, age 40-76, 805 cases Validated food frequency questionnaire, 67 food items Whole grain ≥4.5 v <1.5 servings/day 0.80 (0.60 to 1.06) Age, body mass index, education, energy, saturated fat, calcium, red meat, fruits and vegetables
Wu 200437, USA Health Professional’s Follow-up Study 1986-2000, 14 years 47 311 men, age 45-75, 561 cases of colon cancer Validated food frequency questionnaire, 131 food items Whole grain Fifths: 5 v 1 0.75 (0.57 to 1.00) Age, family history of colorectal cancer in first degree relative, history of endoscopy, physical activity, pack years of smoking before age 30, race, aspirin use, energy
McCullough 200336, USA Cancer Prevention Study 2 1992-7, 4.5 years 62 609 men and 70 554 women, age 50-74, 298/210 cases of colon cancer Validated food frequency questionnaire, 68 items Whole grains, men ≥11.0 v. <2.0 servings/week 0.95 (0.64 to 1.42) Age, exercise metabolic equivalent of tasks, aspirin, smoking, family history of colorectal cancer, body mass index, education, energy, multivitamin use, total calcium, red meat intake, and HRT (women)
Whole grains, women ≥11.2 v <2.5 servings/week 1.17 (0.73 to 1.87)

HRT=hormone replacement therapy.

*Cases refer to colorectal cancer unless specified otherwise.