Table 2.

Hazard Ratios (HR) of Colorectal Cancer Associated with Use of Glucosamine, Glucosamine Plus Chondroitin, and Methylsulfonylmethane (MSM) Supplements over the 10 Years Prior to Baseline

Supplement Use	Cohort	Cases	Age and Sex Adjusted		Multivariate Adjusteda
	N (%)	N (%)	HR	95% CI	HR	95% CI
Glucosamineb
No Use of Glucosamine, Chondroitin, MSM	59,024 (79.6)	461 (83.2)	1.00	Ref	1.00	Ref
Low Use (<4 days/week or <3 yrs)	9,724 (13.1)	63 (11.4)	0.79	0.61, 1.03	0.98	0.72, 1.32
High Use (≥4 days/week and ≥3 years)	5,395 (7.28)	30 (5.42)	0.62	0.43, 0.89	0.71	0.46, 1.11
			P-trend: 0.003		P-trend: 0.19
Glucosamine Alonec
No Use of Glucosamine, Chondroitin, MSM	59,024 (93.3)	461 (94.5)	1.00	Ref	1.00	Ref
Low Use (<4 days/week or <3 years)	3,022 (4.78)	21 (4.30)	0.88	0.57, 1.37	1.04	0.63, 1.73
High Use (≥4 days/week and ≥3 years)	1,229 (1.94)	6 (1.23)	0.56	0.25, 1.26	0.86	0.38, 1.94
			P-trend: 0.15		P-trend: 0.84
Glucosamine Plus Chondroitind
No Use of Glucosamine, Chondroitin, MSM	59,024 (85.5)	461 (88.0)	1.00	Ref	1.00	Ref
Low Use (<4 days/week or <3 years)	6,509 (9.43)	44 (8.40)	0.81	0.59, 1.11	1.07	0.75, 1.51
High Use (≥4 days/week and ≥3 years)	3,481 (5.04)	19 (3.63)	0.60	0.38.0.95	0.55	0.30, 1.01
			P-trend: 0.01		P-trend: 0.16
Methylsulfonylmethane (MSM)e
No Use of Glucosamine, Chondroitin, MSM	59,024 (94.2)	461 (96.4)	1.00	Ref	1.00	Ref
Low Use (<4 days/week or <3 years)	2,852 (4.55)	12 (2.51)	0.51	0.29, 0.91	0.72	0.39, 1.32
High Use (≥4 days/week and ≥3 years)	753 (1.20)	5 (1.05)	0.79	0.33, 1.90	0.48	0.12, 1.94
			P-trend: 0.05		P-trend: 0.14

Abbreviations: HR (hazard ratio); MSM (methylsulfonylmethane); 95% CI (95% confidence interval)

^aMultivariate model adjusted for age, sex, race/ethnicity, education, BMI, energy intake, MET-hours per week of moderate/vigorous activity, alcohol intake, smoking history, multivitamin use, calcium intake (diet+supplement), dietary fiber intake, fruit and vegetable intake (excluding potatoes), red/processed meat intake, aspirin use, non-aspirin NSAID use, family history of colorectal cancer, history of sigmoidoscopy/colonoscopy, history of polyp excision, hormone replacement therapy, and history of arthritis or joint pain

^bHigh/low use of glucosamine defined by use of glucosamine, regardless of whether participant also used chondroitin and/or MSM

^cHigh/low use of glucosamine alone defined by use of glucosamine only; participants using glucosamine in addition to chondroitin and/or MSM are excluded from analyses

^dUsers of glucosamine alone or chondroitin alone excluded from these analyses

^e83% of users of MSM are also users of glucosamine or chondroitin.