Table 4.
Joint and combined associations of the DIS and LIS* with incident CRC overall and by sex; the NIH-AARP, 1995–2011 (N = 453 465)
| Population and DIS quintiles† | LIS quintiles† |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 |
2 |
3 |
4 |
5 |
|||||||
| No. cases | HR (95% CI) | No. cases | HR (95% CI) | No. cases | HR (95% CI) | No. cases | HR (95% CI) | No. cases | HR (95% CI) | P interaction | |
| All participants | |||||||||||
| 1 | 361 | 1.00 (Referent) | 478 | 1.13 (1.06 to 1.20) | 351 | 1.22 (1.15 to 1.30) | 381 | 1.23 (1.16 to 1.31) | 306 | 1.41 (1.32 to 1.50) | |
| 2 | 371 | 1.02 (0.96 to 1.09) | 398 | 1.15 (1.05 to 1.26) | 362 | 1.25 (1.14 to 1.36) | 436 | 1.26 (1.15 to 1.37) | 338 | 1.43 (1.31 to 1.57) | |
| 3 | 341 | 1.07 (1.01 to 1.14) | 391 | 1.21 (1.10 to 1.32) | 423 | 1.31 (1.20 to 1.43) | 474 | 1.32 (1.21 to 1.44) | 379 | 1.51 (1.38 to 1.65) | |
| 4 | 335 | 1.14 (1.07 to 1.21) | 365 | 1.28 (1.17 to 1.40) | 469 | 1.39 (1.27 to 1.51) | 479 | 1.40 (1.28 to 1.53) | 478 | 1.60 (1.46 to 1.74) | |
| 5 | 319 | 1.30 (1.22 to 1.38) | 346 | 1.46 (1.34 to 1.60) | 550 | 1.59 (1.46 to 1.73) | 545 | 1.60 (1.47 to 1.75) | 660 | 1.83 (1.68 to 1.99) | <.001 |
| Men | |||||||||||
| 1 | 214 | 1.00 (Referent) | 337 | 1.15 (1.06 to 1.24) | 229 | 1.30 (1.20 to 1.41) | 269 | 1.27 (1.17 to 1.37) | 194 | 1.52 (1.40 to 1.65) | |
| 2 | 225 | 1.04 (0.97 to 1.13) | 304 | 1.20 (1.07 to 1.34) | 250 | 1.36 (1.22 to 1.52) | 297 | 1.33 (1.19 to 1.48) | 221 | 1.59 (1.42 to 1.78) | |
| 3 | 193 | 1.08 (1.00 to 1.17) | 292 | 1.24 (1.11 to 1.39) | 287 | 1.41 (1.26 to 1.57) | 329 | 1.37 (1.23 to 1.53) | 239 | 1.64 (1.47 to 1.84) | |
| 4 | 201 | 1.12 (1.04 to 1.21) | 268 | 1.29 (1.15 to 1.44) | 326 | 1.46 (1.31 to 1.63) | 312 | 1.42 (1.28 to 1.59) | 290 | 1.71 (1.53 to 1.91) | |
| 5 | 219 | 1.32 (1.23 to 1.43) | 253 | 1.52 (1.36 to 1.70) | 385 | 1.72 (1.55 to 1.92) | 381 | 1.68 (1.51 to 1.87) | 390 | 2.01 (1.80 to 2.24) | <.001 |
| Women | |||||||||||
| 1 | 147 | 1.00 (Referent) | 141 | 1.11 (0.99 to 1.25) | 122 | 1.08 (0.97 to 1.21) | 112 | 1.17 (1.05 to 1.30) | 112 | 1.23 (1.11 to 1.37) | |
| 2 | 146 | 0.97 (0.87 to 1.09) | 94 | 1.08 (0.92 to 1.27) | 112 | 1.05 (0.90 to 1.23) | 139 | 1.13 (0.97 to 1.32) | 117 | 1.20 (1.03 to 1.39) | |
| 3 | 148 | 1.06 (0.95 to 1.18) | 99 | 1.18 (1.01 to 1.39) | 136 | 1.15 (0.99 to 1.34) | 145 | 1.24 (1.07 to 1.44) | 140 | 1.31 (1.13 to 1.52) | |
| 4 | 134 | 1.16 (1.04 to 1.29) | 97 | 1.29 (1.10 to 1.51) | 143 | 1.26 (1.09 to 1.46) | 167 | 1.36 (1.17 to 1.58) | 188 | 1.43 (1.24 to 1.66) | |
| 5 | 100 | 1.26 (1.13 to 1.40) | 93 | 1.40 (1.20 to 1.64) | 165 | 1.36 (1.18 to 1.58) | 164 | 1.47 (1.27 to 1.70) | 270 | 1.55 (1.34 to 1.79) | .004 |
Inflammation scores constructed as described in the text and Table 1; a higher score reflects a higher balance of proinflammatory exposures. CI = confidence interval; CRC = colorectal cancer; DIS = dietary inflammation score; HR = hazards ratio; HRT = hormone replacement therapy; LIS = lifestyle inflammation score; NIH-AARP = National Institutes of Health American Association for Retired Persons Diet and Health Study.
Covariates in the Cox proportional hazards models were: age at entry (continuous), sex, race (black, white, or other), education (less than high school and high school graduate, some college, or college graduate or higher), marital status (married or nonmarried), heart disease or history of stroke at baseline (yes or no), diabetes mellitus at baseline (yes or no), emphysema at baseline (yes or no), gallstone or gallbladder disease at baseline (yes or no), current HRT use (among women), family history of CRC in a first-degree relative, history of colon polyp, total energy intake (kcal/d), and former smoker (yes or no); history of CRC in a first-degree relative, self-reported heart disease diagnosis, age at entry, and sex were included in the SAS STRATA statement.