Table 3.
Sulfur microbial diet and risk of early-onset (age <50 years) conventional adenoma by malignancy risk, NHSII, 1991–2015
| Sulfur microbial diet score (quartile) | P trend § | ||||
|---|---|---|---|---|---|
| 1 (lowest) | 2 | 3 | 4 (highest) | ||
| Histology | |||||
| Tubulovillous/villous | 51 | 57 | 49 | 73 | |
| Age-adjusted OR (95% CI)† | 1 [Ref] | 1.19 (0.80 to 1.77) | 1.06 (0.70 to 1.62) | 1.61 (1.10 to 2.36) | 0.04 |
| Multivariable OR (95% CI)‡ | 1 [Ref] | 1.21 (0.81 to 1.80) | 1.09 (0.72 to 1.65) | 1.65 (1.12 to 2.43) | 0.04 |
| Tubular | 236 | 245 | 243 | 288 | |
| Age-adjusted OR (95% CI)† | 1 [Ref] | 1.03 (0.86 to 1.24) | 1.03 (0.85 to 1.25) | 1.27 (1.06 to 1.53) | 0.05 |
| Multivariable OR (95% CI)‡ | 1 [Ref] | 1.01 (0.84 to 1.22) | 1.02 (0.84 to 1.24) | 1.24 (1.02 to 1.51) | 0.09 |
| Size | |||||
| Large (≥1 cm) | 49 | 56 | 45 | 50 | |
| Age-adjusted OR (95% CI)† | 1 [Ref] | 1.18 (0.79 to 1.76) | 0.99 (0.64 to 1.54) | 1.14 (0.75 to 1.74) | 0.74 |
| Multivariable OR (95% CI)‡ | 1 [Ref] | 1.21 (0.81 to 1.81) | 1.02 (0.66 to 1.59) | 1.17 (0.76 to 1.81) | 0.80 |
| Small (<1 cm) | 175 | 171 | 155 | 223 | |
| Age-adjusted OR (95% CI)† | 1 [Ref] | 0.99 (0.80 to 1.23) | 0.91 (0.72 to 1.14) | 1.36 (1.10 to 1.68) | 0.03 |
| Multivariable OR (95% CI)‡ | 1 [Ref] | 0.98 (0.78 to 1.21) | 0.90 (0.71 to 1.14) | 1.34 (1.07 to 1.66) | 0.06 |
Adjusted for age (continuous), total caloric intake (in quintiles), time period of endoscopy (in 2-year intervals), number of reported endoscopies (continuous), time in years since the most recent endoscopy (continuous), and reason for the current endoscopy (screening, symptoms, missing).
Additionally adjusted for height (continuous), body mass index (in quintiles), family history of colorectal cancer (yes, no), menopausal status (premenopausal, postmenopausal), menopausal hormone use (never, past, current use of menopausal hormones), personal history of type 2 diabetes (yes, no), pack-years of smoking (never, 1–4.9, 5–19.9, 20–39.9, ≥40 pack-years), physical activity (in metabolic equivalent of task-hours/week, quintiles), current use of multivitamin (yes, no), regular use of aspirin (yes, no), and regular use of non-steroidal anti-inflammatory drugs (yes, no).
Calculated using the median of each quartile as a continuous variable.
High-risk adenoma includes adenoma ≥1 cm, or with tubulovillous/villous histology or high-grade dysplasia, or ≥3 adenomas.
Abbreviations: CI (confidence interval), cm (centimeter), OR (odds ratio)