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Yogurt consumption and risk of conventional and serrated precursors of colorectal cancer
  1. Xiaobin Zheng1,2,3,
  2. Kana Wu4,
  3. Mingyang Song4,5,6,7,
  4. Shuji Ogino7,8,9,
  5. Charles S Fuchs10,
  6. Andrew T Chan5,6,
  7. Edward L Giovannucci4,7,8,
  8. Yin Cao1,11,
  9. Xuehong Zhang8
  1. 1 Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
  2. 2 Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  3. 3 Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  4. 4 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  5. 5 Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  6. 6 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  8. 8 Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
  9. 9 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  10. 10 Yale Cancer Center, New Haven, Connecticut, USA
  11. 11 Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
  1. Correspondence to Dr Yin Cao, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine; yin.cao{at}wustl.edu and Dr Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School; xuehong.zhang{at}channing.harvard.edu

https://doi.org/10.1136/gutjnl-2019-318374

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    Davenport et al 1 underscored the urgent need to identify new modifiable factors for colorectal adenomas. A few studies2 3 reported that higher yogurt intake may reduce the risk of colorectal cancer (CRC), potentially mediated by the gut microbiome. However, no study has yet evaluated the association between yogurt intake and precursors of CRC.

    We prospectively evaluated the association between yogurt intake and risk of conventional adenoma and serrated lesion, among 32 606 men in the Health Professionals Follow-up Study (HPFS) and 55 743 women in the Nurses’ Health Study (NHS), who have undergone lower endoscopy between 1986 and 2012. These participants provided detailed information on demographics, lifestyle and diet including yogurt consumption every 4 years. Multivariable logistic regressions were used to calculate ORs and 95% CIs associated with cumulative average of yogurt intake. We examined the associations by adenoma type (conventional adenomas only, serrated lesions only or both), malignant potential (for conventional adenomas: high-risk (≥1 cm or with villous component or high grade/severe dysplasia, or ≥3 adenomas) vs low risk; for serrated lesions: ≥1 vs <1 cm) and anatomical site (proximal, distal or rectum).

    We documented 5811 adenomas in men and 8116 adenomas in women. In men, compared with individuals without yogurt consumption, men who consumed ≥2 servings/week had a lower risk of conventional adenoma (multivariable OR=0.81, 95% CI=0.71 to 0.94, ptrend=0.01; table 1). This inverse association was more pronounced for adenomas with high malignant potential …

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    Footnotes

    • YC and XZ contributed equally.

    • Contributors XiZ, YC and XuZ had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: XiZ, YC, XuZ. Acquisition of data: KW, MS, ATC, ELG, YC. Analysis and interpretation of data: all coauthors. Drafting of the manuscript: XiZ, YC, XuZ. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: XiZ, YC. Obtained funding: SO, ATC, ELG, XuZ. Administrative, technical or material support: YC, XuZ. Study supervision: YC, XuZ.

    • Funding Grant support: The Health Professionals Follow-up Study and Nurses’ Health Study were supported by the National Institutes of Health (NIH) grants UM1CA186107, P50CA127003, P01CA87969 and UM1CA167552. This work was additional funded by NIH grants (R03 CA197879 and R21 CA222940 to KW, R21 CA230873 to KW and SO, R01 CA151993 and R35 CA197735 to SO; K24 DK098311 to ATC; K07 CA218377 to YC; K07 CA188126 to XuZ). XiZ is supported by International Programme for PhD Candidates, Sun Yat-Sen University. KW is supported by an Investigator Initiated Grants from the American Institute for Cancer Research. SO is supported by Nodal Award from the Dana-Farber Harvard Cancer Center and by grants from the Project P Fund for Colorectal Cancer Research, the Friends of the Dana-Farber Cancer Institute, Bennett Family Fund, the Entertainment Industry Foundation through National Colorectal Cancer Research Alliance and American Association for Cancer Research (Stand Up to Cancer Colorectal Cancer Dream Team Translational Research Grant). ATC is a Stuart and Suzanne Steele MGH Research Scholar. XuZ is also supported by the American Cancer Society Research Scholar Grant (RSG NEC-130476) and Boston Nutrition Obesity Research Center Pilot and Feasibility Award.

    • Competing interests Charles S. Fuchs reports consulting role for Agios, Bain Capital, Bayer, Celgene, Dicerna, Five Prime Therapeutics, Gilead Sciences, Eli Lilly, Entrinsic Health, Genentech, KEW, Merck, Merrimack Pharmaceuticals, Pfizer, Sanofi, Taiho, and Unum Therapeutics. He also serves as a Director for CytomX Therapeutics and owns unexercised stock options for CytomX and Entrinsic Health.

    • Provenance and peer review Not commissioned; internally peer reviewed.