Foods as risk factors for colorectal cancer: a case-control study in Burgundy (France)

Although the high meat-low vegetable diet is considered the reference high- risk diet for colorectal cancer, particularly in USA communities, other at- risk dietary patterns, such as high intakes of processed meat and refined c arbohydrates are emerging. Little is known about risk factors for colorecta l cancer in France, a country at high risk of rectal cancer and moderately high risk of colon cancer. We compared diet of colorectal cancer cases (n = 171) and general population controls (n = 309) in Burgundy (France). Categ ories of intake were established by sex and based on the distributions of f ood intakes in controls. Odds ratios for the fourth vs first quartile of in take (OR4) were 2.0 (1.1-3.6) for refined cereal products (rice, pasta and pastry), 2.4 (1.3-4.5) for delicatessen, 2.3 (1.2-4.2) for pates,1.7 (1.1-2 .8) for offal and 2.1 (1.1-4.0) for butter, lard and cream. There was no as sociation with consumption of fresh meat (OR4 = 1.2), fish (OR4 = 1.5), egg (OR4 = 1.1) or dairy products (OR4 = 1.0). A protective effect of vegetabl es was only observed for left colon cancer (OR3 = 0.3; 0.1-0.6). In men, th e most significant risk factors were refined cereal products, seasoning ani mal fats, chocolate and coffee, whereas risk factors were delicatessen, fat meat, pasta, rice, and chocolate in women. The strong association with ref ined cereal products is consistent with the hypothesis of a role of hyperin sulinism in colorectal carcinogenesis. The association with processed but n ot fresh meat suggests the importance of exogenous carcinogenesis in that a rea. (C) 1999 Lippincott Williams & Wilkins.