Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
Cancer Epidemiol Biomarkers Prev. 2019 Nov;28(11):1884-1890. doi: 10.1158/1055-9965.EPI-19-0326. Epub 2019 Aug 27.
Fiber-based prebiotic supplements are marketed for maintaining bowel health and promoting beneficial gut bacteria. However, the association between prebiotic supplement use and colorectal cancer risk and mortality is unknown.
The association between prebiotic use and colorectal cancer risk and mortality was evaluated in postmenopausal women in the Women's Health Initiative study. Self-reported prebiotic use was documented at study enrollment. Adjudicated colorectal cancer cases and mortality were captured using medical and death records. Cox proportional hazards models were used to estimate the HR related to prebiotic use and colorectal cancer risk and mortality.
In total, 3,032 colorectal cancer cases were diagnosed during an average 15.4 years of follow-up. Overall, 3.7% of women used a prebiotic with psyllium, the major fiber type. Use of any prebiotic supplement was not associated with colorectal cancer risk or mortality. The type of prebiotic supplement (none vs. insoluble or soluble) was not associated with colorectal cancer risk; however, use of insoluble fiber prebiotics compared with none was associated with higher colorectal cancer mortality [HR, 2.79; 95% confidence interval (CI), 1.32-5.90; = 0.007]. Likelihood ratio tests indicated no significant interactions between prebiotic use and other colorectal cancer risk factors, including metabolic syndrome.
Prebiotic fiber supplement use was not associated with colorectal cancer risk. Insoluble, but not soluble, prebiotic fiber use was associated with higher colorectal cancer mortality. These findings do not support the promotion of prebiotic fiber supplements to reduce colorectal cancer risk or colorectal cancer mortality.
Further investigation is warranted for findings regarding insoluble prebiotic fiber and higher colorectal cancer mortality in postmenopausal women.
基于纤维的益生元补充剂被用于维持肠道健康和促进有益肠道细菌。然而，益生元补充剂的使用与结直肠癌风险和死亡率之间的关系尚不清楚。
在妇女健康倡议研究中，评估了绝经后妇女中益生元使用与结直肠癌风险和死亡率之间的关系。在研究入组时记录了自我报告的益生元使用情况。使用医疗和死亡记录来捕获经裁决的结直肠癌病例和死亡率。使用 Cox 比例风险模型来估计与益生元使用相关的结直肠癌风险和死亡率的 HR。
在平均 15.4 年的随访期间，共诊断出 3032 例结直肠癌病例。总体而言，3.7%的女性使用了含有车前子的益生元，车前子是主要的纤维类型。使用任何益生元补充剂与结直肠癌风险或死亡率无关。益生元补充剂的类型（无 vs. 不溶性或可溶性）与结直肠癌风险无关；然而，与无益生元补充剂相比，使用不溶性纤维益生元与更高的结直肠癌死亡率相关[HR，2.79；95%置信区间（CI），1.32-5.90；P = 0.007]。似然比检验表明，益生元使用与其他结直肠癌风险因素（包括代谢综合征）之间没有显著的相互作用。
益生元纤维补充剂的使用与结直肠癌风险无关。不溶性，但不是可溶性，益生元纤维的使用与更高的结直肠癌死亡率相关。这些发现不支持推广益生元纤维补充剂以降低结直肠癌风险或结直肠癌死亡率。
需要进一步调查关于绝经后妇女中不溶性益生元纤维和更高的结直肠癌死亡率的发现。
