A summary measure of pro- and anti-oxidant exposures and risk of incident, sporadic, colorectal adenomas

Cancer Causes Control. 2008 Dec;19(10):1051-64. doi: 10.1007/s10552-008-9169-y. Epub 2008 Jun 10.


Despite compelling basic science evidence, the search for causal associations linking specific pro- and anti-oxidants to presumably oxidative stress-related neoplasms, such as colorectal adenoma, has produced inconsistent results. We developed an oxidative balance score (OBS) to characterize the pro-oxidant and anti-oxidant exposures of 2,305 participants in a case-control study of colorectal adenoma that used both endoscopy-confirmed and community controls. Twelve lifestyle medical and dietary factors with known pro- or anti-oxidant properties were considered. Each high anti-oxidant exposure and low pro-oxidant exposure was awarded one or two points depending on the level of exposure, and the points for each OBS component were summed. We observed a significant inverse association between OBS (continuous variable) and colorectal adenoma in the analyses with either community, or endoscopy controls (each p-trend < 0.01). When the OBS was treated as an ordinal variable and a score of <or=3 points was used as the referent category, in the analyses with the endoscopy controls the adjusted odds ratios for scores of 4-6, 7-9, 10-12, 13-15, and 16+, were 0.42, 0.32, 0.22, 0.20, and 0.19, respectively, with all 95% confidence intervals excluding 1.0. The corresponding analysis for community controls showed a similar trend. Our findings are in line with the basic science evidence supporting the role of oxidative stress in colorectal neoplasia.

MeSH terms

  • Adenoma / etiology
  • Adenoma / genetics
  • Adenoma / pathology
  • Antioxidants / administration & dosage*
  • Case-Control Studies
  • Causality
  • Colonoscopy
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / etiology
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / prevention & control
  • Confidence Intervals
  • Diet / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Oxidative Stress / physiology*
  • Reactive Oxygen Species / adverse effects
  • Risk Factors
  • Surveys and Questionnaires


  • Antioxidants
  • Reactive Oxygen Species