Dietary fiber and the risk of colorectal cancer and adenoma in women

N Engl J Med. 1999 Jan 21;340(3):169-76. doi: 10.1056/NEJM199901213400301.


Background: A high intake of dietary fiber has been thought to reduce the risk of colorectal cancer and adenoma.

Methods: We conducted a prospective study of 88,757 women, who were 34 to 59 years old and had no history of cancer, inflammatory bowel disease, or familial polyposis, who completed a dietary questionnaire in 1980. During a 16-year follow-up period, 787 cases of colorectal cancer were documented. In addition, 1012 patients with adenomas of the distal colon and rectum were found among 27,530 participants who underwent endoscopy during the follow-up period.

Results: After adjustment for age, established risk factors, and total energy intake, we found no association between the intake of dietary fiber and the risk of colorectal cancer; the relative risk for the highest as compared with the lowest quintile group with respect to fiber intake was 0.95 (95 percent confidence interval, 0.73 to 1.25). No protective effect of dietary fiber was observed when we omitted, adjustment for total energy intake, when events during the first six years of follow-up were excluded, or when we excluded women who altered their fiber intake during the follow-up period. No significant association between fiber intake and the risk of colorectal adenoma was found.

Conclusions: Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer or adenoma.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenoma / epidemiology
  • Adenoma / prevention & control*
  • Adult
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / prevention & control
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / prevention & control*
  • Dietary Fiber / administration & dosage*
  • Energy Intake
  • Female
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Rectal Neoplasms / epidemiology
  • Rectal Neoplasms / prevention & control
  • Risk
  • Risk Factors
  • Surveys and Questionnaires