Abstract
The association between dietary carbohydrate intake and colorectal cancer (CRC) risk remains controversial. We therefore conducted this meta-analysis to assess the relationship between them. A literature search from the databases of PubMed, Embase, Web of Science and Medline was performed for available articles published in English (up to September 2016). Pooled relative risk (RR) with 95% confidence interval (CI) was calculated to evaluate the association between dietary carbohydrate intake and CRC risk. The random-effect model (REM) was selected as the pooling method. Publication bias was estimated using Egger’s regression asymmetry test and funnel plot. A total of 17 articles involving 14402 CRC patients and 846004 participants were eligible with the inclusion criteria in this meta-analysis. The pooled RR with 95% CI of dietary carbohydrate intake for CRC, colon cancer and rectum cancer risk were 1.08 (95% CI =0.93–1.23, I2 =68.3%, Pheterogeneity<0.001), 1.09 (95% CI =0.95–1.25, I2 =48.3%) and 1.17 (95% CI =0.98–1.39, I2 =17.8%) respectively. When we conducted the subgroup analysis by gender, the significant association was found in men’s populations (summary RR =1.23, 95% CI =1.01–1.57), but not in the women’s populations. In the further subgroup analyses for study design and geographic locations, we did not find any association between dietary carbohydrate intake and CRC risk in the subgroup results respectively. No significant publication bias was found either by the Egger’s regression asymmetry test or by the funnel plot. This meta-analysis suggested that higher dietary carbohydrate intake may be an increased factor for CRC risk in men populations. Further studies are wanted to confirm this relationship.
Highlights
Colorectal cancer (CRC) is the third most common cancer and the third most common cause of high mortality cancer rates in the United States [1]
The inclusion criteria were as follows: (i) observational study published as the original study to assess the association between dietary carbohydrate intake and CRC risk; (ii) the exposure of interest was dietary carbohydrate intake; (iii) the outcome of interest was CRC; (iv) relative risk (RR) or odds ratio (OR) with corresponding 95% confidence interval (CI) were available; (v) the complete and recent study was chosen if a study had been published more than once
The following information was extracted from each study: the first author’s name, publication year, mean age or age range, country, gender, study design, disease type, number of cases and participants, variables adjusted for the analysis and RR with their 95% CI
Summary
Colorectal cancer (CRC) is the third most common cancer and the third most common cause of high mortality cancer rates in the United States [1]. Several lines of evidence indicate that insulin resistance may play a role in the aetiology of CRC. Some risk factors for CRC including overweight and obesity, low physical activity and Type II diabetes are linked to insulin resistance [3,4]. Many studies were conducted to assess the association between dietary carbohydrate intake on CRC risk up to now, there is no comprehensive conclusion. For higher category of dietary carbohydrate intake, a prospective study by Higginbotham et al [6] reported that it could increase the CRC risk.
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