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Journal of Oncology
Volume 2013, Article ID 703854, 14 pages
Review Article

Subsite-Specific Dietary Risk Factors for Colorectal Cancer: A Review of Cohort Studies

1Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway
2Department of Etiological Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, 0304 Oslo, Norway
3Section of Cancer Information, International Agency for Research on Cancer, 69372 Lyon, France
4Department of Registration, Cancer Registry of Norway, Institute of Population-Based Cancer Research, 0304 Oslo, Norway

Received 11 October 2012; Accepted 30 November 2012

Academic Editor: Anne-Kathrin Illner

Copyright © 2013 Anette Hjartåker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. A shift in the total incidence from left- to right-sided colon cancer has been reported and raises the question as to whether lifestyle risk factors are responsible for the changing subsite distribution of colon cancer. The present study provides a review of the subsite-specific risk estimates for the dietary components presently regarded as convincing or probable risk factors for colorectal cancer: red meat, processed meat, fiber, garlic, milk, calcium, and alcohol. Methods. Studies were identified by searching PubMed through October 8, 2012 and by reviewing reference lists. Thirty-two prospective cohort studies are included, and the estimates are compared by sex for each risk factor. Results. For alcohol, there seems to be a stronger association with rectal cancer than with colon cancer, and for meat a somewhat stronger association with distal colon and rectal cancer, relative to proximal colon cancer. For fiber, milk, and calcium, there were only minor differences in relative risk across subsites. No statement could be given regarding garlic. Overall, many of the subsite-specific risk estimates were nonsignificant, irrespective of exposure. Conclusion. For some dietary components the associations with risk of cancer of the rectum and distal colon appear stronger than for proximal colon, but not for all.