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Br J Cancer. 1987 June; 55(6): 687–694.
PMCID: PMC2002031

Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study.


The aetiology of colorectal cancer was studied in a cohort of 11,888 residents of a retirement community. After four and one-half years of follow-up, 58 male and 68 female incident colorectal cancers were identified. Daily alcohol drinkers experienced nearly a two-fold increase in risk (2 sided P = 0.002). Colorectal cancer was also positively associated with Quetelet's index and inversely associated with avocational physical activity. The results were consistent for both sexes but were statistically significant only for males. With the exception of dietary vitamin C, none of the nutrients under study (i.e., vitamins A and E, dietary fibre, calcium, and beta carotene) showed a significant association with colorectal cancer. An inverse relationship between colorectal cancer and dietary vitamin C was observed in females, but there was no association with either vitamin C from supplements or with total vitamin C intake. Males and females who had 3 or more children showed a significantly reduced risk of colorectal cancer (RR = 0.45, 95% CI = 0.2, 0.9), but those with no children did not show the highest risk.

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  • Ames BN. Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative diseases. Science. 1983 Sep 23;221(4617):1256–1264. [PubMed]
  • Bebb HT, Houser HB, Witschi JC, Littell AS, Fuller RK. Calorie and nutrient contribution of alcoholic beverages to the usual diets of 155 adults. Am J Clin Nutr. 1971 Sep;24(9):1042–1052. [PubMed]
  • Bingham S, Williams DR, Cole TJ, James WP. Dietary fibre and regional large-bowel cancer mortality in Britain. Br J Cancer. 1979 Sep;40(3):456–463. [PMC free article] [PubMed]
  • Bingham SA, Williams DR, Cummings JH. Dietary fibre consumption in Britain: new estimates and their relation to large bowel cancer mortality. Br J Cancer. 1985 Sep;52(3):399–402. [PMC free article] [PubMed]
  • Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES II survey. I. Vitamins and minerals. Am J Epidemiol. 1985 Jul;122(1):13–26. [PubMed]
  • Byers T, Graham S, Swanson M. Parity and colorectal cancer risk in women. J Natl Cancer Inst. 1982 Nov;69(5):1059–1062. [PubMed]
  • Byers T, Marshall J, Fiedler R, Zielezny M, Graham S. Assessing nutrient intake with an abbreviated dietary interview. Am J Epidemiol. 1985 Jul;122(1):41–50. [PubMed]
  • Breslow NE, Enstrom JE. Geographic correlations between cancer mortality rates and alcohol-tobacco consumption in the United States. J Natl Cancer Inst. 1974 Sep;53(3):631–639. [PubMed]
  • Burkitt DP. Epidemiology of cancer of the colon and rectum. Cancer. 1971 Jul;28(1):3–13. [PubMed]
  • Dales LG, Friedman GD, Ury HK, Grossman S, Williams SR. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol. 1979 Feb;109(2):132–144. [PubMed]
  • Drasar BS, Irving D. Environmental factors and cancer of the colon and breast. Br J Cancer. 1973 Feb;27(2):167–172. [PMC free article] [PubMed]
  • Garabrant DH, Peters JM, Mack TM, Bernstein L. Job activity and colon cancer risk. Am J Epidemiol. 1984 Jun;119(6):1005–1014. [PubMed]
  • Garland C, Shekelle RB, Barrett-Connor E, Criqui MH, Rossof AH, Paul O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet. 1985 Feb 9;1(8424):307–309. [PubMed]
  • Gerhardsson M, Norell SE, Kiviranta H, Pedersen NL, Ahlbom A. Sedentary jobs and colon cancer. Am J Epidemiol. 1986 May;123(5):775–780. [PubMed]
  • Graham S, Dayal H, Swanson M, Mittelman A, Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst. 1978 Sep;61(3):709–714. [PubMed]
  • Gray GE, Paganini-Hill A, Ross RK, Henderson BE. Assessment of three brief methods of estimation of vitamin A and C intakes for a prospective study of cancer: comparison with dietary history. Am J Epidemiol. 1984 Apr;119(4):581–590. [PubMed]
  • Haenszel W, Kurihara M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst. 1968 Jan;40(1):43–68. [PubMed]
  • Haenszel W, Locke FB, Segi M. A case-control study of large bowel cancer in Japan. J Natl Cancer Inst. 1980 Jan;64(1):17–22. [PubMed]
  • Hill MJ. The effect of some factors on the faecal concentration of acid steroids, neutral steroids and urobilins. J Pathol. 1971 Aug;104(4):239–245. [PubMed]
  • Holdstock DJ, Misiewicz JJ, Smith T, Rowlands EN. Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity. Gut. 1970 Feb;11(2):91–99. [PMC free article] [PubMed]
  • Howe GR, Craib KJ, Miller AB. Age at first pregnancy and risk of colorectal cancer: a case-control study. J Natl Cancer Inst. 1985 Jun;74(6):1155–1159. [PubMed]
  • Jain M, Cook GM, Davis FG, Grace MG, Howe GR, Miller AB. A case-control study of diet and colo-rectal cancer. Int J Cancer. 1980 Dec 15;26(6):757–768. [PubMed]
  • Jones BR, Barrett-Connor E, Criqui MH, Holdbrook MJ. A community study of calorie and nutrient intake in drinkers and nondrinkers of alcohol. Am J Clin Nutr. 1982 Jan;35(1):135–139. [PubMed]
  • Lew EA, Garfinkel L. Variations in mortality by weight among 750,000 men and women. J Chronic Dis. 1979;32(8):563–576. [PubMed]
  • Liu K, Stamler J, Moss D, Garside D, Persky V, Soltero I. Dietary cholesterol, fat, and fibre, and colon-cancer mortality. An analysis of international data. Lancet. 1979 Oct 13;2(8146):782–785. [PubMed]
  • McMichael AJ, Potter JD, Hetzel BS. Time trends in colo-rectal cancer mortality in relation to food and alcohol consumption: United States, United Kingdom, Australia and New Zealand. Int J Epidemiol. 1979 Dec;8(4):295–303. [PubMed]
  • McMichael AJ, Potter JD. Reproduction, endogenous and exogenous sex hormones, and colon cancer: a review and hypothesis. J Natl Cancer Inst. 1980 Dec;65(6):1201–1207. [PubMed]
  • McMichael AJ, Potter JD. Parity and death from colon cancer in women: a case-control study. Community Health Stud. 1984;8(1):19–25. [PubMed]
  • Manousos O, Day NE, Trichopoulos D, Gerovassilis F, Tzonou A, Polychronopoulou A. Diet and colorectal cancer: a case-control study in Greece. Int J Cancer. 1983 Jul 15;32(1):1–5. [PubMed]
  • Miller AB, Howe GR, Jain M, Craib KJ, Harrison L. Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer. Int J Cancer. 1983 Aug 15;32(2):155–161. [PubMed]
  • Modan B, Barell V, Lubin F, Modan M, Greenberg RA, Graham S. Low-fiber intake as an etiologic factor in cancer of the colon. J Natl Cancer Inst. 1975 Jul;55(1):15–18. [PubMed]
  • Nomura AM, Stemmermann GN, Heilbrun LK, Salkeld RM, Vuilleumier JP. Serum vitamin levels and the risk of cancer of specific sites in men of Japanese ancestry in Hawaii. Cancer Res. 1985 May;45(5):2369–2372. [PubMed]
  • Nomura A, Heilbrun LK, Stemmermann GN. Body mass index as a predictor of cancer in men. J Natl Cancer Inst. 1985 Feb;74(2):319–323. [PubMed]
  • Papadimitriou C, Day N, Tzonou A, Gerovassilis F, Manousos O, Trichopoulos D. Biosocial correlates of colorectal cancer in Greece. Int J Epidemiol. 1984 Jun;13(2):155–159. [PubMed]
  • Phillips RL. Role of life-style and dietary habits in risk of cancer among seventh-day adventists. Cancer Res. 1975 Nov;35(11 Pt 2):3513–3522. [PubMed]
  • Phillips RL, Snowdon DA. Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists. J Natl Cancer Inst. 1985 Feb;74(2):307–317. [PubMed]
  • Pollack ES, Nomura AM, Heilbrun LK, Stemmermann GN, Green SB. Prospective study of alcohol consumption and cancer. N Engl J Med. 1984 Mar 8;310(10):617–621. [PubMed]
  • Potter JD, McMichael AJ. Large bowel cancer in women in relation to reproductive and hormonal factors: a case-control study. J Natl Cancer Inst. 1983 Oct;71(4):703–709. [PubMed]
  • Potter JD, McMichael AJ. Diet and cancer of the colon and rectum: a case-control study. J Natl Cancer Inst. 1986 Apr;76(4):557–569. [PubMed]
  • Reddy BS, Weisburger JH, Wynder EL. Fecal bacterial beta-glucuronidase: control by diet. Science. 1974 Feb 1;183(4123):416–417. [PubMed]
  • Stähelin HB, Rösel F, Buess E, Brubacher G. Cancer, vitamins, and plasma lipids: prospective Basel study. J Natl Cancer Inst. 1984 Dec;73(6):1463–1468. [PubMed]
  • Stemmermann G, Nomura AM, Heilbrun LK, Mower H, Hayashi T. Colorectal cancer in Hawaiian Japanese men: a progress report. Natl Cancer Inst Monogr. 1985 Dec;69:125–131. [PubMed]
  • Thornton J, Symes C, Heaton K. Moderate alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol. Lancet. 1983 Oct 8;2(8354):819–822. [PubMed]
  • Weiss NS, Daling JR, Chow WH. Incidence of cancer of the large bowel in women in relation to reproductive and hormonal factors. J Natl Cancer Inst. 1981 Jul;67(1):57–60. [PubMed]
  • Wynder EL, Shigematsu T. Environmental factors of cancer of the colon and rectum. Cancer. 1967 Sep;20(9):1520–1561. [PubMed]
  • Wynder EL, Kajitani T, Ishikawa S, Dodo H, Takano A. Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data. Cancer. 1969 May;23(5):1210–1220. [PubMed]

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