TY - JOUR
T1 - Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas
AU - Alberts, David S.
AU - Martínez, María Elena
AU - Roe, Denise J.
AU - Guillén-Rodríguez, José M.
AU - Marshall, James R.
AU - Van Leeuwen, J. Barbara
AU - Reid, Mary E.
AU - Ritenbaugh, Cheryl
AU - Vargas, Perla A.
AU - Bhattacharyya, A. B.
AU - Earnest, David L.
AU - Sampliner, Richard E.
AU - Parish, Dianne
AU - Koonce, Kris
AU - Fales, Lianne
PY - 2000/4/20
Y1 - 2000/4/20
N2 - Background: The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by dietary factors. Epidemiologic evidence that cereal fiber protects against colorectal cancer is equivocal. We conducted a randomized trial to determine whether dietary supplementation with wheat-bran fiber reduces the rate of recurrence of colorectal adenomas. Methods: We randomly assigned 1429 men and women who were 40 to 80 years of age and who had had one or more histologically confirmed colorectal adenomas removed within three months before recruitment to a supervised program of dietary supplementation with either high amounts (13.5 g per day) or low amounts (2 g per day) of wheat-bran fiber. The primary end point was the presence or absence of new adenomas at the time of follow-up colonoscopy. Subjects and physicians, including colonoscopists, were unaware of the group assignments. Results: Of the 1303 subjects who completed the study, 719 had been randomly assigned to the high-fiber group and 584 to the low-fiber group. The median times from randomization to the last follow-up colonoscopy were 34 months in the high-fiber group and 36 months in the low-fiber group. By the time of the last follow-up colonoscopy, at least one adenoma had been identified in 338 subjects in the high-fiber group (47.0 percent) and in 299 subjects in the low-fiber group (51.2 percent). The multivariate adjusted odds ratio for recurrent adenoma in the high-fiber group, as compared with the low-fiber group, was 0.88 (95 percent confidence interval, 0.70 to 1.11; P=0.28), and the relative risk of recurrence according to the number of adenomas, in the high-fiber group as compared with the low-fiber group, was 0.99 (95 percent confidence interval, 0.71 to 1.36; P=0.93). Conclusions: As used in this study, a dietary supplement of wheat-bran fiber does not protect against recurrent colorectal adenomas. (C) 2000, Massachusetts Medical Society.
AB - Background: The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by dietary factors. Epidemiologic evidence that cereal fiber protects against colorectal cancer is equivocal. We conducted a randomized trial to determine whether dietary supplementation with wheat-bran fiber reduces the rate of recurrence of colorectal adenomas. Methods: We randomly assigned 1429 men and women who were 40 to 80 years of age and who had had one or more histologically confirmed colorectal adenomas removed within three months before recruitment to a supervised program of dietary supplementation with either high amounts (13.5 g per day) or low amounts (2 g per day) of wheat-bran fiber. The primary end point was the presence or absence of new adenomas at the time of follow-up colonoscopy. Subjects and physicians, including colonoscopists, were unaware of the group assignments. Results: Of the 1303 subjects who completed the study, 719 had been randomly assigned to the high-fiber group and 584 to the low-fiber group. The median times from randomization to the last follow-up colonoscopy were 34 months in the high-fiber group and 36 months in the low-fiber group. By the time of the last follow-up colonoscopy, at least one adenoma had been identified in 338 subjects in the high-fiber group (47.0 percent) and in 299 subjects in the low-fiber group (51.2 percent). The multivariate adjusted odds ratio for recurrent adenoma in the high-fiber group, as compared with the low-fiber group, was 0.88 (95 percent confidence interval, 0.70 to 1.11; P=0.28), and the relative risk of recurrence according to the number of adenomas, in the high-fiber group as compared with the low-fiber group, was 0.99 (95 percent confidence interval, 0.71 to 1.36; P=0.93). Conclusions: As used in this study, a dietary supplement of wheat-bran fiber does not protect against recurrent colorectal adenomas. (C) 2000, Massachusetts Medical Society.
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U2 - 10.1056/NEJM200004203421602
DO - 10.1056/NEJM200004203421602
M3 - Article
C2 - 10770980
AN - SCOPUS:0342657814
SN - 0028-4793
VL - 342
SP - 1156
EP - 1162
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 16
ER -