Prospective evaluation of trans-fatty acid intake and colorectal cancer risk in the Iowa Women's Health Study

Paul J. Limburg, Wen Liu-Mares, Robert A. Vierkant, Alice H. Wang, Lisa Harnack, Andrew P. Flood, Thomas A. Sellers, James R. Cerhan

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Concerns regarding the safety of dietary trans-fatty acids (tFAs) have generated recent public interest, scientific discussion and legislative action. Although most widely recognized as a risk factor for cardiovascular disease, associations between tFA intake and incident cancer have also been proposed. With respect to colorectal cancer (CRC), existing observational data remain limited and inconclusive. Therefore, we conducted a prospective evaluation of tFA intake and CRC risk, overall and by anatomic subsite, among participants in the Iowa Women's Health Study (IWHS), a population-based cohort of older women (ages 55-69 years at enrollment). Exposure data were collected at baseline using a semiquantitative food-frequency questionnaire. Incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. CRC risks were estimated using Cox proportional hazards regression models. In total, 35,216 women met our inclusion criteria and 1,229 CRC cases (631 proximal, 571 distal, 27 site not specified) were observed through 18 years of follow-up. Adjusting for age and total energy consumption, tFA intake in the 4th versus 1st quartile was not significantly associated with overall CRC risk [relative risk (RR) = 1.12; 95% confidence interval (CI) = 0.96-1.32]. Similarly, risk estimates based on proximal (RR = 1.09; 95% CI = 0.87-1.37) and distal (RR = 1.18; 95% CI = 0.93-1.49) CRC subsites did not differ from unity. Multivariable adjustment yielded slightly attenuated risk estimates, but the observed associations were not meaningfully altered. Given these findings, tFA intake does not appear to be a major CRC risk factor, at least among older women.

Original languageEnglish (US)
Pages (from-to)2717-2719
Number of pages3
JournalInternational Journal of Cancer
Issue number11
StatePublished - Dec 1 2008


  • Cohort study
  • Colorectal cancer
  • Dietary fat
  • trans-fatty acids

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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