The Association Between Prebiotic Fiber Supplement Use and Colorectal Cancer Risk and Mortality in the Women's Health Initiative
Menée aux Etats-Unis à partir de données portant sur 3 032 patientes atteintes d'un cancer colorectal, cette étude de cohorte analyse l'association entre une supplémentation en fibres et en prébiotiques, le risque de développer la maladie et la mortalité spécifique (durée moyenne de suivi : 15,4 ans)
Background: Fiber-based prebiotic supplements are marketed for maintaining bowel health and promoting beneficial gut bacteria. However, the association between prebiotic supplement use and colorectal cancer (CRC) risk and mortality is unknown. Methods: The association between prebiotic use and CRC risk and mortality was evaluated in postmenopausal women in the Women's Health Initiative study. Self-reported prebiotic use was documented at study enrollment. Adjudicated CRC cases and mortality were captured using medical and death records. Cox proportional hazards models were used to estimate the hazard ratio related to prebiotic use and CRC risk and mortality. Results: In total, 3,032 CRC cases were diagnosed during an average 15.4 years of follow-up. Overall, 3.7% of women used a prebiotic with psyllium the majority fiber type. Use of any prebiotic supplement was not associated with CRC risk or mortality. The type of prebiotic supplement (none vs. insoluble or soluble) was not associated with CRC risk; however, use of insoluble fiber prebiotics compared to none was associated with higher CRC-mortality (HR: 2.79; 95%CI: 1.32-5.90; p=0.007). Likelihood ratio tests indicated no significant interactions between prebiotic use and other CRC risk factors including metabolic syndrome. Conclusion: Prebiotic fiber supplement use was not associated with CRC risk. Insoluble but not soluble prebiotic fiber use was associated with higher CRC-mortality. These findings do not support the promotion of prebiotic fiber supplements to reduce CRC risk or CRC-mortality. Impact: Further investigation is warranted for findings regarding insoluble prebiotic fiber and higher CRC-mortality in post-menopausal women.