Calcium intake may explain the reduction of colorectal cancer odds by dietary selenium - a case-control study in Poland

Abstract

Abstract Background Colorectal cancer (CRC) has been placed among top three cancer sites in high income countries. Although there are several inconsistencies across studies it is widely accepted that diet contributes to approximately 70% of CRC. Several dietary factors have been investigated; however, the knowledge about the role of trace elements and their interplay with other dietary factors in CRC odds is limited. The aim of the study was to estimate the odds ratio of colorectal cancer associated with the content of selenium in diet, and to check whether dietary calcium is a modifier of selenium effect in the population characterized by low selenium intake. Methods Face-to-face interviews were used to gather data on dietary habits (by 148-item semi-quantitative food frequency questionnaire) and covariates among 683 histologically confirmed incident colorectal cancer cases and 759 hospital-based controls in a case-control study. Data was collected in a period between 2000 and 2012. Setting: Lesser Poland, Central Europe. Logistic regression models were used to assess the role of dietary selenium intake and calcium-selenium interaction in colorectal cancer odds. Results After the adjustment for several covariates dietary selenium was associated with the decrease of colorectal cancer odds by 8% (OR = 0.92, 95%CI: 0.84–0.99 for every 10μg Se/day increase). In individuals with lower (< 1000 mg/day) calcium content the odds of colorectal cancer was decreased by 13%(for every 10μg Se/day) and by 44% and 66% depending on the categories of selenium intake (60 to < 80 μg/day and ≥ 80 μg/day, respectively). The effect of dietary selenium was modified by dietary calcium (p for interaction < .005). Conclusions The study has shown a beneficial effect of dietary selenium for colorectal cancer and a modification effect of dietary calcium in a population characterized by lower levels of selenium intake. The results provide the basis for well-planned controlled trials to confirm the findings.

Keywords

• Dietary selenium
• Dietary calcium
• Large bowel cancer
• Risk estimate
• Modification effect