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The D1822V APC polymorphism interacts with fat, calcium, and fiber intakes in modulating the risk of colorectal cancer in Portuguese persons^1,2,3

¹ From the Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal (CSG and MB); the Serviço de Gastrenterologia do Instituto Português de Oncologia de Lisboa Francisco Gentil Entidade Publica Empresarial, Lisbon, Portugal (MC, PF, and CNL); the Unidade de Nutrição e Metabolismo Instituto de Medicina Molecular da Universidade de Lisboa, Lisbon, Portugal (CSG and PMV)

Background: Both genetic and environmental factors affect the risk of colorectal cancer (CRC).

Objective: We aimed to examine the interaction between the D1822V polymorphism of the APC gene and dietary intake in persons with CRC.

Design: Persons with CRC (n = 196) and 200 healthy volunteers, matched for age and sex in a case-control study, were evaluated with respect to nutritional status and lifestyle factors and for the D1822V polymorphism.

Results: No significant differences were observed in energy and macronutrient intakes. Cases had significantly (P < 0.05) lower intakes of carotenes, vitamins C and E, folate, and calcium than did controls. Fiber intake was significantly (P = 0.004) lower in cases than in controls, whereas alcohol consumption was associated with a 2-fold risk of CRC. In addition, cases were significantly (P = 0.001) more likely than were controls to be sedentary. The homozygous variant for the APC gene (VV) was found in 4.6% of cases and in 3.5% of controls. Examination of the potential interactions between diet and genotype found that a high cholesterol intake was associated with a greater risk of colorectal cancer only in noncarriers (DD) of the D1822V APC allele (odds ratio: 1.66; 95% CI: 1.00, 2.76). In contrast, high fiber and calcium intakes were more markedly associated with a lower risk of CRC in patients carrying the polymorphic allele (DV/VV) (odds ratio: 0.50; 95% CI: 0.27, 0.94 for fiber; odds ratio: 0.51; 95% CI: 0.28, 0.93 for calcium) than in those without that allele.

Conclusion: These results suggest a significant interaction between the D1822V polymorphism and the dietary intakes of cholesterol, calcium, and fiber for CRC risk.

Key Words: Colorectal cancer • diet • genetic polymorphism • lifestyle factors

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