A Case-control Study of Roles of Diet in Colorectal Carcinoma in a South Indian Population


Introduction: The worldwide incidence of colorectal cancer has increased rapidly in the past few decadesand dietary habits have been implicated in the cause. Though the Indian diet varies substantially from westerndiet, there has not been detailed studies on any association. Materials and
Methods: This is hospital based casecontrol study enrolling 108 cases and 324 controls, all hailing from the Malabar region of Kerala, India. Thesubjects were interviewed using food frequency questionnaires for commonly consumed dietary items in theregion.
Results: A strong association was found between colorectal cancer and tapioca (OR=2.7 p=0.001), beef(OR=4.25, p=0.000) and pungent spices (OR=9.62, p=0.018). Fruits and vegetables a showed strong inverseassociation (OR= 0.15 p=0.002). Fish consumption on a daily basis showed a 25% reduction in risk on univariateanalysis. Heavy consumption of sugar (OR=2.80) and tobacco use (OR=8.79) showed significant high risk.
Conclusions: There is strong evidence from our study that intake of beef, refined carbohydrates and tobaccocan promote colorectal cancer. Our study has also thrown light on some of the other commonly consumed items,like tapioca and spices which have positive associations. These are commonly consumed in Malabar region ofKerala. A cohort study is now needed to confirm our findings.