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Modification of the associations between lifestyle, dietary factors and colorectal cancer risk by APC variants

Theodoratou, Evropi; Campbell, Harry; Tenesa, Albert; McNeill, Geraldine; Cetnarskyj, Roseanne; Barnetson, Rebecca A; Porteous, Mary E; Dunlop, Malcolm G; Farrington, Susan M


Evropi Theodoratou

Harry Campbell

Albert Tenesa

Geraldine McNeill

Roseanne Cetnarskyj

Rebecca A Barnetson

Mary E Porteous

Malcolm G Dunlop

Susan M Farrington


In a large Scottish case–control study, we investigated the effects of adenomatous polyposis coli (APC) Asp1822Val (rs459552) and APC Glu1317Gln substitutions on colorectal cancer (CRC) risk and whether these associations were influenced by lifestyle and dietary factors. We did not observe any associations between the variants and CRC risk in the whole population. Post-menopausal women taking hormone replacement therapy (HRT) and participants who consumed a diet low in total fat, saturated fatty acids, monounsaturated fatty acids (MUFAs) and trans fatty acids had a lower risk of CRC [odds ratio (95% confidence interval): 0.53 (0.41, 0.68); 0.84 (0.72, 0.98); 0.72 (0.62, 0.85); 0.85 (0.73, 1.00) and 0.78 (0.67, 0.92), respectively]. This risk reduction was stronger in those homozygous for the variant APC 1822 allele with significant interaction relationships for HRT, red meat and MUFA intakes (P for interaction case-only design: 0.02, 0.002 and 0.02, respectively). Low n3 polyunsaturated fatty acids intake was associated with an increased CRC risk for the wild-type and heterozygous APC 1822 individuals but with a decreased CRC risk in those homozygous for the variant allele (P for interaction case-only design: 0.09). The interaction relationships with the APC 1317 variant were of the same direction though not significant, possibly due to the low frequency of the variant allele. Our results confirm the findings of three recent case–control studies suggesting a number of possible biological mechanisms. However, further large-scale studies are necessary in order to replicate these findings and confirm the role of these APC gene variants and their interaction with dietary and lifestyle exposures in colorectal carcinogenesis.


Theodoratou, E., Campbell, H., Tenesa, A., McNeill, G., Cetnarskyj, R., Barnetson, R. A., …Farrington, S. M. (2008). Modification of the associations between lifestyle, dietary factors and colorectal cancer risk by APC variants. Carcinogenesis, 29, 1774-1780.

Journal Article Type Article
Publication Date 2008
Deposit Date Mar 13, 2014
Print ISSN 0143-3334
Electronic ISSN 1460-2180
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 29
Pages 1774-1780
Keywords adenomatous polyposis coli (APC); colorectal cancer (CRC); APC gene variants; diet; lifestyle;
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