Epidemiologic and scientific research indicates that diet and other lifestyle factors have a significant influence on the risk of developing colon cancer. However, the influence of diet, physical activity, obesity, and other lifestyle factors on the outcome of patients with established colon cancer is virtually unknown. Randomized clinical trials demonstrate a significant survival advantage for individuals with stage III colon cancer who receive adjuvant fluorouracil-based chemotherapy. Nonetheless, 40-45% of stage III patients receiving current adjuvant chemotherapy will develop metastases. Patients often seek to understand what, if any, diet and lifestyle will reduce their chances of cancer recurrence as well as the potential toxicities associated with adjuvant therapy. Moreover, how diet and lifestyle influence prognosis may depend, in part, on molecular characteristics of the tumor. In response to a NIH Program Announcement, PA-06-404, """"""""Studies of Energy Balance and Cancer in Humans,"""""""" we propose to address these gaps in knowledge by utilizing a large, completed National Cancer Institute-sponsored adjuvant chemotherapy trial (CALGB 89803) in stage III colon cancer which provides a) two longitudinal prospective, validated assessments of diet, medication, and lifestyle;b) paraffin-embedded tumor specimens to examine how dietary factors interact with specific molecular alterations;and c) comprehensive data on cancer recurrence, mortality, and chemotherapy-related toxicity. Since pathologic stage, performance status, post-operative therapy and follow-up were carefully defined in this trial, residual confounding by disease characteristics and use of adjuvant therapy should be minimized. This database will provide a unique opportunity to examine the influence of diet (Aim 1), energy balance (Aim 2), and aspirin and other medications (Aim 3) on the risk of colon cancer recurrence, mortality, and chemotherapy-related toxicity.
Each specific aim i n this proposal extends current knowledge in these areas. Beyond the aforementioned hypotheses, this cohort will allow for the rapid examination of future hypotheses as they emerge. Ultimately, this database will permit us to ascertain the influence of numerous factors on colon cancer survival, improve our understanding of colon cancer biology, and potentially offer substantive dietary and lifestyle recommendations for patients and health care providers.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Epidemiology of Cancer Study Section (EPIC)
Program Officer
Su, Joseph
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Dana-Farber Cancer Institute
United States
Zip Code
Cao, Yin; Wu, Kana; Mehta, Raaj et al. (2017) Long-term use of antibiotics and risk of colorectal adenoma. Gut :
Liu, Li; Nishihara, Reiko; Qian, Zhi Rong et al. (2017) Association Between Inflammatory Diet Pattern and Risk of Colorectal Carcinoma Subtypes Classified by Immune Responses to Tumor. Gastroenterology 153:1517-1530.e14
Mehta, Raaj S; Song, Mingyang; Nishihara, Reiko et al. (2017) Dietary Patterns and Risk of Colorectal Cancer: Analysis by Tumor Location and Molecular Subtypes. Gastroenterology 152:1944-1953.e1
Hamada, Tsuyoshi; Cao, Yin; Qian, Zhi Rong et al. (2017) Aspirin Use and Colorectal Cancer Survival According to Tumor CD274 (Programmed Cell Death 1 Ligand 1) Expression Status. J Clin Oncol 35:1836-1844
Gu, Mancang; Nishihara, Reiko; Chen, Yang et al. (2017) Aspirin exerts high anti-cancer activity in PIK3CA-mutant colon cancer cells. Oncotarget 8:87379-87389
Nishihara, Reiko; Glass, Kimberly; Mima, Kosuke et al. (2017) Biomarker correlation network in colorectal carcinoma by tumor anatomic location. BMC Bioinformatics 18:304
Mehta, Raaj S; Nishihara, Reiko; Cao, Yin et al. (2017) Association of Dietary Patterns With Risk of Colorectal Cancer Subtypes Classified by Fusobacterium nucleatum in Tumor Tissue. JAMA Oncol 3:921-927
Sarma, Elizabeth A; Kawachi, Ichiro; Poole, Elizabeth M et al. (2017) Social integration and survival after diagnosis of colorectal cancer. Cancer :
Yurgelun, Matthew B; Kulke, Matthew H; Fuchs, Charles S et al. (2017) Cancer Susceptibility Gene Mutations in Individuals With Colorectal Cancer. J Clin Oncol 35:1086-1095
Momen-Heravi, Fatemeh; Masugi, Yohei; Qian, Zhi Rong et al. (2017) Tumor expression of calcium sensing receptor and colorectal cancer survival: Results from the nurses' health study and health professionals follow-up study. Int J Cancer 141:2471-2479

Showing the most recent 10 out of 71 publications