REPLY
Diet and Colorectal Adenomatous Polyps
Alfred I. Neugut and
Gail C. Garbowski
15 August 1993 | Volume 119 Issue 4 | Page 343
IN RESPONSE:
We appreciate Dr. Anand's comments. The time lag between the preparation of a manuscript and its publication can lead to missing a recent publication. Indeed, a new review article by our group [1] now documents seven published studies on diet and adenomatous polyps; more are undoubtedly on the way.
Overall, we agree that dietary variables play a role in the incidence of adenomatous polyps, similar to that shown for colorectal cancer. We did not find an association of alcohol with adenomatous polyps after adjusting for cigarette smoking, which is related to adenoma incidence [2]. To date, however, our report [3] is the only published observational study on risk factors for polyp recurrence.
Our article did not address the physiologic and cellular mechanisms by which dietary factors may play a role in colon carcinogenesis. We are particularly attracted to the diacylglycerol mechanism suggested by Dr. Anand and agree that evidence for its possible intermediary role is accumulating [4]. As always, much work remains to be done in elucidating these mechanisms and exploring their interactions with genetic predisposition.
1. Neugut AI, Jacobson JS, DeVivo I. Epidemiology of colorectal adenomatous polyps. Cancer Epidemiol Biomarkers Prev. 1993; 2:159-76.
2. Lee WC, Neugut AI, Garbowski GC, et al. Cigarettes, alcohol, coffee and caffeine as risk factors for colorectal adenomatous polyps. Ann Epidemiol; (In press).
3. Neugut AI, Garbowski GC, Lee WC, Murray T, Nieves JW, Forde KA, et al. Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps: a case–control study. Ann Intern Med. 1993; 118:91-5.
4. Weinstein IB. Cancer prevention: recent progress and future opportunities. Cancer Res. 1991; 51(Suppl):5080s-5s.
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