Dietary fiber in the reduction of colon cancer risk

The evidence for an inverse association between a diet of foods high in fiber and colon cancer risk is reviewed in the context of the epidemiological criteria for causality. Five criteria are assessed: consistency of the association, strength of the association, specificity of the hypothesis, temporal relationship of the association, and coherence of the association. Forty epidemiological studies, described in 55 original reports, are analyzed in terms of an association between fiber intake and colon cancer. This evaluation clearly suggests a relationship between colon cancer and diet low in fiber. The epidemiological studies focus on dietary patterns in which fiber usually occurs as a complex mixture with other foods. At present, information on the chemistry and function of various types of fiber as well as the mechanisms of cancer inhibition still is quite limited. As dietary fiber may interact with or be linked to other dietary factors, the impact of total diet and dietary interactions should be considered in studies of colon cancer risk and in dietary counseling.