NUTRITION Dietary fibre and risk of breast cancer in the UK Women’s Cohort Study

Background Reports of relationships between dietary fibre intake and breast cancer have been inconsistent. Previous cohort studies have been limited by a narrow range of intakes. Methods Women who developed invasive breast cancer, 350 post-menopausally and 257 pre-menopausally, during 240 959 person-years of follow-up in the UK Women’s Cohort Study (UKWCS) were studied. This cohort has 35 792 subjects with a wide range of exposure to dietary fibre with intakes of total fibre in the lowest quintile of <20 g/day up to430 g/day in the top quintile. Fibre and breast cancer relationships were explored using Cox regression modelling adjusted for measurement error. Effects of fibre, adjusting for confounders were examined for pre- and post-menopausal women separately. Results In pre-menopausal, but not post-menopausal women a statistically significant inverse relationship was found between total fibre intake and risk of breast cancer (P for trend 0.01). The top quintile of fibre intake was associated with a hazard ratio of 0.48 [95 % confidence interval (CI) 0.24–0.96] compared with the lowest quintile. Pre-menopausally, fibre from cereals was inversely associated with risk of breast cancer (P for trend 0.05) and fibre from fruit had a borderline inverse relationship (P for trend 0.09). A further model including dietary folate strengthened the significance of the inverse relationship between total fibre and pre-menopausal breast cancer. Conclusions These findings suggest that in pre-menopausal women, total fibre is protective against breast cancer; in particular, fibre from cereals and possibly fruit