Date of Conferral

2020

Degree

Ph.D.

School

Public Health

Advisor

James Rohrer

Abstract

The colorectal cancer (CRC) survivor population is increasing in the United States. The lack of effective dietary recommendations in recurrence prevention undermines the health-related quality of life of survivors. Grounded in the socioecological model, dietary behavior is a personal-level risk factor that individuals may control. This study investigated the CRC-specific mortality risk as predicted by diet quality, dietary fiber intake, and dietary fat intake in hope of contributing to future dietary recommendations. A secondary analysis using data from 1,166 CRC survivors in the Multiethnic Cohort Study was analyzed via Cox proportional hazard regression models to estimate mortality risk. Results from the regression models found that postdiagnosis diet quality, as measure by the Healthy Eating Index-2010, was not associated with CRC-specific mortality risk. However, a change in scores from below-median to above-median from prediagnosis was associated with an increased risk (HR = 2.00, 95% CI [1.02, 3.99], p = 0.044). Meanwhile, dietary fiber intake of moderate and high levels was associated with 58% and 52% risk reduction (p = 0.011 and 0.041, respectively). Finally, neither total dietary fat intake nor fat from fish and shellfish was associated with CRC-specific mortality risk. The findings suggested a need to identify an effective tool to evaluate diet quality post-CRC. Additionally, while dietary fiber intake was favorable in improving long-term outcomes, dietary fat and fish consumption may not directly contribute to CRC-specific mortality risk reduction during long-term survivorship. This study provided new evidence on the dietary needs of minority CRC survivors and may shape public health education.

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