Abstract
Studies have provided evidence of an inverse association between atopic allergic conditions (AACs) and invasive colorectal cancer (CRC) incidence and mortality in predominantly white populations. We examined the association between AACs (asthma, hay fever, or allergy) and CRC among white, African-American, Native Hawaiian, Japanese-American, and Latino men and women in the Multiethnic Cohort Study within Hawaii and Los Angeles, California. The prospective analysis included 4,834 incident CRC cases and 1,363 CRC-related deaths ascertained between 1993 and 2010. We examined associations by ethnicity, location, stage, and potential effect modification by CRC risk factors. AACs were associated with a reduced risk of CRC incidence among both men and women (relative risk (RR) = 0.86, 95% confidence interval (CI): 0.80, 0.92). The reduction in risk was noted in all populations except Latinos and was significant in whites (RR = 0.85, 95% CI: 0.73, 0.98), African Americans (RR = 0.81, 95% CI: 0.70, 0.95), Native Hawaiians (RR = 0.72, 95% CI: 0.54, 0.96), and Japanese Americans (RR = 0.87, 95% CI: 0.78, 0.98). Individuals with AACs also had a 20% reduction in CRC-related mortality (P = 0.001). These findings provide evidence for the potential protective role of the reactive immune system in colorectal cancer.