||5R03CA212983-02 Interpret this number
||Sloan-Kettering Inst Can Research
||Characterizing the Role of Glucosamine and Chondroitin Supplements in the Prevention of Colorectal Tumors
Colorectal cancer (CRC) is the third most common cancer among men and women in the United States, and it
is critical that we identify safe, effective, and easily implemented preventive strategies. Recent evidence has
emerged to suggest that use of glucosamine and chondroitin supplements is associated with reduced
inflammation and risk of CRC. Given that inflammation has been implicated in the etiology of CRC, this may
represent the mechanism by which these popular, non-vitamin, non-mineral supplements may act to reduce
risk of CRC. With excellent safety profiles, glucosamine and chondroitin may be ideal candidates for a potential
preventive strategy. Little is known, however, about when and how these popular supplements affect
inflammation and subsequent colorectal carcinogenesis. To date, no study has evaluated whether use of these
supplements is associated with risk of the CRC precursor lesion, colorectal adenoma. Evidence of an
association with adenoma would suggest that glucosamine and chondroitin act early in the process of
carcinogenesis, thereby making these popular supplements a potential candidate for an adenoma prevention
trial. Furthermore, despite evidence to suggest that use of these supplements is associated with reduced
inflammation in humans, it is unknown if this association varies by supplement form (ie, glucosamine
hydrochloride vs glucosamine sulfate), formulation (ie, glucosamine alone vs glucosamine + chondroitin), and
dose. Should the association continue to indicate a chemopreventive effect, addressing whether the
association with inflammation varies by supplement form, formulation, and dose will help inform the
development of an appropriate intervention strategy.
We therefore propose the first-ever study examining the association between use of glucosamine and
chondroitin supplements and risk of adenoma (Aim 1). Among nearly 44,000 persons screened for colorectal
cancer between 2002 and 2012 in the Nurses' Health Study (NHS) and Health Professionals Follow-up Study
(HPFS), high-risk adenomas (n=1,643) will be compared with screen-negative controls in terms of prior
glucosamine and chondroitin use. We further propose to use nationally representative data on over 27,000
adults from the National Health and Nutrition Examination Survey (NHANES) to evaluate whether the
association between use of glucosamine and chondroitin supplements and inflammation, as measured by C-
reactive protein concentration, varies by supplement form, formulation, and dose (Aim 2). Given the consistent
and promising evidence to suggest that these supplements may reduce inflammation and risk of CRC, it is
critical that we elucidate how and when these supplements act to affect inflammation and subsequent
colorectal carcinogenesis. Such information is critical to informing our understanding of the chemopreventive
potential of these supplements and can guide the development of future preventive efforts.
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