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Dong X, He J, Lin L, Zhu Y, Chen C, Su L, Zhao Y, Zhang R, Wei Y, Chen F, Christiani DC. Association between aspirin use and lung cancer incidence depends on high-frequency use, bodyweight, and age in U.S. adults. Transl Lung Cancer Res 2021; 10:392-401. [PMID: 33569321 PMCID: PMC7867785 DOI: 10.21037/tlcr-20-414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background Chemoprevention of cancer with aspirin is controversial as a primary prevention strategy. We sought to investigate the association between aspirin frequency and risk of lung cancer in The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Methods Using data from 101,722 participants in PLCO, we used a Cox regression model coupling with propensity score to detect the association between aspirin frequency and lung cancer risk. Results High-frequency aspirin use significantly increased risk of lung cancer by 28% compared to no use (HR =1.28; 95% CI, 1.14–1.45; P=3.37×10−5), especially for current smoker (HR =1.30; 95% CI, 1.07–1.57; P=6.82×10−3). However, the increased lung cancer risk due to high-frequency aspirin use significantly decreased with increasing bodyweight (HRinteraction =0.96; 95% CI, 0.94–0.99; P=1.26×10−2). Further, for participants with bodyweight <80 kg, high-frequency aspirin use showed an elevated risk at <76 years of age (HRage<76 =1.47; 95% CI, 1.25–1.73; P=3.81×10−6). Our study used propensity score under various confounding and stratification analyses by cardio-cerebrovascular status, which all presented similar evidences. Conclusions High-frequency aspirin use is associated with the increased risk of lung cancer. Current smoker or people with age <76 years and bodyweight <80 kg should be more cautious to high-frequency aspirin use for lung cancer chemoprevention. This study provides a new insight for lung cancer chemoprevention.
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Affiliation(s)
- Xuesi Dong
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Jieyu He
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China
| | - Lijuan Lin
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China
| | - Ying Zhu
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China
| | - Chao Chen
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Yang Zhao
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.,Department of Medical Oncology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Ruyang Zhang
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.,Department of Medical Oncology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Yongyue Wei
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.,China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Biomedical Big Data of Nanjing Medical University, Nanjing, China.,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Cancer Center, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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2
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Wu S, Fisher-Hoch SP, Reininger BM, Lee M, McCormick JB. Fruit and Vegetable Intake is Inversely Associated with Cancer Risk in Mexican-Americans. Nutr Cancer 2019; 71:1254-1262. [PMID: 31017487 DOI: 10.1080/01635581.2019.1603315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: There is inconsistent evidence and limited data in the Hispanic population concerning fruit and vegetable intake and cancer risk. This study explored the effect of fruit and vegetable intake on cancer risk in Mexican-Americans. Methods: Participants in this cross-sectional study were drawn from the Cameron County Hispanic Cohort. Consumption of fruits and vegetables were assessed using a validated questionnaire. Cancer was self-reported by the participants based on being told by a health care provider that they had cancer. Results: Among 2,381 participants with available dietary data, 82 reported a diagnosis of cancer. Participants who met recommendations of five or more servings of fruit and vegetable per day had a significantly 86% lower risk for reported cancer compared with those who did not meet recommendations, after adjusting for other covariates. Every portion increment of total fruit and vegetable intake was significantly associated with the reduced cancer risk by 11% with the adjustment of other covariates. Conclusions: Fruit and vegetable intake was inversely associated with cancer risk in Mexican-Americans. Improving the consumption of fruit and vegetable might be an effective area for further research as part of a strategy for cancer prevention and control among Mexican-Americans independent of other factors.
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Affiliation(s)
- Shenghui Wu
- Department of Epidemiology and Biostatistics, University of Texas Health San Antonio-Laredo Campus, Mays Cancer Center at UT Health San Antonio MD Anderson , Laredo , Texas , USA
| | - Susan P Fisher-Hoch
- Department of Epidemiology, University of Texas Health Science Center-Houston, School of Public Health , Brownsville , Texas , USA
| | - Belinda M Reininger
- Department of Health Promotion and Health Behavior, University of Texas Health Science Center-Houston, School of Public Health , Brownsville , Texas , USA
| | - Miryoung Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center-Houston, School of Public Health , Brownsville , Texas , USA
| | - Joseph B McCormick
- Department of Epidemiology, University of Texas Health Science Center-Houston, School of Public Health , Brownsville , Texas , USA
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Diet quality and Gleason grade progression among localised prostate cancer patients on active surveillance. Br J Cancer 2019; 120:466-471. [PMID: 30679782 PMCID: PMC6462004 DOI: 10.1038/s41416-019-0380-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/20/2018] [Accepted: 01/03/2019] [Indexed: 01/11/2023] Open
Abstract
Background High diet quality may support a metabolic and anti-inflammatory state less conducive to tumour progression. We prospectively investigated diet quality in relation to Gleason grade progression among localised prostate cancer patients on active surveillance, a clinical management strategy of disease monitoring and delayed intervention. Methods Men with newly diagnosed Gleason score 6 or 7 prostate cancer enroled on a biennial monitoring regimen. Patients completed a food frequency questionnaire (FFQ) at baseline (n = 411) and first 6-month follow-up (n = 263). Cox proportional hazards models were fitted to evaluate multivariable-adjusted associations of diet quality [defined via the Healthy Eating Index (HEI)-2015] with Gleason grade progression. Results After a median follow-up of 36 months, 76 men progressed. Following adjustment for clinicopathologic factors, we observed a suggestive inverse association between baseline diet quality and Gleason grade progression [hazard ratio (HR) and 95% confidence interval (CI) for the highest vs. the lowest HEI-2015 tertile: 0.59 (0.32–1.08); Ptrend = 0.06]. We observed no associations with diet quality at 6-month follow-up, nor change in diet quality from baseline. Conclusions In localised prostate cancer patients on surveillance, higher diet quality or conformance with United States dietary guidelines at enrolment may lower risk of Gleason grade progression, though additional confirmatory research is needed.
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Dietary Patterns in Puerto Rican and Mexican-American Breast Cancer Survivors: A Pilot Study. J Immigr Minor Health 2018; 19:341-348. [PMID: 26984227 DOI: 10.1007/s10903-016-0398-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Breast cancer is the leading cause of cancer death among Hispanic women. Certain dietary factors have been associated with the risk of breast cancer recurrence, but data in Hispanic survivors is scarce. OBJECTIVE to examine dietary patterns and diet quality in two groups of Hispanic breast cancer survivors. METHODS 23 Mexican-American (MA) and 22 Puerto Rican (PR) female breast cancer survivors completed a culturally adapted validated food frequency questionnaire. Intake was standardized per 1000 kcal and compared to US Dietary Guidelines and the DASH-style diet adherence score was calculated. RESULTS Overweight/obese was 70 % in MA and 91 % in PR. PR consumed diets rich in fruit/100 % fruit juices and beans, while MA diets were high in vegetables, beans, and total grains. Both groups consumed high amounts of starchy vegetables, refined grains, animal protein and calories from solid fats and added sugars but low intakes of whole grains, dairy products and nuts and seeds. DASH scores were relatively low. CONCLUSION MA and PR female breast cancer survivors have different dietary patterns but both groups had relatively low diet quality. These groups could benefit from culturally tailored interventions to improve diet quality, which could potentially reduce cancer recurrence. ClinicalTrials.gov Identifier NCT01504789.
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Stephens TT, Resinicow K, Latimer-Sport M, Walker L. Social Cognitive Predictors of Dietary Behavior Among African Americans. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1024901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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6
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Yamamura Y, Oum R, Gbito KYE, Garcia-Manero G, Strom SS. Dietary intake of vegetables, fruits, and meats/beans as potential risk factors of acute myeloid leukemia: a Texas case-control study. Nutr Cancer 2013; 65:1132-40. [PMID: 24168094 DOI: 10.1080/01635581.2013.834946] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Diet has been identified as a risk factor for some cancers, but its role in adult de novo acute myeloid leukemia (AML) is unclear. This study was conducted at the University of Texas MD Anderson Cancer Center to evaluate associations between consumption of vegetables, fruits, and meats with AML risk among Texas residents. All participants, 323 adult de novo AML cases and 380 frequency-matched controls, completed demographic and food frequency questionnaires. Overall, AML risk was significantly decreased among those who consumed the most dark green vegetables, seafood, and nuts/seeds; and it was significantly increased among greatest consumers of red meat. Among men, AML risk was lowest among those whose consumption was in the highest quartile for fruits [odds ratio (OR) = 0.25, 95% confidence interval (CI) = 0.10-0.69], poultry (OR = 0.28, 95%CI = 0.10-0.78), and seafood (OR = 0.39, 95%CI = 0.16-0.96) compared to those in the lowest. Among women, risk was lowest among those whose consumption was in the highest quartile of dark-green vegetables (OR = 0.28, 95%CI = 0.12-.68), orange vegetables (OR = 0.40, 95%CI = 0.17-.96) and nuts/beans (OR = 0.26, 95%CI = 0.11-0.60). Based on these findings, interventions can be developed to modify intake of specific dietary components to reduce cancer risk.
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Affiliation(s)
- Yuko Yamamura
- a Department of Epidemiology , The University of Texas M. D. Anderson Cancer Center , Houston , Texas , USA
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7
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Lee PN, Forey BA, Coombs KJ. Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer. BMC Cancer 2012; 12:385. [PMID: 22943444 PMCID: PMC3505152 DOI: 10.1186/1471-2407-12-385] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 07/18/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices. METHODS Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose-response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma ("squamous") and adenocarcinoma ("adeno"). RESULTS 287 studies (20 subsidiary) were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96) current smoking (8.43, 7.63-9.31), ex smoking (4.30, 3.93-4.71) and pipe/cigar only smoking (2.92, 2.38-3.57). It was stronger for squamous (current smoking RR 16.91, 13.14-21.76) than adeno (4.21, 3.32-5.34), and evident in both sexes (RRs somewhat higher in males), all continents (RRs highest for North America and lowest for Asia, particularly China), and both study types (RRs higher for prospective studies). Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40). RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked, duration, earlier starting age, tar level and fraction smoked and decreased with time quit. Relationships were strongest for small and squamous cell, intermediate for large cell and weakest for adenocarcinoma. Covariate-adjustment little affected RR estimates. CONCLUSIONS The association of lung cancer with smoking is strong, evident for all lung cancer types, dose-related and insensitive to covariate-adjustment. This emphasises the causal nature of the relationship. Our results quantify the relationships more precisely than previously.
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Affiliation(s)
- Peter N Lee
- P N Lee Statistics and Computing Ltd, Sutton, Surrey, United Kingdom
| | - Barbara A Forey
- P N Lee Statistics and Computing Ltd, Sutton, Surrey, United Kingdom
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8
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Racial and Ethnic Diversity in Lung Cancer. Lung Cancer 2010. [DOI: 10.1007/978-1-60761-524-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Sidorchuk A, Agardh EE, Aremu O, Hallqvist J, Allebeck P, Moradi T. Socioeconomic differences in lung cancer incidence: a systematic review and meta-analysis. Cancer Causes Control 2009; 20:459-71. [PMID: 19184626 DOI: 10.1007/s10552-009-9300-8] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 01/12/2009] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the associations between various socioeconomic indicators and lung cancer incidence. METHODS We searched PubMed and EMBASE databases for studies on socioeconomic position (SEP) and lung cancer incidence published through October 2007. Random-effect model was used to pool the risk estimates from the individual studies. We stratified the analysis by adjustment strategy to investigate the influence of smoking on socioeconomic gradient in lung cancer incidence. RESULTS Out of 3,288 citations, we identified 64 studies eligible for inclusion. Compared to the highest SEP level, we observed an overall increased risk in lung cancer incidence among people with low educational SEP (61%), low occupational SEP (48%), and low income-based SEP (37%). The negative social gradient for lung cancer incidence remained for most of the possible sets of pooled estimates obtained in subgroup analyses for occupational and educational SEP with less consistency for SEP based on income in studies adjusted and unadjusted for smoking. No evidence of publication bias was apparent. CONCLUSION Lung cancer incidence was associated with low educational, occupational, and income-based SEP. The association, adjusted or unadjusted for smoking, points out the importance of social position to be addressed in all discussions on cancer preventive measures.
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Affiliation(s)
- Anna Sidorchuk
- Division of Social Medicine, Unit of Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, Karolinska Hospital, Stockholm 17176, Sweden.
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10
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Carpenter CL, Yu MC, London SJ. Dietary isothiocyanates, glutathione S-transferase M1 (GSTM1), and lung cancer risk in African Americans and Caucasians from Los Angeles County, California. Nutr Cancer 2009; 61:492-9. [PMID: 19838921 PMCID: PMC3617906 DOI: 10.1080/01635580902752270] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Isothiocyanates, found in cruciferous vegetables, are anticarcinogenic. Racial differences in smoking do not fully account for the African-American excess lung cancer incidence. African Americans consume more cruciferous vegetables than U.S. Whites. Impact on lung cancer risk is unknown. The glutathione S transferase M1 (GSTM1) gene promotes urinary isothiocyanate excretion. We evaluated dietary isothiocyanates and lung cancer using a population-based case-control study of 933 African Americans and Caucasians (non-Hispanic U.S. White) from Los Angeles County, California (311 cases; 622 controls). Broccoli, cauliflower, greens, and cabbage food-frequency variables represented isothiocyanates. Isothiocyanates were protective for lung cancer risk. Adjusted odds ratio (OR) for the uppermost quartile > 80 micro mol isothiocyanates/wk, compared to lowest, was 0.65 [95% confidence interval (CI) = 0.41-1.00, trend P = 0.02]. Association was stronger among subjects with homozygous deletion of GSTM1 (OR = 0.52, 95% CI = 0.31-0.86) than subjects with at least one GSTM1 copy (OR = 0.77, 95% CI = 0.49-1.21). The difference was not statistically significant (P = 0.16). Despite African Americans consuming more cruciferous vegetables, the isothiocyanate association did not vary by race (P = 0.52). Reduced lung cancer risk with higher isothiocyanate intake may be slightly stronger among subjects with deletion of GSTM1.
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Affiliation(s)
- Catherine L Carpenter
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1742, USA.
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Chao C. Associations between beer, wine, and liquor consumption and lung cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2008; 16:2436-47. [PMID: 18006934 DOI: 10.1158/1055-9965.epi-07-0386] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Epidemiologic studies suggest that the effect on lung cancer risk may be different for beer, wine, and liquor. We conducted dose-specific meta-analyses and dose-response meta-regression to summarize findings from the current literature on the association between consumption of beer, wine, or liquor and lung cancer risk. RESULTS Average beer consumption of one drink or greater per day was associated with an increased risk of lung cancer [relative risk (RR), 1.23; 95% confidence interval (95% CI), 1.06-1.41]. This association was observed in both men and women, although it was only significant in men. A J-shaped dose-response curve was suggested for beer intake. An inverse association was observed for both average wine consumption of less than one drink per day (RR, 0.77; 95% CI, 0.59-1.00) and one drink or greater per day (RR, 0.78; 95% CI, 0.60-1.02) in the drinking range incurred in the source studies. Average liquor consumption of one drink or greater per day was found to be associated with increased risk in men (RR, 1.33; 95% CI, 1.10-1.62). No association was observed for liquor drinking in women. The presence of heterogeneity between studies was detected. Study design, country, gender, adjustment factors, and lung cancer histologic type were not significant predictors of the heterogeneity. CONCLUSIONS The results from this meta-analysis suggest that high consumption of beer and liquors may be associated with increased lung cancer risk, whereas modest wine consumption may be inversely associated with risk. More research with improved control of confounding is needed to confirm these findings and to establish the dose-response relationship, particularly risk at high consumption levels.
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Affiliation(s)
- Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California 91101-2453, USA.
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Abstract
Our aim was to review the epidemiological literature on possible cancer-preventive effects of the consumption of fruits and vegetables in humans, to quantify the effect of high versus low consumption of fruits and vegetables, and to give an overall assessment of the existing evidence. We based our work on an expert meeting conducted by the International Agency for Research on Cancer in 2003. A qualitative reading and evaluation of relevant articles on the cancer-preventive effect of the consumption of fruits and vegetables was made followed by the calculation of the mean relative risk and range for cohort and case-control studies separately. The possible population-preventable fraction for modifying diet in relation to fruit and vegetable consumption was calculated as well as an overall statement about the degree of evidence for the cancer-preventive effect of fruit and vegetable consumption for each cancer site. There is limited evidence for a cancer-preventive effect of the consumption of fruits and vegetables for cancer of the mouth and pharynx, esophagus, stomach, colon-rectum, larynx, lung, ovary (vegetables only), bladder (fruit only), and kidney. There is inadequate evidence for a cancer-preventive effect of the consumption of fruits and vegetables for all other sites. Applying this range of risk difference to the range of prevalence of low intake, the preventable fraction for low fruit and vegetable intake would fall into the range of 5-12%. It is important to recognize that this is only a crude range of estimates and that the proportion of cancers that might be preventable by increasing fruit and vegetable intake may vary beyond this range for specific cancer sites and across different regions of the world.
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Affiliation(s)
- Harri Vainio
- Finnish Institute of Occupational Health, Helsinki, Finland
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Smith-Warner SA, Spiegelman D, Yaun SS, Albanes D, Beeson WL, van den Brandt PA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Pietinen P, Rohan TE, Speizer FE, Willett WC, Hunter DJ. Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. Int J Cancer 2004; 107:1001-11. [PMID: 14601062 DOI: 10.1002/ijc.11490] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation.
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Affiliation(s)
- Stephanie A Smith-Warner
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
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14
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Development and validation of a semi-quantitative food frequency questionnaire for young adult women in the southwestern United States. Nutr Res 2004. [DOI: 10.1016/j.nutres.2003.09.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Riboli E, Norat T. Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk. Am J Clin Nutr 2003; 78:559S-569S. [PMID: 12936950 DOI: 10.1093/ajcn/78.3.559s] [Citation(s) in RCA: 664] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Diets rich in fruit and vegetables have been recommended for preventing cancer. The evidence supporting this recommendation is based on observational studies, although results of several prospective studies have cast some doubts on whether fruit and vegetables are associated with cancer risk reduction. OBJECTIVE We sought to summarize evidence from case-control and prospective studies on fruit and vegetable intake and cancer risk with a meta-analytic approach. DESIGN Published case-control and cohort studies that reported on total vegetable and fruit intake and risk of cancer of several sites were included. Relative risks were estimated by using linear logistic regression models. RESULTS Case-control studies overall support a significant reduction in the risks of cancers of the esophagus, lung, stomach, and colorectum associated with both fruit and vegetables; breast cancer is associated with vegetables but not with fruit; and bladder cancer is associated with fruit but not with vegetables. The overall relative risk estimates from cohort studies suggest a protective effect of both fruit and vegetables for most cancer sites considered, but the risk reduction is significant only for cancers of the lung and bladder and only for fruit. CONCLUSIONS Prospective studies provide weaker evidence than do case-control studies of the association of fruit and vegetable consumption with reduced cancer risk. The discrepancies may be related to recall and selection biases in case-control studies. In contrast, the association may have been underestimated in prospective studies because of the combined effects of imprecise dietary measurements and limited variability of dietary intakes within each cohort.
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Affiliation(s)
- Elio Riboli
- Unit of Nutrition and Cancer, International Agency for Research on Cancer, Lyon Cedex, France.
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Fiander H, Schneider H. Dietary ortho phenols that induce glutathione S-transferase and increase the resistance of cells to hydrogen peroxide are potential cancer chemopreventives that act by two mechanisms: the alleviation of oxidative stress and the detoxification of mutagenic xenobiotics. Cancer Lett 2000; 156:117-24. [PMID: 10880760 DOI: 10.1016/s0304-3835(00)00368-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oxidative stress is implicated in the etiology of cancer, hence compounds that alleviate oxidative stress by inducing enzymes that defend against free radical damage might be useful as cancer chemopreventives. Glutathione S-transferase (GST) has been suggested to be a candidate for a critical enzyme in protecting cells against free radical damage, in part, because its level of induction correlates with protection of the cell line IMR-32 against hydrogen peroxide-induced oxidative stress. The present study identified dietary ortho phenols that both induce GST and protect the cell line IMR-32 against hydrogen peroxide-caused oxidative stress. The ortho phenol (o-phenol) inducers were better protectors against oxidative stress than a number of GST inducers that did not bear phenolic groups, possibly because the phenol residues of the ortho phenols allowed their action as antioxidants as well as inducers of GST. GST has previously been thought to protect cells against cancer by detoxifying mutagenic xenobiotics. The present results suggest that ortho phenol inducers of GST might be useful as cancer chemopreventives that act by two independent mechanisms, the alleviation of oxidative stress and the detoxification of mutagenic xenobiotics.
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Affiliation(s)
- H Fiander
- Institute for Biological Sciences, National Research Council of Canada, K1A 0R6, Ottawa, Canada
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Canto MT, Chu KC. Annual cancer incidence rates for Hispanics in the United States: surveillance, epidemiology, and end results, 1992-1996. Cancer 2000; 88:2642-52. [PMID: 10861444 DOI: 10.1002/1097-0142(20000601)88:11<2642::aid-cncr29>3.0.co;2-s] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The expansion of the Surveillance, Epidemiology, and End Results (SEER) program and the determination of annual population estimates by county level for different racial/ethnic groups since 1990 allow the calculation of annual cancer incidence rates for Hispanics. METHODS Incidence rates were calculated for 11 SEER areas representing 25% of the Hispanic population. Standard regression analyses of log-transformed rates were used to determine the trends of the rates. RESULTS An important measure of the cancer burden among Hispanics is the rank order of their cancers. For Hispanic males, the five major cancers (in declining order) are prostate, lung and bronchus, colon/rectum, non-Hodgkin lymphoma, and stomach cancers. For Hispanic females, the top five cancers are breast, colon/rectum, lung and bronchus, cervix, and endometrial cancers. Another measure of cancer burden is their rates relative to white non-Hispanics. Hispanic males have rates greater than white non-Hispanic males for stomach (1.6 times greater) and liver and IBD cancers (2.2), whereas Hispanic females have greater rates for cervix (2.2 times greater), liver and IBD (2.0), stomach (2.1), and gallbladder cancers (3.3). Other measures of cancer burden include the trends in Hispanic rates. Hispanic males have significant declining trends for all sites, prostate cancer, and urinary bladder cancer, and an increasing trend for liver and IBD cancers. Hispanic females have significant declining trends for cervix and urinary bladder cancers. CONCLUSIONS The SEER cancer incidence rates and trends provide a general overview of the cancer burden among Hispanics residing in the SEER sites. This type of information is critical for determining interventions to reduce the cancer burden among Hispanics in the United States.
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Affiliation(s)
- M T Canto
- Office of Special Populations Research, National Institutes of Health, Bethesda, Maryland
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Lykkesfeldt J, Christen S, Wallock LM, Chang HH, Jacob RA, Ames BN. Ascorbate is depleted by smoking and repleted by moderate supplementation: a study in male smokers and nonsmokers with matched dietary antioxidant intakes. Am J Clin Nutr 2000; 71:530-6. [PMID: 10648268 DOI: 10.1093/ajcn/71.2.530] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lack of reliable dietary data has hampered the ability to effectively distinguish between effects of smoking and diet on plasma antioxidant status. As confirmed by analyses of comprehensive food-frequency questionnaires, the total dietary intakes of fruit and vegetables and of dietary antioxidants were not significantly different between the study groups in the present study, thereby enabling isolation of the effect of smoking. OBJECTIVE Our objective was to investigate the effect of smoking on plasma antioxidant status by measuring ascorbic acid, alpha-tocopherol, gamma-tocopherol, beta-carotene, and lycopene, and subsequently, to test the effect of a 3-mo dietary supplementation with a moderate-dose vitamin cocktail. DESIGN In a double-blind, placebo-controlled design, the effect of a vitamin cocktail containing 272 mg vitamin C, 31 mg all-rac-alpha-tocopheryl acetate, and 400 microg folic acid on plasma antioxidants was determined in a population of smokers (n = 37) and nonsmokers (n = 38). The population was selected for a low intake of fruit and vegetables and recruited from the San Francisco Bay area. RESULTS Only ascorbic acid was significantly depleted by smoking per se (P < 0.01). After the 3-mo supplementation period, ascorbic acid was efficiently repleted in smokers (P < 0.001). Plasma alpha-tocopherol and the ratio of alpha- to gamma-tocopherol increased significantly in both supplemented groups (P < 0.05). CONCLUSIONS Our data suggest that previous reports of lower concentrations of plasma vitamin E and carotenoids in smokers than in nonsmokers may primarily have been caused by differences in dietary habits between study groups. Plasma ascorbic acid was depleted by smoking and repleted by moderate supplementation.
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Affiliation(s)
- J Lykkesfeldt
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, USA
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Abstract
Dietary associations were examined as part of a case-control study exploring reasons for exceptionally high rates of lung cancer in northeast Florida. Interviews, which included a nationally standardized food frequency questionnaire, were conducted with 507 patients diagnosed with lung cancer during 1993-1996 or their next of kin and 1,007 persons of similar age, race, and gender randomly selected from the general population. A substantial reduction in risk was associated with high consumption of nutrient-dense fruits and vegetables. Risk was nearly doubled among men and women in the highest quartile of fat intake. The effects were most prominent for saturated and monounsaturated fats and not apparent for polyunsaturated fat consumption. Increased risk was linked to consumption of several individual high-fat foods, including some traditional Southern foods or methods of cooking, such as cooking vegetables with lard/fatback/bacon fat. Reported use of vitamin/mineral supplements was associated with decrease risk of lung cancer as well as dietary consumption of vitamins A, C, and E and some carotenoids. The findings are consistent with emerging evidence that risk of lung cancer rises with increasing dietary fat consumption. They indicate the need for further research to determine whether the association between fat intake and lung cancer is causal and, if so, to clarify the relationships with individual fat fractions.
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Affiliation(s)
- D L Mohr
- University of North Florida, Jacksonville 32224, USA
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