Järvinen R, Knekt P, Hakulinen T, Aromaa A
Department of Clinical Nutrition, University of Kuopio, PO Box 1627, Fin 70211 Kuopio, Finland.
Eur J Clin Nutr. 2001 Nov;55(11):1000-7. doi: 10.1038/sj.ejcn.1601260.
To study the relationship between consumption of milk and milk products, calcium, lactose and vitamin D and occurrence of colorectal cancers.
Prospective cohort study.
A total of 9959 men and women aged 15 y or older without history of cancer at baseline. During a 24 y follow-up, 72 new cancers of the large bowel (38 in the colon and 34 in the rectum) were detected.
Consumption of milk and total milk products was suggested to be inversely related to colon cancer incidence, whereas no similar association was seen for rectal cancer. The relative risk between the highest and lowest quartiles of intake adjusted for potential confounding factors was 0.46 (95% confidence interval 0.14-1.46, P for trend 0.09) for milk and 0.37 (95% CI=0.12-1.39, P for trend 0.06) for total milk products. Lactose intake showed a similar inverse relationship with colon cancer: the relative risk was 0.31 (95% CI=0.08-1.15, P for trend 0.03). Intake of vitamin D or total dietary calcium was not significantly related to colorectal cancer risk, whereas calcium provided by fermented milk products was associated with increased colorectal cancer incidence; in the highest quartile the multivariate adjusted relative risk for colorectal cancer was 2.07 (95% CI=1.00-4.28).
Our results indicate that individuals showing high consumption of milk have a potentially reduced risk of colon cancer; however, the association does not appear to be due to intake of calcium, vitamin D, or to specific effects of fermented milk.
This study was supported by a grant from the Swedish Cancer Foundation.
研究牛奶及奶制品、钙、乳糖和维生素D的摄入量与结直肠癌发病之间的关系。
前瞻性队列研究。
共有9959名15岁及以上、基线时无癌症病史的男性和女性。在24年的随访期间,检测到72例新发的大肠癌症(38例发生在结肠,34例发生在直肠)。
牛奶及奶制品的摄入量与结肠癌发病率呈负相关,而直肠癌未见类似关联。经潜在混杂因素校正后,摄入量最高四分位数与最低四分位数之间的相对风险,牛奶为0.46(95%置信区间0.14 - 1.46,趋势P值0.09),奶制品总量为0.37(95%置信区间 = 0.12 - 1.39,趋势P值0.06)。乳糖摄入量与结肠癌也呈类似的负相关:相对风险为0.31(95%置信区间 = 0.08 - 1.15,趋势P值0.03)。维生素D或膳食总钙的摄入量与结直肠癌风险无显著关联,而发酵奶制品提供的钙与结直肠癌发病率增加有关;在最高四分位数中,结直肠癌的多变量校正相对风险为2.07(95%置信区间 = 1.00 - 4.28)。
我们的结果表明,牛奶摄入量高的个体患结肠癌的风险可能降低;然而,这种关联似乎并非由于钙、维生素D的摄入,也不是由于发酵牛奶的特定作用。
本研究由瑞典癌症基金会的一项资助支持。