Giovannucci Edward, Rimm Eric B, Liu Yan, Stampfer Meir J, Willett Walter C
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2003 Dec;12(12):1403-9.
High intake of cruciferous vegetables may offer some protection against prostate cancer, but overall data are inconclusive. Thus, we examined the association between cruciferous vegetable intake and risk of prostate cancer in the Health Professionals Follow-Up Study. Between 1986 and 2000, 2,969 cases of nonstage T1a prostate cancer were diagnosed in 47,365 men who completed dietary assessments in 1986, 1990, and 1994. We calculated the multivariate relative risk (RR) and 95% confidence intervals (CIs) using Cox regression. Overall, we found no appreciable association between baseline intake of cruciferous vegetables and risk of prostate cancer (RR, 0.93; 95% CI, 0.82-1.05, for > or = 5 versus < or = 1 serving/week; P for trend = 0.30), and only a slight suggestive association for organ-confined prostate cancer (RR, 0.88; 95% CI, 0.74-1.05; P for trend = 0.06). The inverse association was stronger for men under the age of 65 years (RR, 0.81; 95% CI, 0.64-1.02; P for trend = 0.02), especially for organ-confined cancers (RR, 0.72; 95% CI, 0.54-0.97; P for trend = 0.007). In addition, this inverse association was stronger when we restricted the analysis to men with more consistent intake of vegetables over the 10 years before 1986, when we limited the analysis to men who had had a prostate-specific antigen test, and when we considered an 8-year time lag. This study does not provide compelling evidence of a protective influence of cruciferous vegetables on prostate cancer risk. However, if cruciferous vegetables are protective early in prostate carcinogenesis, as suggested by proposed mechanisms, we may expect stronger associations, as observed, for more remote diet for prostate-specific antigen-detected early stage (organ-confined) cancers in younger men. In contrast, for advanced cancers in older men, which were probably initiated decades in the past, recent dietary intakes of cruciferous vegetables may be irrelevant. These findings suggest that future studies of cruciferous vegetables should focus on early stages of prostate cancer.
大量摄入十字花科蔬菜可能对前列腺癌有一定的预防作用,但总体数据尚无定论。因此,我们在健康专业人员随访研究中考察了十字花科蔬菜摄入量与前列腺癌风险之间的关联。1986年至2000年间,在1986年、1990年和1994年完成饮食评估的47365名男性中,有2969例被诊断为非T1a期前列腺癌。我们使用Cox回归计算了多变量相对风险(RR)和95%置信区间(CI)。总体而言,我们发现十字花科蔬菜的基线摄入量与前列腺癌风险之间没有明显关联(RR为0.93;95%CI为0.82 - 1.05,每周摄入≥5份与每周摄入≤1份相比;趋势P值 = 0.30),对于器官局限性前列腺癌只有轻微的提示性关联(RR为0.88;95%CI为0.74 - 1.05;趋势P值 = 0.06)。65岁以下男性的负相关更强(RR为0.81;95%CI为0.64 - 1.02;趋势P值 = 0.02),尤其是对于器官局限性癌症(RR为0.72;95%CI为0.54 - 0.97;趋势P值 = 0.007)。此外,当我们将分析限制在1986年前10年蔬菜摄入量更一致的男性中、将分析限于进行过前列腺特异性抗原检测的男性中以及考虑8年的时间滞后时,这种负相关更强。本研究没有提供令人信服的证据表明十字花科蔬菜对前列腺癌风险有保护作用。然而,如果如所提出的机制所暗示的那样,十字花科蔬菜在前列腺癌发生早期具有保护作用,那么我们可能会预期,如观察到的那样,对于年轻男性中通过前列腺特异性抗原检测出的早期(器官局限性)癌症,更远期的饮食有更强的关联。相比之下,对于老年男性的晚期癌症,其可能在几十年前就已开始,近期十字花科蔬菜的饮食摄入量可能无关紧要。这些发现表明,未来关于十字花科蔬菜的研究应聚焦于前列腺癌的早期阶段。