Männistö Satu, Smith-Warner Stephanie A, Spiegelman Donna, Albanes Demetrius, Anderson Kristin, van den Brandt Piet A, Cerhan James R, Colditz Graham, Feskanich Diane, Freudenheim Jo L, Giovannucci Edward, Goldbohm R Alexandra, Graham Saxon, Miller Anthony B, Rohan Thomas E, Virtamo Jarmo, Willett Walter C, Hunter David J
Harvard School of Public Health, Department of Nutrition, Boston, Massachusetts, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Jan;13(1):40-8. doi: 10.1158/1055-9965.epi-038-3.
Intervention trials with supplemental beta-carotene have observed either no effect or a harmful effect on lung cancer risk. Because food composition databases for specific carotenoids have only become available recently, epidemiological evidence relating usual dietary levels of these carotenoids with lung cancer risk is limited. We analyzed the association between lung cancer risk and intakes of specific carotenoids using the primary data from seven cohort studies in North America and Europe. Carotenoid intakes were estimated from dietary questionnaires administered at baseline in each study. We calculated study-specific multivariate relative risks (RRs) and combined these using a random-effects model. The multivariate models included smoking history and other potential risk factors. During follow-up of up to 7-16 years across studies, 3,155 incident lung cancer cases were diagnosed among 399,765 participants. beta-Carotene intake was not associated with lung cancer risk (pooled multivariate RR = 0.98; 95% confidence interval, 0.87-1.11; highest versus lowest quintile). The RRs for alpha-carotene, lutein/zeaxanthin, and lycopene were also close to unity. beta-Cryptoxanthin intake was inversely associated with lung cancer risk (RR = 0.76; 95% confidence interval, 0.67-0.86; highest versus lowest quintile). These results did not change after adjustment for intakes of vitamin C (with or without supplements), folate (with or without supplements), and other carotenoids and multivitamin use. The associations generally were similar among never, past, or current smokers and by histological type. Although smoking is the strongest risk factor for lung cancer, greater intake of foods high in beta-cryptoxanthin, such as citrus fruit, may modestly lower the risk.
补充β-胡萝卜素的干预试验观察到对肺癌风险无影响或有有害影响。由于特定类胡萝卜素的食物成分数据库直到最近才可用，因此将这些类胡萝卜素的日常饮食水平与肺癌风险相关联的流行病学证据有限。我们使用来自北美和欧洲七项队列研究的原始数据，分析了肺癌风险与特定类胡萝卜素摄入量之间的关联。类胡萝卜素摄入量通过每项研究基线时发放的饮食问卷进行估算。我们计算了各研究特定的多变量相对风险（RR），并使用随机效应模型进行合并。多变量模型纳入了吸烟史和其他潜在风险因素。在长达7至16年的跨研究随访期间，399,765名参与者中诊断出3,155例新发肺癌病例。β-胡萝卜素摄入量与肺癌风险无关（合并多变量RR = 0.98；95%置信区间，0.87 - 1.11；最高五分位数与最低五分位数相比）。α-胡萝卜素、叶黄素/玉米黄质和番茄红素（摄入）的RR也接近1。β-隐黄质摄入量与肺癌风险呈负相关（RR = 0.76；95%置信区间，0.67 - 0.86；最高五分位数与最低五分位数相比）。在对维生素C（无论是否补充）、叶酸（无论是否补充）、其他类胡萝卜素和多种维生素使用（情况）进行调整后，这些结果没有改变。在从不吸烟、曾经吸烟或当前吸烟者中以及按组织学类型划分时，这些关联通常相似。尽管吸烟是肺癌最强的风险因素，但更多摄入富含β-隐黄质的食物，如柑橘类水果，可能会适度降低风险。
