膳食叶酸摄入量与卵巢癌发病率：瑞典乳腺X线摄影队列研究

Dietary folate intake and incidence of ovarian cancer: the Swedish Mammography Cohort.

作者信息

Larsson Susanna C, Giovannucci Edward, Wolk Alicja

机构信息

Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Natl Cancer Inst. 2004 Mar 3;96(5):396-402. doi: 10.1093/jnci/djh061.

DOI:10.1093/jnci/djh061

PMID:14996861

Abstract

BACKGROUND

Mounting evidence suggests that a low intake of the water-soluble B vitamin folate is associated with breast and colorectal carcinogenesis, especially among alcohol drinkers. However, epidemiologic data specifically linking folate intake to ovarian cancer risk are limited.

METHODS

We examined the association between dietary folate intake (i.e., folate from food sources) and the incidence of total epithelial ovarian cancer and its subtypes by analyzing data from the Swedish Mammography Cohort, a population-based prospective cohort of 61 084 women, aged 38-76 years, who, at baseline (i.e., from 1987 to 1990), were cancer-free and had completed a food-frequency questionnaire. Through June 30, 2003, 266 incident cases of invasive epithelial ovarian cancer were diagnosed. We used Cox proportional hazards models to estimate multivariable relative risks (RRs) of ovarian cancer with 95% confidence intervals (CIs). All statistical tests were two-sided.

RESULTS

Overall, dietary folate intake was weakly inversely associated with total epithelial ovarian cancer risk (RR for highest versus lowest quartile of intake = 0.67, 95% CI = 0.43 to 1.04; P(trend) =.08). Among women who consumed more than 20 g of alcohol (approximately two drinks) per week, there was a strong inverse association between dietary folate intake and total epithelial ovarian cancer risk (RR for highest versus lowest quartile of intake = 0.26, 95% CI = 0.11 to 0.60; P(trend) =.001), but among women who consumed 20 g or less of alcohol per week, there was no such association (RR for highest versus lowest quartile of intake = 1.00, 95% CI = 0.59 to 1.70; P(trend) =.80). The absolute risk of epithelial ovarian cancer for the lowest three quartiles versus the highest quartile of folate intake was 8 per 100 000 person-years (95% CI = 0 to 16 per 100 000 person-years) overall and 26 per 100 000 person-years (95% CI = 10 to 42 per 100 000 person-years) among those who consumed more than 20 g of alcohol per week. The association between dietary folate intake and cancer risk did not vary substantially among subtypes of epithelial ovarian cancer.

CONCLUSION

A high dietary folate intake may play a role in reducing the risk of ovarian cancer, especially among women who consume alcohol.

摘要

背景

越来越多的证据表明，水溶性B族维生素叶酸摄入量低与乳腺癌和结直肠癌的发生有关，尤其是在饮酒者中。然而，将叶酸摄入量与卵巢癌风险具体联系起来的流行病学数据有限。

方法

我们通过分析瑞典乳腺X线摄影队列的数据，研究了膳食叶酸摄入量（即来自食物来源的叶酸）与上皮性卵巢癌及其亚型的发病率之间的关联。该队列是一个基于人群的前瞻性队列，有61084名年龄在38 - 76岁之间的女性，在基线时（即1987年至1990年）无癌症且完成了一份食物频率问卷。截至2003年6月30日，共诊断出266例浸润性上皮性卵巢癌病例。我们使用Cox比例风险模型来估计卵巢癌的多变量相对风险（RRs）及95%置信区间（CIs）。所有统计检验均为双侧检验。

结果

总体而言，膳食叶酸摄入量与上皮性卵巢癌总风险呈弱负相关（摄入量最高四分位数与最低四分位数的RR = 0.67，95% CI = 0.43至·1.04；P趋势 = 0.08）。在每周饮酒超过20克（约两杯）的女性中，膳食叶酸摄入量与上皮性卵巢癌总风险之间存在强负相关（摄入量最高四分位数与最低四分位数的RR = 0.26，95% CI = 0.11至0.60；P趋势 = 0.001），但在每周饮酒20克或更少的女性中，不存在这种关联（摄入量最高四分位数与最低四分位数的RR = 1.00，95% CI = 0.59至1.70；P趋势 = 0.80）。叶酸摄入量最低的三个四分位数与最高四分位数相比，上皮性卵巢癌的绝对风险总体为每10万人年8例（95% CI = 每10万人年0至16例），在每周饮酒超过20克的人群中为每10万人年26例（95% CI = 每10万人年10至42例）。膳食叶酸摄入量与癌症风险之间的关联在上皮性卵巢癌的各亚型中没有显著差异。