欧洲癌症与营养前瞻性调查（EPIC）中肉类摄入量与胃和食管腺癌风险的关系

Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC).

作者信息

González Carlos A, Jakszyn Paula, Pera Guillem, Agudo Antonio, Bingham Sheila, Palli Domenico, Ferrari Pietro, Boeing Heiner, del Giudice Giuseppe, Plebani Mario, Carneiro Fátima, Nesi Gabriella, Berrino Franco, Sacerdote Carlotta, Tumino Rosario, Panico Salvatore, Berglund Göran, Simán Henrik, Nyrén Olof, Hallmans Göran, Martinez Carmen, Dorronsoro Miren, Barricarte Aurelio, Navarro Carmen, Quirós José R, Allen Naomi, Key Timothy J, Day Nicholas E, Linseisen Jakob, Nagel Gabriele, Bergmann Manuela M, Overvad Kim, Jensen Majken K, Tjonneland Anne, Olsen Anja, Bueno-de-Mesquita H Bas, Ocke Marga, Peeters Petra H M, Numans Mattijs E, Clavel-Chapelon Françoise, Boutron-Ruault Marie-Christine, Trichopoulou Antonia, Psaltopoulou Theodora, Roukos Dimitrios, Lund Eiliv, Hemon Bertrand, Kaaks Rudolf, Norat Teresa, Riboli Elio

机构信息

Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain.

出版信息

J Natl Cancer Inst. 2006 Mar 1;98(5):345-54. doi: 10.1093/jnci/djj071.

DOI:10.1093/jnci/djj071

PMID:16507831

Abstract

BACKGROUND

Dietary factors are thought to have an important role in gastric and esophageal carcinogenesis, but evidence from cohort studies for such a role is lacking. We examined the risks of gastric cancer and esophageal adenocarcinoma associated with meat consumption within the European Prospective Investigation Into Cancer and Nutrition (EPIC) cohort.

METHODS

A total of 521,457 men and women aged 35-70 years in 10 European countries participated in the EPIC cohort. Dietary and lifestyle information was collected at recruitment. Cox proportional hazard models were used to examine associations between meat intake and risks of cardia and gastric non-cardia cancers and esophageal adenocarcinoma. Data from a calibration substudy were used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. In a nested case-control study, we examined interactions between Helicobacter pylori infection status (i.e., plasma H. pylori antibodies) and meat intakes. All statistical tests were two-sided.

RESULTS

During a mean follow-up of 6.5 years, 330 gastric adenocarcinoma and 65 esophageal adenocarcinomas were diagnosed. Gastric non-cardia cancer risk was statistically significantly associated with intakes of total meat (calibrated HR per 100-g/day increase = 3.52; 95% CI = 1.96 to 6.34), red meat (calibrated HR per 50-g/day increase = 1.73; 95% CI = 1.03 to 2.88), and processed meat (calibrated HR per 50-g/day increase = 2.45; 95% CI = 1.43 to 4.21). The association between the risk of gastric non-cardia cancer and total meat intake was especially large in H. pylori-infected subjects (odds ratio per 100-g/day increase = 5.32; 95% CI = 2.10 to 13.4). Intakes of total, red, or processed meat were not associated with the risk of gastric cardia cancer. A positive but non-statistically significant association was observed between esophageal adenocarcinoma cancer risk and total and processed meat intake in the calibrated model. In this study population, the absolute risk of development of gastric adenocarcinoma within 10 years for a study subject aged 60 years was 0.26% for the lowest quartile of total meat intake and 0.33% for the highest quartile of total meat intake.

CONCLUSION

Total, red, and processed meat intakes were associated with an increased risk of gastric non-cardia cancer, especially in H. pylori antibody-positive subjects, but not with cardia gastric cancer.

摘要

背景

饮食因素被认为在胃癌和食管癌的发生过程中起重要作用，但队列研究缺乏此类作用的证据。我们在欧洲癌症与营养前瞻性调查（EPIC）队列中研究了肉类消费与胃癌和食管腺癌风险之间的关系。

方法

10个欧洲国家的521457名年龄在35 - 70岁的男性和女性参与了EPIC队列。在招募时收集饮食和生活方式信息。使用Cox比例风险模型研究肉类摄入量与贲门癌、胃非贲门癌和食管腺癌风险之间的关联。校准子研究的数据用于校正饮食测量误差的风险比（HRs）和95%置信区间（CIs）。在一项巢式病例对照研究中，我们研究了幽门螺杆菌感染状态（即血浆幽门螺杆菌抗体）与肉类摄入量之间的相互作用。所有统计检验均为双侧检验。

结果

在平均6.5年的随访期间，诊断出330例胃腺癌和65例食管腺癌。胃非贲门癌风险与总肉类摄入量（每增加100克/天的校准HR = 3.52；95% CI = 1.96至6.34）、红肉摄入量（每增加50克/天的校准HR = 1.73；95% CI = 1.03至2.88）和加工肉类摄入量（每增加50克/天的校准HR = 2.45；95% CI = 1.43至4.21）在统计学上显著相关。胃非贲门癌风险与总肉类摄入量之间的关联在幽门螺杆菌感染的受试者中尤为明显（每增加100克/天的优势比 = 5.32；95% CI = 2.10至13.4）。总肉类、红肉或加工肉类的摄入量与胃贲门癌风险无关。在校准模型中，观察到食管腺癌风险与总肉类和加工肉类摄入量之间存在正相关但无统计学意义。在该研究人群中，60岁研究对象在10年内发生胃腺癌的绝对风险，总肉类摄入量最低四分位数组为0.26%，最高四分位数组为0.33%。