Cross Amanda J, Leitzmann Michael F, Subar Amy F, Thompson Frances E, Hollenbeck Albert R, Schatzkin Arthur
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland 20852, USA.
Cancer Res. 2008 Nov 15;68(22):9274-9. doi: 10.1158/0008-5472.CAN-08-2015.
Diets high in red and processed meats are associated with carcinogenesis of the large intestine, but no prospective study has examined meat and fat intake in relation to cancer of the small intestine. We prospectively investigated meat and fat intakes, estimated from a food frequency questionnaire, in relation to small intestinal cancer among half a million men and women enrolled in the NIH-AARP Diet and Health Study. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). During up to 8 years of follow-up, 60 adenocarcinomas and 80 carcinoid tumors of the small intestine were diagnosed. Despite slightly elevated HRs for red meat, there were no clear associations for red or processed meat intake and either adenocarcinoma or carcinoid tumors of the small intestine. In contrast, we noted a markedly elevated risk for carcinoid tumors of the small intestine with saturated fat intake in both the categorical (highest versus lowest tertile: HR, 3.18; 95% CI, 1.62-6.25) and continuous data (HR, 3.72; 95% CI, 1.79-7.74 for each 10-g increase in intake per 1,000 kcal). Our findings suggest that the positive associations for meat intake reported in previous case-control studies may partly be explained by saturated fat intake.
富含红肉和加工肉类的饮食与大肠癌的致癌作用相关,但尚无前瞻性研究考察肉类和脂肪摄入量与小肠癌的关系。我们在参加美国国立卫生研究院-美国退休人员协会饮食与健康研究的50万名男性和女性中,前瞻性地调查了根据食物频率问卷估算的肉类和脂肪摄入量与小肠癌的关系。我们使用Cox比例风险回归来估计风险比(HR)和95%置信区间(95%CI)。在长达8年的随访期间,诊断出60例小肠腺癌和80例类癌肿瘤。尽管红肉的HR略有升高,但红肉或加工肉类摄入量与小肠腺癌或类癌肿瘤之间并无明确关联。相比之下,我们注意到,无论是分类数据(最高三分位数与最低三分位数相比:HR,3.18;95%CI,1.62 - 6.25)还是连续数据(每1000千卡摄入量每增加10克,HR,3.72;95%CI,1.79 - 7.74),小肠类癌肿瘤的风险都随着饱和脂肪摄入量的增加而显著升高。我们的研究结果表明,先前病例对照研究中报告的肉类摄入量的正相关关系可能部分由饱和脂肪摄入量来解释。