Dolecek Therese A, McCarthy Bridget J, Joslin Charlotte E, Peterson Caryn E, Kim Seijeoung, Freels Sally A, Davis Faith G
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA.
J Am Diet Assoc. 2010 Mar;110(3):369-82. doi: 10.1016/j.jada.2009.11.014.
Dietary factors have been the focus of many studies on the etiology of ovarian cancer and may potentially affect survival. Indeed, three recent studies outside the United States have suggested that diet plays a role in ovarian cancer survival.
The study purpose was to evaluate the hypothesis that women diagnosed with ovarian cancer whose reported prediagnosis food patterns more closely reflect recommendations for optimal health experience a survival advantage compared with those reporting poorer diets.
A longitudinal follow-up study design was used to examine prediagnosis usual diet effects on survival among 341 Cook County, Illinois, residents diagnosed with epithelial ovarian cancer during 1994-1998. These women participated in a previous case-control study where diet was assessed using a validated food frequency questionnaire. This diet information was categorized utilizing the Dietary Guidelines for Americans 2005. Deaths through 2005 were ascertained using a national death index search.
Hazard ratios (HR) and 95% confidence intervals (CI) adjusting for important covariables were obtained from proportional hazards regression models to evaluate diet effects on survival from ovarian cancer.
Comparisons of high to low food group or subgroup intakes demonstrated statistically significant prediagnosis food pattern associations with survival time. Longer survival was associated with total fruits and vegetables (HR 0.61, 95% CI 0.38 to 0.98, P for trend=0.10) and vegetables separately (HR 0.66, 95% CI 0.43 to 1.01, P for trend <0.05). Subgroup analyses showed only yellow and cruciferous vegetables to significantly favor survival. Conversely, a survival disadvantage was shown for meats, not generally recommended (HR 2.28, 95% CI 1.34 to 3.89, P for trend <0.01), and specifically the red and cured/processed meats subgroups. An increased HR was also observed for the milk (all types) subgroup (HR 2.15, 95% CI 1.20 to 3.84, P for trend <0.05).
Prediagnosis adherence to diets that reflect recommendations for optimal nutrition and cancer prevention may have benefits that continue even after an ovarian cancer diagnosis.
饮食因素一直是许多卵巢癌病因研究的重点，并且可能会影响生存率。事实上，最近美国以外的三项研究表明，饮食在卵巢癌生存中发挥着作用。
本研究的目的是评估这样一种假设，即与报告饮食较差的女性相比，被诊断患有卵巢癌且其诊断前的饮食模式更符合最佳健康建议的女性具有生存优势。
采用纵向随访研究设计，以检验1994年至1998年期间伊利诺伊州库克县341名被诊断患有上皮性卵巢癌的居民诊断前的日常饮食对生存的影响。这些女性参与了之前的一项病例对照研究，在该研究中使用经过验证的食物频率问卷评估饮食情况。利用《2005年美国膳食指南》对这些饮食信息进行分类。通过全国死亡指数搜索确定截至2005年的死亡情况。
从比例风险回归模型中获得调整了重要协变量的风险比（HR）和95%置信区间（CI），以评估饮食对卵巢癌生存的影响。
高食物组或亚组摄入量与低食物组或亚组摄入量的比较表明，诊断前的饮食模式与生存时间之间存在统计学上显著的关联。总水果和蔬菜摄入量（HR 0.61，95% CI 0.38至0.98，趋势P值 = 0.10）以及单独的蔬菜摄入量（HR 0.66，95% CI 0.43至1.01，趋势P值 <0.05）与更长的生存期相关。亚组分析显示只有黄色蔬菜和十字花科蔬菜对生存有显著益处。相反，肉类（一般不推荐食用）显示出生存劣势（HR 2.28，95% CI 1.34至3.89，趋势P值 <0.01），特别是红肉和腌制/加工肉类亚组。牛奶（所有类型）亚组也观察到风险比增加（HR 2.15，95% CI 1.20至3.84，趋势P值 <0.05）。
诊断前坚持反映最佳营养和癌症预防建议的饮食可能会带来益处，即使在卵巢癌诊断后这种益处仍会持续。
