乳制品和膳食钙的诊断前摄入量与结直肠癌生存率——欧洲癌症与营养前瞻性调查（EPIC）队列研究结果
Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival--results from the EPIC cohort study.
作者信息
Dik Vincent K, Murphy Neil, Siersema Peter D, Fedirko Veronika, Jenab Mazda, Kong So Y, Hansen Camilla P, Overvad Kim, Tjønneland Anne, Olsen Anja, Dossus Laure, Racine Antoine, Bastide Nadia, Li Kuanrong, Kühn Tilman, Boeing Heiner, Aleksandrova Krasimira, Trichopoulou Antonia, Trichopoulos Dimitrios, Barbitsioti Antonia, Palli Domenico, Contiero Paolo, Vineis Paolo, Tumino Rosaria, Panico Salvatore, Peeters Petra H M, Weiderpass Elisabete, Skeie Guri, Hjartåker Anette, Amiano Pilar, Sánchez María-José, Fonseca-Nunes Ana, Barricarte Aurelio, Chirlaque María-Dolores, Redondo Maria-Luisa, Jirström Karin, Manjer Jonas, Nilsson Lena M, Wennberg Maria, Bradbury Kathryn E, Khaw Kay-Tee, Wareham Nicholas, Cross Amanda J, Riboli Elio, Bueno-de-Mesquita H Bas
机构信息
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
出版信息
Cancer Epidemiol Biomarkers Prev. 2014 Sep;23(9):1813-23. doi: 10.1158/1055-9965.EPI-14-0172. Epub 2014 Jun 10.
BACKGROUND
We investigated whether prediagnostic reported intake of dairy products and dietary calcium is associated with colorectal cancer survival.
METHODS
Data from 3,859 subjects with colorectal cancer (42.1% male; mean age at diagnosis, 64.2 ± 8.1 years) in the European Investigation into Cancer and Nutrition cohort were analyzed. Intake of dairy products and dietary calcium was assessed at baseline (1992-2000) using validated, country-specific dietary questionnaires. Multivariable Cox regression models were used to calculate HR and corresponding 95% confidence intervals (CI) for colorectal cancer-specific death (n = 1,028) and all-cause death (n = 1,525) for different quartiles of intake.
RESULTS
The consumption of total dairy products was not statistically significantly associated with risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.17; 95% CI, 0.97-1.43) nor that of all-cause death (Q4 vs. Q1, 1.16; 95% CI, 0.98-1.36). Multivariable-adjusted HRs for colorectal cancer-specific death (Q4 vs. Q1) were 1.21 (95% CI, 0.99-1.48) for milk, 1.09 (95% CI, 0.88-1.34) for yoghurt, and 0.93 (95% CI, 0.76-1.14) for cheese. The intake of dietary calcium was not associated with the risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.01; 95% CI, 0.81-1.26) nor that of all-cause death (Q4 vs. Q1, 1.01; 95% CI, 0.84-1.21).
CONCLUSIONS
The prediagnostic reported intake of dairy products and dietary calcium is not associated with disease-specific or all-cause risk of death in patients diagnosed with colorectal cancer.
IMPACT
The impact of diet on cancer survival is largely unknown. This study shows that despite its inverse association with colorectal cancer risk, the prediagnostic intake of dairy and dietary calcium does not affect colorectal cancer survival.
背景
我们研究了诊断前报告的乳制品和膳食钙摄入量是否与结直肠癌生存率相关。
方法
对欧洲癌症与营养调查队列中3859例结直肠癌患者（男性占42.1%；诊断时平均年龄为64.2±8.1岁）的数据进行了分析。在基线期（1992 - 2000年），使用经过验证的、特定国家的膳食问卷评估乳制品和膳食钙的摄入量。采用多变量Cox回归模型计算不同摄入量四分位数下结直肠癌特异性死亡（n = 1028）和全因死亡（n = 1525）的风险比（HR）及相应的95%置信区间（CI）。
结果
总乳制品的摄入量与结直肠癌特异性死亡风险无统计学显著关联（调整后HR，四分位数4 vs. 四分位数1，1.17；95% CI，0.97 - 1.43），与全因死亡风险也无关联（四分位数4 vs. 四分位数1，1.16；95% CI，0.98 - 1.36）。牛奶、酸奶和奶酪的多变量调整后结直肠癌特异性死亡风险比（四分位数4 vs. 四分位数1）分别为1.21（95% CI，0.99 - 1.48）、1.09（95% CI，0.88 - 1.34）和0.93（95% CI，0.76 - 1.14）。膳食钙的摄入量与结直肠癌特异性死亡风险无关联（调整后HR，四分位数4 vs. 四分位数1，1.01；95% CI，0.81 - 1.26），与全因死亡风险也无关联（四分位数4 vs. 四分位数1，1.01；95% CI，0.84 - 1.21）。
结论
诊断前报告的乳制品和膳食钙摄入量与结直肠癌患者的疾病特异性或全因死亡风险无关。
影响
饮食对癌症生存率的影响在很大程度上尚不清楚。本研究表明，尽管乳制品和膳食钙的诊断前摄入量与结直肠癌风险呈负相关，但并不影响结直肠癌的生存率。
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