Er Vanessa, Lane J Athene, Martin Richard M, Emmett Pauline, Gilbert Rebecca, Avery Kerry N L, Walsh Eleanor, Donovan Jenny L, Neal David E, Hamdy Freddie C, Jeffreys Mona
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Bristol, United Kingdom.
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2014 Oct;23(10):2066-77. doi: 10.1158/1055-9965.EPI-14-0322. Epub 2014 Jul 13.
The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) published eight recommendations for cancer prevention, but they are not targeted at prostate cancer prevention. We investigated whether adherence to the WCRF/AICR recommendations and a prostate cancer dietary index is associated with prostate cancer risk.
We conducted a nested case-control study of 1,806 prostate-specific antigen (PSA)-detected prostate cancer cases and 12,005 controls in the ProtecT trial. We developed a prostate cancer dietary index by incorporating three dietary factors most strongly associated with prostate cancer. Scores were computed to quantify adherence to the WCRF/AICR recommendations and the prostate cancer dietary index separately.
The prostate cancer dietary index score was associated with decreased risk of prostate cancer [OR per 1 score increment: 0.91; 95% confidence interval (CI): 0.84-0.99; Ptrend = 0.04] but the WCRF/AICR index score was not (OR: 0.99; 95% CI: 0.94-1.05; Ptrend = 0.71). There was no heterogeneity in association by prostate cancer stage (P = 0.81) or grade (P = 0.61). Greater adherence to recommendations to increase plant foods (OR per 0.25 index score increment: 0.94; 95% CI: 0.89-0.99; Ptrend = 0.02) and tomato products (OR adherence vs. nonadherence: 0.82; 95% CI: 0.70-0.97; P = 0.02) was inversely associated with overall prostate cancer risk.
Adherence to the prostate cancer-specific dietary recommendations was associated with decreased risk of prostate cancer. High intake of plant foods and tomato products in particular may help protect against prostate cancer.
Meeting the WCRF/AICR recommendations alone is insufficient for prostate cancer prevention. Additional dietary recommendations should be developed.
世界癌症研究基金会（WCRF）和美国癌症研究学会（AICR）发布了八项癌症预防建议，但这些建议并非针对前列腺癌预防。我们调查了遵循WCRF/AICR建议以及前列腺癌饮食指数是否与前列腺癌风险相关。
我们在ProtecT试验中对1806例通过前列腺特异性抗原（PSA）检测出的前列腺癌病例和12005例对照进行了巢式病例对照研究。我们通过纳入与前列腺癌关联最密切的三个饮食因素制定了前列腺癌饮食指数。分别计算得分以量化对WCRF/AICR建议和前列腺癌饮食指数的遵循情况。
前列腺癌饮食指数得分与前列腺癌风险降低相关[每增加1分的比值比（OR）：0.91；95%置信区间（CI）：0.84 - 0.99；趋势P值 = 0.04]，但WCRF/AICR指数得分则不然（OR：0.99；95% CI：0.94 - 1.05；趋势P值 = 0.71）。按前列腺癌分期（P = 0.81）或分级（P = 0.61）分析，关联不存在异质性。更多地遵循增加植物性食物的建议（每增加0.25指数得分单位的OR：0.94；95% CI：0.89 - 0.99；趋势P值 = 0.02）以及番茄制品的建议（遵循建议与不遵循建议的OR：0.82；95% CI：0.70 - 0.97；P = 0.02）与总体前列腺癌风险呈负相关。
遵循前列腺癌特异性饮食建议与前列腺癌风险降低相关。特别是大量摄入植物性食物和番茄制品可能有助于预防前列腺癌。
仅遵循WCRF/AICR建议不足以预防前列腺癌。应制定额外的饮食建议。
