Pelucchi Claudio, Bosetti Cristina, Galeone Carlotta, La Vecchia Carlo
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Int J Cancer. 2015 Jun 15;136(12):2912-22. doi: 10.1002/ijc.29339. Epub 2014 Nov 26.
The debate on the potential carcinogenic effect of dietary acrylamide is open. In consideration of the recent findings from large prospective investigations, we conducted an updated meta-analysis on acrylamide intake and the risk of cancer at several sites. Up to July 2014, we identified 32 publications. We performed meta-analyses to calculate the summary relative risk (RR) of each cancer site for the highest versus lowest level of intake and for an increment of 10 µg/day of dietary acrylamide, through fixed-effects or random-effects models, depending on the heterogeneity test. Fourteen cancer sites could be examined. No meaningful associations were found for most cancers considered. The summary RRs for high versus low acrylamide intake were 0.87 for oral and pharyngeal, 1.14 for esophageal, 1.03 for stomach, 0.94 for colorectal, 0.93 for pancreatic, 1.10 for laryngeal, 0.88 for lung, 0.96 for breast, 1.06 for endometrial, 1.12 for ovarian, 1.00 for prostate, 0.93 for bladder and 1.13 for lymphoid malignancies. The RR was of borderline significance only for kidney cancer (RR = 1.20; 95% confidence interval, CI, 1.00-1.45). All the corresponding continuous estimates ranged between 0.95 and 1.03, and none of them was significant. Among never-smokers, borderline associations with dietary acrylamide emerged for endometrial (RR = 1.23; 95% CI, 1.00-1.51) and ovarian (RR = 1.39; 95% CI, 0.97-2.00) cancers. This systematic review and meta-analysis of epidemiological studies indicates that dietary acrylamide is not related to the risk of most common cancers. A modest association for kidney cancer, and for endometrial and ovarian cancers in never smokers only, cannot be excluded.
关于膳食丙烯酰胺潜在致癌作用的争论尚无定论。鉴于近期大型前瞻性调查的结果,我们对丙烯酰胺摄入量与多个部位癌症风险进行了更新的荟萃分析。截至2014年7月,我们共识别出32篇出版物。我们通过固定效应或随机效应模型进行荟萃分析,以计算摄入量最高与最低水平相比以及膳食丙烯酰胺摄入量每天增加10微克时各癌症部位的汇总相对风险(RR),具体取决于异质性检验结果。共可对14个癌症部位进行检查。对于所考虑的大多数癌症,未发现有意义的关联。丙烯酰胺高摄入量与低摄入量相比的汇总RR值如下:口腔和咽癌为0.87,食管癌为1.14,胃癌为1.03,结直肠癌为0.94,胰腺癌为0.93,喉癌为1.10,肺癌为0.88,乳腺癌为0.96,子宫内膜癌为1.06,卵巢癌为1.12,前列腺癌为1.00,膀胱癌为0.93,淋巴系统恶性肿瘤为1.13。仅肾癌的RR值具有临界显著性(RR = 1.20;95%置信区间,CI,1.00 - 1.45)。所有相应的连续性估计值在0.95至1.03之间,均无显著性。在从不吸烟者中,膳食丙烯酰胺与子宫内膜癌(RR = 1.23;95% CI,1.00 - 1.51)和卵巢癌(RR = 1.39;95% CI,0.97 - 2.00)出现临界关联。这项对流行病学研究的系统评价和荟萃分析表明,膳食丙烯酰胺与大多数常见癌症的风险无关,但不能排除其与肾癌以及仅在从不吸烟者中的子宫内膜癌和卵巢癌存在适度关联。