Donat-Vargas Carolina, Berglund Marika, Glynn Anders, Wolk Alicja, Åkesson Agneta
Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
Department of Risk and Benefit Assessment, National Food Agency, Box 622, SE-751 26, Uppsala, Sweden.
Eur J Cancer. 2017 Feb;72:137-143. doi: 10.1016/j.ejca.2016.11.016. Epub 2016 Dec 26.
For malignant melanoma, other risk factors aside from sun exposure have been hardly explored. Polychlorinated biphenyls (PCBs)-mainly from fatty fish- may affect melanogenesis and promote melanoma progression, while long-chain n-3 polyunsaturated fatty acids seem to exert antineoplastic actions in melanoma cells.
We aimed to assess the association of validated estimates of dietary PCB exposure as well as the intake of eicosapentaenoic acid and docosahexaenoic acid (EPA-DHA), accounting for sun habits and skin type, with the risk of malignant melanoma in middle-aged and elderly women.
We included 20,785 women at baseline in 2009 from the prospective population-based Swedish Mammography Cohort. Validated estimates of dietary PCB exposure and EPA-DHA intake were obtained via a food frequency questionnaire. Incident melanoma cases were ascertained through register-linkage.
During 4.5 years of follow-up, we ascertained 67 incident cases of melanoma. After multivariable adjustments, exposure to dietary PCBs was associated with four-fold increased risk of malignant melanoma (hazard ratio [HR], 4.0 [95% confidence interval {CI}, 1.2-13; P for trend = 0.02]), while EPA-DHA intake was associated with 80% lower risk (HR, 0.2 [95% CI, 0.1-0.8; P for trend = 0.03]), comparing the highest exposure tertiles with the lowest.
While we found a direct association between dietary PCB exposure and risk of melanoma, EPA-DHA intake showed to have a substantial protective association. Question of benefits and risk from fish consumption is very relevant and further prospective studies in the general population verifying these findings are warranted.
对于恶性黑色素瘤,除日晒外的其他风险因素鲜有研究。多氯联苯(PCBs)——主要来自富含脂肪的鱼类——可能影响黑色素生成并促进黑色素瘤进展,而长链n-3多不饱和脂肪酸似乎对黑色素瘤细胞具有抗肿瘤作用。
我们旨在评估经验证的膳食多氯联苯暴露估计值以及二十碳五烯酸和二十二碳六烯酸(EPA-DHA)的摄入量,并考虑日晒习惯和皮肤类型,与中老年女性患恶性黑色素瘤风险之间的关联。
我们纳入了2009年来自基于人群的前瞻性瑞典乳腺X线摄影队列研究基线期的20,785名女性。通过食物频率问卷获得经验证的膳食多氯联苯暴露估计值和EPA-DHA摄入量。通过登记链接确定黑色素瘤发病病例。
在4.5年的随访期间,我们确定了67例黑色素瘤发病病例。经过多变量调整后,膳食多氯联苯暴露与恶性黑色素瘤风险增加四倍相关(风险比[HR],4.0[95%置信区间{CI},1.2 - 13;趋势P值 = 0.02]),而EPA-DHA摄入量与风险降低80%相关(HR,0.2[95%CI,0.1 - 0.8;趋势P值 = 0.03]),最高暴露三分位数与最低三分位数相比。
虽然我们发现膳食多氯联苯暴露与黑色素瘤风险之间存在直接关联,但EPA-DHA摄入量显示出显著的保护关联。鱼类消费的益处和风险问题非常重要,有必要在一般人群中进行进一步的前瞻性研究以验证这些发现。