乳腺癌患者食用烤、烧、熏肉与生存情况
Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer.
作者信息
Parada Humberto, Steck Susan E, Bradshaw Patrick T, Engel Lawrence S, Conway Kathleen, Teitelbaum Susan L, Neugut Alfred I, Santella Regina M, Gammon Marilie D
机构信息
Affiliations of authors: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC (HPJr, LSE, KC, MDG); Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC (SES); Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (PTB); Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (SLT); Department of Epidemiology (AIN), Department of Medicine (AIN), and Department of Environmental Health (RMS), Columbia University, New York, NY.
出版信息
J Natl Cancer Inst. 2017 Jan 5;109(6). doi: 10.1093/jnci/djw299. Print 2017 Jun.
BACKGROUND
Grilled, barbecued, and smoked meat intake, a prevalent dietary source of polycyclic aromatic hydrocarbon (PAH) carcinogens, may increase the risk of incident breast cancer. However, no studies have examined whether intake of this PAH source influences survival after breast cancer.
METHODS
We interviewed a population-based cohort of 1508 women diagnosed with first primary invasive or in situ breast cancer in 1996 and 1997 at baseline and again approximately five years later to assess grilled/barbecued and smoked meat intake. After a median of 17.6 years of follow-up, 597 deaths, of which 237 were breast cancer related, were identified. Multivariable Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality as related to prediagnosis intake, comparing high (above the median) to low intake, as well as postdiagnosis changes in intake, comparing every combination of pre-/postdiagnosis intake to low pre-/postdiagnosis intake. All statistical tests were two-sided.
RESULTS
High prediagnosis grilled/barbecued and smoked meat intake was associated with increased risk of all-cause mortality (HR = 1.23, 95% CI = 1.03 to 1.46). Other associations were noted, but estimates were not statistically significant. These include high prediagnosis smoked beef/lamb/pork intake and increased all-cause (HR = 1.17, 95% CI = 0.99 to 1.38, P = .10) and breast cancer-specific (HR = 1.23, 95% CI = 0.95 to 1.60, P = .09) mortality. Also, among women with continued high grilled/barbecued and smoked meat intake after diagnosis, all-cause mortality risk was elevated 31% (HR = 1.31, 95% CI = 0.96 to 1.78). Further, breast cancer-specific mortality was decreased among women with any pre- and postdiagnosis intake of smoked poultry/fish (HR = 0.55, 95% CI = 0.31 to 0.97).
CONCLUSION
High intake of grilled/barbecued and smoked meat may increase mortality after breast cancer.
背景
烤、煎、熏肉是多环芳烃（PAH）致癌物的常见饮食来源，可能会增加患乳腺癌的风险。然而，尚无研究探讨摄入这种PAH来源是否会影响乳腺癌患者的生存率。
方法
我们对1508名于1996年和1997年被诊断为原发性浸润性或原位乳腺癌的女性进行了一项基于人群的队列研究，在基线时进行了访谈，并在大约五年后再次访谈以评估烤/煎和熏肉的摄入量。经过17.6年的中位随访，共确定了597例死亡，其中237例与乳腺癌相关。多变量Cox回归用于估计与诊断前摄入量相关的死亡率的调整风险比（HR）和95%置信区间（CI），比较高摄入量（高于中位数）与低摄入量，以及诊断后摄入量的变化，比较诊断前/后摄入量的每种组合与诊断前/后低摄入量。所有统计检验均为双侧检验。
结果
诊断前烤/煎和熏肉的高摄入量与全因死亡率增加相关（HR = 1.23，95% CI = 1.03至1.46）。还发现了其他关联，但估计无统计学意义。这些关联包括诊断前熏牛肉/羊肉/猪肉的高摄入量与全因死亡率增加（HR = 1.17，95% CI = 0.99至1.38，P = 0.10）以及乳腺癌特异性死亡率增加（HR = 1.23，95% CI = 0.95至1.60，P = 0.09）。此外，在诊断后继续高摄入烤/煎和熏肉的女性中，全因死亡风险升高了31%（HR = 1.31，95% CI = 0.96至1.78）。此外，在诊断前后摄入过烟熏家禽/鱼类的女性中，乳腺癌特异性死亡率降低（HR = 0.55，95% CI = 0.31至0.97）。
结论
烤/煎和熏肉的高摄入量可能会增加乳腺癌患者的死亡率。
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