Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Division of Cancer Statistics and Integration, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Int J Cancer. 2018 Jun 15;142(12):2441-2460. doi: 10.1002/ijc.31268. Epub 2018 Jan 31.
While many epidemiological studies have studied the association between lung cancer risk and fruits and vegetable consumption (the major sources of antioxidant vitamins), only a few have investigated the direct association with antioxidants in consideration of cancer subtypes and smoking status. Here, we examined the association between consumption of antioxidant vitamins and lung cancer risk in one of the largest prospective cohort studies in Japan. We investigated the association of dietary antioxidant vitamins intake, namely retinol, vitamin C, vitamin E, α-carotene, and β-carotene and subsequent incidence of lung cancer among 38,207 men and 41,498 women in the Japan Public Health Center-based prospective study. Cox proportional hazard regression was performed with adjustment for potential confounders and by strata of cancer subtypes and smoking status. Antioxidant and other dietary intakes were assessed using a food frequency questionnaire (FFQ). During 1,233,096 person-years of follow-up between 1995 and 2013, a total of 1,690 lung cancer cases were newly diagnosed. In a multivariate regression model, while higher retinol intake was positively associated with overall lung cancer risk in men (HR 1.26; 95% CI 1.05-1.51; p = 0.003), the estimates were more evident with small cell carcinoma (HR 1.92; 95% CI 1.13-3.24; p < 0.001). Null associations were observed for other antioxidant vitamins. Our prospective study suggests that higher consumption of retinol may be associated with an increased risk of lung cancer in men, especially with small cell carcinoma, although confirmation is required.
虽然许多流行病学研究都研究了肺癌风险与水果和蔬菜摄入（抗氧化维生素的主要来源）之间的关系，但只有少数研究考虑到癌症亚型和吸烟状况，直接研究了与抗氧化剂的直接关联。在这里，我们在日本最大的前瞻性队列研究之一中研究了抗氧化维生素消耗与肺癌风险之间的关联。我们调查了膳食抗氧化维生素摄入（视黄醇、维生素 C、维生素 E、α-胡萝卜素和β-胡萝卜素）与日本公共卫生中心前瞻性研究中 38207 名男性和 41498 名女性随后发生的肺癌之间的关联。使用 Cox 比例风险回归，调整了潜在混杂因素，并按癌症亚型和吸烟状况进行分层。抗氧化剂和其他饮食摄入量通过食物频率问卷（FFQ）进行评估。在 1995 年至 2013 年期间进行了 1233096 人年的随访期间，共新诊断出 1690 例肺癌病例。在多变量回归模型中，虽然男性摄入较高的视黄醇与总体肺癌风险呈正相关（HR 1.26；95%CI 1.05-1.51；p = 0.003），但对于小细胞癌，估计值更为明显（HR 1.92；95%CI 1.13-3.24；p < 0.001）。其他抗氧化维生素则未观察到关联。我们的前瞻性研究表明，男性摄入较高的视黄醇可能与肺癌风险增加有关，尤其是小细胞癌，但需要进一步证实。
