Department of Community Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
Sci Rep. 2019 Jan 22;9(1):296. doi: 10.1038/s41598-018-36445-6.
The incidence of colorectal cancer (CRC) has increased among Norwegian women, and is among the highest in the world. In order to understand this increase, country specific dietary exposures have been investigated. The aim of this study was to quantify the association between consumption of brown cheese, a common bread topping in Norway, and colorectal, colon, and rectal cancer in the prospective Norwegian Women and Cancer (NOWAC) Study. Data on brown cheese consumption and adjustment factors was available for 82 527 women. During a mean of 14.6 years of follow-up (1.2 million person-years), there were 1360 cases of colorectal cancer (907 colon; 453 rectal). Multivariable Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for colorectal, colon, and rectal cancer sites. We modelled restricted cubic splines with 4 knots, to assess a possible non-linear relationship between brown cheese intake and the investigated cancer sites. In the age-adjusted model, consumption of more than 2 slices (>16 grams) of brown cheese per day was associated with 13% reduced risk of colon cancer (95% CI 4%-21%) compared to women who did not consume brown cheese. The multivariable-adjusted model, however, showed no association between brown cheese consumption and the risk of colorectal, colon, or rectal cancer (colorectal: HR = 0.93, 95% CI 0.76-1.13, p-trend 0.37; colon: HR = 0.83, 95% CI 0.65-1.06; p-trend = 0.10; rectal: HR = 1.16, 95% CI 0.84-1.1.61, p-trend = 0.41). In this large, prospective cohort study of women, consumption of brown cheese was suggestively protective against colon cancer. However, adjustment attenuated the inverse risk association. Brown cheese consumption was not associated with rectal cancer, or colorectal cancer overall.
在挪威女性中，结直肠癌（CRC）的发病率有所增加，位居世界前列。为了了解这种增加的原因，人们已经调查了特定于国家的饮食暴露情况。本研究的目的是定量分析在挪威前瞻性妇女与癌症研究（NOWAC）中，食用棕色奶酪（挪威常见的面包顶部配料）与结直肠、结肠和直肠癌之间的关联。对于 82527 名女性，我们可以获得有关棕色奶酪食用量和调整因素的数据。在平均 14.6 年的随访期间（120 万人年），有 1360 例结直肠癌（907 例结肠癌；453 例直肠癌）。我们使用多变量 Cox 比例风险模型计算结直肠、结肠和直肠癌症部位的危险比（HR）和 95%置信区间（CI）。我们使用 4 个结的限制立方样条来评估棕色奶酪摄入量与所研究癌症部位之间可能存在的非线性关系。在年龄调整模型中，与不食用棕色奶酪的女性相比，每天食用超过 2 片（>16 克）棕色奶酪与结肠癌风险降低 13%相关（95%CI 4%-21%）。然而，多变量调整模型显示，棕色奶酪的消耗与结直肠、结肠癌或直肠癌的风险之间没有关联（结直肠癌：HR=0.93，95%CI 0.76-1.13，p-trend=0.37；结肠癌：HR=0.83，95%CI 0.65-1.06；p-trend=0.10；直肠癌：HR=1.16，95%CI 0.84-1.1.61，p-trend=0.41）。在这项针对女性的大型前瞻性队列研究中，棕色奶酪的消耗提示可预防结肠癌。然而，调整后的风险关联减弱了。棕色奶酪的消耗与直肠癌或结直肠癌总发病率无关。
