Zhang Fang Fang, Cudhea Frederick, Shan Zhilei, Michaud Dominique S, Imamura Fumiaki, Eom Heesun, Ruan Mengyuan, Rehm Colin D, Liu Junxiu, Du Mengxi, Kim David, Lizewski Lauren, Wilde Parke, Mozaffarian Dariush
Friedman School of Nutrition Science and Policy.
T. H. Chan School of Public Health, Harvard University, Boston, MA.
JNCI Cancer Spectr. 2019 May 22;3(2):pkz034. doi: 10.1093/jncics/pkz034. eCollection 2019 Jun.
Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the United States.
Using a comparative risk assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of seven dietary factors among US adults ages 20 years or older, and by population subgroups.
An estimated 80 110 (95% uncertainty interval [UI] = 76 316 to 83 657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI = 5.0% to 5.5%) of all new cancer cases in 2015. Of these, 67 488 (95% UI = 63 583 to 70 978) and 4.4% (95% UI = 4.2% to 4.6%) were attributable to direct associations and 12 589 (95% UI = 12 156 to 13 038) and 0.82% (95% UI = 0.79% to 0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (n = 52 225, 38.3%). By diet, low consumption of whole grains (n = 27 763, 1.8%) and dairy products (n = 17 692, 1.2%) and high intake of processed meats (n = 14 524, 1.0%) contributed to the highest burden. Men, middle-aged (45-64 years) and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, and race/ethnicity groups.
More than 80 000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.
饮食是癌症的一个重要风险因素，且可通过干预加以控制。估算与饮食相关的癌症负担可为美国制定基于证据的营养政策优先级提供依据，以减轻癌症负担。
我们使用了一个比较风险评估模型，该模型纳入了关于饮食摄入量的全国代表性数据、全国癌症发病率，以及前瞻性队列研究的荟萃分析中估计的饮食与癌症风险的关联，我们估算了20岁及以上美国成年人中因七种饮食因素摄入不足导致的新癌症病例的年度数量和比例，并按人群亚组进行了估算。
估计有80110例（95%不确定性区间[UI]=76316至83657）新癌症病例可归因于不良饮食，占2015年所有新癌症病例的5.2%（95%UI=5.0%至5.5%）。其中，67488例（95%UI=63583至70978）和4.4%（95%UI=4.2%至4.6%）可归因于直接关联，12589例（95%UI=12156至13038）和0.82%（95%UI=0.79%至0.85%）可归因于肥胖介导的关联。按癌症类型划分，结直肠癌与饮食相关的病例数量和比例最高（n=52225，38.3%）。按饮食划分，全谷物摄入量低（n=27763，1.8%）、乳制品摄入量低（n=17692，1.2%）以及加工肉类摄入量高（n=14524，1.0%）导致的负担最高。男性、中年（45 - 64岁）以及少数种族/族裔（非西班牙裔黑人、西班牙裔及其他）与饮食相关的癌症负担比例高于其他年龄、性别和种族/族裔群体。
估计2015年美国成年人中有超过80000例新癌症病例与不良饮食有关，中年男性和少数种族/族裔在美国与饮食相关的癌症负担中所占比例最大。
