辛辣食物消费与胃肠道癌症风险：来自中国慢性病前瞻性研究的结果。
Spicy food consumption and risk of gastrointestinal-tract cancers: findings from the China Kadoorie Biobank.
机构信息
Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
出版信息
Int J Epidemiol. 2021 Mar 3;50(1):199-211. doi: 10.1093/ije/dyaa275.
BACKGROUND
Previous case-control studies have reported positive associations of spicy food consumption with risks of certain gastrointestinal-tract (GI) cancers. However, there is no prospective evidence on such associations, particularly from China, where there are high incidence rates of GI cancers and spicy food is widely consumed.
METHODS
The prospective China Kadoorie Biobank study recruited >512 000 adults aged 30-79 years from 10 areas in China during 2004-2008; 2350 oesophageal, 3350 stomach and 3061 colorectal incident cancer cases were recorded by 1 January 2017, after a median of 10.1 years of follow-up. Cox regression yielded adjusted hazard ratios (HRs) for each cancer associated with spicy food intake.
RESULTS
Overall, 30% of participants reported daily spicy food consumption at baseline. Spicy food consumption was inversely associated with oesophageal cancer risk, with adjusted HRs of 1.00, 0.88, 0.76, 0.84 and 0.81 for those who never/rarely consumed (reference) and consumed monthly, 1-2 days/week, 3-5 days/week and 6-7 days/week, respectively (ptrend < 0.002). The association remained similar after excluding the first 3 years of follow-up but appeared stronger in participants who did not smoke or drink alcohol regularly (ptrend < 0.0001). The corresponding HRs for stomach cancer were 1.00, 0.97, 0.95, 0.92 and 0.89 (ptrend = 0.04), with the association disappearing after excluding the first 3 years of follow-up. For colorectal cancer, the HRs were 1.00, 1.00, 0.95, 0.87 and 0.90, respectively (ptrend = 0.04) and the inverse association appeared to be restricted to rectal rather than colon cancer (pheterogeneity = 0.004). The types and strength of spice used showed little additional effects on these associations.
CONCLUSION
In Chinese adults, higher spicy food consumption was associated with lower risks of certain GI cancers, particularly among individuals who never smoked or drank alcohol regularly.
背景
先前的病例对照研究报告称，食用辛辣食物与某些胃肠道（GI）癌症的风险呈正相关。然而，目前还没有来自中国的前瞻性证据，中国 GI 癌症的发病率很高，而且辛辣食物的食用非常普遍。
方法
前瞻性的中国慢性病前瞻性研究于 2004-2008 年期间在中国的 10 个地区招募了>512000 名 30-79 岁的成年人；截至 2017 年 1 月 1 日，中位随访 10.1 年后，记录了 2350 例食管癌、3350 例胃癌和 3061 例结直肠癌的发病病例。Cox 回归分析得出了与辛辣食物摄入相关的每种癌症的调整后风险比（HR）。
结果
总体而言，30%的参与者在基线时报告了每天食用辛辣食物。辛辣食物的摄入与食管癌风险呈负相关，从不/很少食用（参考）和每月、1-2 天/周、3-5 天/周和 6-7 天/周食用的调整后 HR 分别为 1.00、0.88、0.76、0.84 和 0.81（ptrend<0.002）。在排除随访的前 3 年后，该关联仍然相似，但在不规律吸烟或饮酒的参与者中关联更强（ptrend<0.0001）。胃癌的相应 HR 分别为 1.00、0.97、0.95、0.92 和 0.89（ptrend=0.04），在排除随访的前 3 年后，该关联消失。对于结直肠癌，HR 分别为 1.00、1.00、0.95、0.87 和 0.90（ptrend=0.04），且这种负相关似乎仅限于直肠癌而不是结肠癌（p 异质性=0.004）。所用香料的类型和强度对这些关联几乎没有额外影响。
结论
在中国成年人中，较高的辛辣食物摄入与某些胃肠道癌症的风险较低相关，尤其是在从不规律吸烟或饮酒的个体中。
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