Risch H A, Burch J D, Miller A B, Hill G B, Steele R, Howe G R
Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario.
Am J Epidemiol. 1988 Jun;127(6):1179-91. doi: 10.1093/oxfordjournals.aje.a114911.
A case-control study of diet and bladder cancer was conducted during 1979-1982 in Edmonton, Calgary, Toronto, and Kingston, Canada. A total of 826 histologically verified cancer cases were individually matched by age, sex, and area of residence to 792 randomly selected population controls. Subjects were interviewed concerning their histories of exposure to a number of dietary factors, including table-top artificial sweeteners, low calorie foods and drinks, beverages containing caffeine or ethanol, and certain other food items. Also, subjects provided information on their past medical, occupational, and residential histories, in addition to their exposures to tobacco and other life-style factors. For the analysis, conditional logistic regression methods were used. Under adjustment for cumulative lifetime amount of cigarette smoking, the dietary factors, with little exception, were not associated with significant alteration of risk for bladder cancer. In particular, ever regular use of artificial sweeteners did not appear to be associated with increased risk, either among men (odds ratio = 0.95, p = 0.70) or among women (odds ratio = 1.15, p = 0.53). However, daily intake of cholesterol, calculated from reported frequencies of consumption of nine relevant food items, suggested a mild increase in risk; the odds ratio estimate of trend was 1.07/100 mg average daily intake (i.e., 1.07(5.5) = 1.45 for 550 mg cholesterol per day, as might be consumed in one egg; p = 0.009). A history of diabetes mellitus of onset after age 20 years also seemed to be associated with increased risk of bladder cancer (odds ratio = 1.65, p = 0.019), but this increase did not appear to be the result of use of insulin or other medications, or use of artificial sweeteners or low calorie foods. Thus, this study tends to confirm reports of a lack of association between use of artificial sweeteners and subsequent risk of bladder cancer.
1979年至1982年期间，在加拿大的埃德蒙顿、卡尔加里、多伦多和金斯敦开展了一项关于饮食与膀胱癌的病例对照研究。总共826例经组织学确诊的癌症病例，按照年龄、性别和居住地区，与792名随机选取的人群对照进行个体匹配。就一系列饮食因素的接触史对受试者进行了访谈，这些因素包括桌面人工甜味剂、低热量食品和饮料、含咖啡因或乙醇的饮品以及某些其他食品。此外，受试者还提供了其过去的医疗、职业和居住史信息，以及他们接触烟草和其他生活方式因素的情况。分析采用条件逻辑回归方法。在对累计终生吸烟量进行调整后，除少数例外，饮食因素与膀胱癌风险的显著改变并无关联。特别是，男性（优势比=0.95，p=0.70）或女性（优势比=1.15，p=0.53）中，曾经常使用人工甜味剂似乎与风险增加无关。然而，根据九种相关食品的报告食用频率计算得出的每日胆固醇摄入量，提示风险有轻微增加；趋势的优势比估计值为每平均每日摄入量100毫克为1.07（即每天摄入550毫克胆固醇，如一个鸡蛋中可能含有的量，优势比为1.07(5.5)=1.45；p=0.009）。20岁以后发病的糖尿病史似乎也与膀胱癌风险增加有关（优势比=1.65，p=0.019），但这种增加似乎并非使用胰岛素或其他药物、或使用人工甜味剂或低热量食品所致。因此，本研究倾向于证实关于人工甜味剂使用与随后膀胱癌风险缺乏关联的报告。
