Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA.
Br J Dermatol. 2021 Aug;185(2):353-362. doi: 10.1111/bjd.19896. Epub 2021 May 9.
Melanoma incidence has been dramatically increasing worldwide. Psoralen, a known photocarcinogen, is naturally abundant in citrus products, leading to the hypothesis that high citrus consumption may increase melanoma risk.
To investigate the association between total citrus consumption and melanoma risk, and the association between individual citrus products and melanoma risk, and to test for interactions between total citrus intake and established melanoma risk factors.
Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between citrus consumption and melanoma risk among 1592 cases and 197 372 controls from the UK Biobank cohort. Citrus consumption data were collected via five rounds of 24-h recall questionnaires. International Classification of Diseases codes were used to determine melanoma outcome.
After adjusting for potential confounders, participants in the highest category of total citrus intake (> 2 servings per day) had a significantly increased risk of melanoma (OR 1·63, 95% CI 1·24-2·12) relative to those with no consumption. For individual citrus products, participants with the most orange and orange juice consumption (> 1 serving per day) had a significantly increased melanoma risk relative to those with no consumption (OR 1·79, 95% CI 1·07-2·78 and OR 1·54, 95% CI 1·10-2·10, respectively). Fair- or very fair-skinned participants with high citrus consumption had an even greater melanoma risk (OR 1·75, 95% CI 1·31-2·29).
High citrus consumption was associated with an increased risk of melanoma in a large, prospective, population-based cohort. Further validation of these findings could lead to improved melanoma prevention strategies.
黑色素瘤的发病率在全球范围内显著增加。补骨脂素是一种已知的光致癌物质,在柑橘类产品中含量丰富,这导致了这样一种假设,即大量食用柑橘可能会增加患黑色素瘤的风险。
调查总柑橘类消费与黑色素瘤风险之间的关联,以及个体柑橘类产品与黑色素瘤风险之间的关联,并检验总柑橘摄入量与已确立的黑色素瘤危险因素之间的相互作用。
使用逻辑回归来估计英国生物库队列中 1592 例病例和 197372 例对照者中柑橘类消费与黑色素瘤风险之间的比值比(OR)和 95%置信区间(CI)。通过五轮 24 小时回忆问卷收集柑橘类消费数据。国际疾病分类代码用于确定黑色素瘤的结果。
在调整了潜在的混杂因素后,与不消费的参与者相比,总柑橘摄入量最高组(> 2 份/天)的黑色素瘤风险显著增加(OR 1.63,95%CI 1.24-2.12)。对于个体柑橘产品,与不消费的参与者相比,摄入最多的橙子和橙汁(> 1 份/天)的黑色素瘤风险显著增加(OR 1.79,95%CI 1.07-2.78 和 OR 1.54,95%CI 1.10-2.10)。高柑橘摄入量的肤色较浅或非常浅的参与者黑色素瘤风险更高(OR 1.75,95%CI 1.31-2.29)。
在一个大型的、前瞻性的、基于人群的队列中,高柑橘类消费与黑色素瘤风险增加相关。对这些发现的进一步验证可能会导致更好的黑色素瘤预防策略。