Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Epidemiology and Public Health; and Marlene and Stewart Greenbaum, Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Nutr Cancer. 2022;74(8):2803-2814. doi: 10.1080/01635581.2022.2032217. Epub 2022 Feb 1.
Cancer incidence is rising rapidly in Sub-Saharan Africa (SSA). Dietary intake is an established risk factor for certain cancers but only a few epidemiological studies have been conducted in SSA. This study systematically reviewed and summarized the published literature on this issue and identified gaps that can be addressed in future research. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and literature searched was conducted until 11/2/2021. Out of the 5,457 potential references, we reviewed 19 eligible studies: 17 case-controls, two cross-sectionals and no cohort study. South Africa and Kenya conducted the majorities of the studies. The commonest studied cancers were esophageal (9/19), colorectal (4/19) and breast (4/19). Only four studies utilized a validated Food Frequency Questionnaire (FFQ). Although most studies (16/19) reported associations between dietary intake and cancer risks, they were lacking important confounders including total energy intake, multivitamin intake, body fat measures, physical-activity, smoking, and alcohol. Despite rapidly expanding cases of cancer associated with diet, the existent evidence on diet-cancer relationship is too scarce to deduce solid conclusions. There is a need for large cohorts with comprehensive datasets, validated dietary instruments while using advanced statistical analyses that can provide further insights into the imperative links between African diet and cancer risk.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2032217 .
癌症在撒哈拉以南非洲（SSA）的发病率正在迅速上升。饮食摄入是某些癌症的既定风险因素，但在 SSA 仅进行了少数几项流行病学研究。本研究系统地回顾和总结了关于这个问题的已发表文献，并确定了可以在未来研究中解决的差距。我们遵循了系统评价和荟萃分析的首选报告项目（PRISMA），文献检索截止到 2021 年 11 月 2 日。在 5457 篇潜在参考文献中，我们回顾了 19 项符合条件的研究：17 项病例对照研究，2 项横断面研究，没有队列研究。南非和肯尼亚进行了大多数研究。最常见的研究癌症是食管癌（9/19）、结直肠癌（4/19）和乳腺癌（4/19）。只有四项研究使用了经过验证的食物频率问卷（FFQ）。尽管大多数研究（16/19）报告了饮食摄入与癌症风险之间的关联，但它们缺乏重要的混杂因素，包括总能量摄入、多种维生素摄入、体脂测量、身体活动、吸烟和饮酒。尽管与饮食相关的癌症病例迅速增加，但关于饮食与癌症关系的现有证据太少，无法得出确凿的结论。需要有大型队列，这些队列要有全面的数据集和经过验证的饮食仪器，同时使用先进的统计分析方法，可以更深入地了解非洲饮食与癌症风险之间的重要联系。本文的补充数据可在 https://doi.org/10.1080/01635581.2022.2032217 在线获取。
