Byers T E, Graham S, Haughey B P, Marshall J R, Swanson M K
Am J Epidemiol. 1987 Mar;125(3):351-63. doi: 10.1093/oxfordjournals.aje.a114542.
This study compares the diets of 450 lung cancer cases (296 males, 154 females) with those of 902 controls (587 males, 315 females). Cases were lung cancer patients diagnosed between August 1980 and July 1984 in three western New York counties, while controls were selected from the general population of these same counties. Usual diet was estimated by detailed interviews using a modified food frequency method. Case-control comparisons were made for dietary fat, protein, fiber, calories, cholesterol, and vitamins A, C, and E according to quartiles of intake, adjusting for age and pack-years of cigarettes by multiple logistic regression. Risk was lower for males in the lowest quartile of total dietary fat intake compared with those in the highest quartile (relative risk = 0.5), although the overall trend in the association with dietary fat was not statistically significant (p = 0.12). Likewise, there was a weak, but not statistically significant, direct association between dietary cholesterol and lung cancer in men (p = 0.17). The intake of vitamin A from fruits and vegetables (carotene) was much more strongly associated with reduced cancer risk. For males, the relative risks by quartiles (lowest intake to highest intake) were 1.8, 1.8, 1.0, 1.0 (p for trend = 0.001). For females, this relation was considerably weaker, and was not statistically significant. These findings are generally in agreement with those of several previous studies. The risk reduction associated with vitamin A from fruits and vegetables (carotene) was most evident for males, for those with squamous cell cancers, for light or ex-smokers, and for those over 60 years of age.
本研究比较了450例肺癌患者(296例男性,154例女性)与902名对照者(587例男性,315例女性)的饮食情况。病例组为1980年8月至1984年7月在纽约州西部三个县诊断出的肺癌患者,而对照组则从这些县的普通人群中选取。通过使用改良的食物频率法进行详细访谈来估算日常饮食。根据摄入量的四分位数,对饮食中的脂肪、蛋白质、纤维、卡路里、胆固醇以及维生素A、C和E进行病例对照比较,并通过多元逻辑回归对年龄和吸烟包年数进行调整。与总膳食脂肪摄入量最高四分位数的男性相比,最低四分位数的男性风险较低(相对风险=0.5),尽管膳食脂肪与肺癌之间关联的总体趋势无统计学意义(p=0.12)。同样,男性饮食胆固醇与肺癌之间存在微弱但无统计学意义的直接关联(p=0.17)。水果和蔬菜(胡萝卜素)中的维生素A摄入量与降低癌症风险的关联更为密切。对于男性,按四分位数(最低摄入量到最高摄入量)计算的相对风险分别为1.8、1.8、1.0、1.0(趋势p值=0.001)。对于女性,这种关系则弱得多,且无统计学意义。这些发现总体上与之前几项研究的结果一致。水果和蔬菜(胡萝卜素)中的维生素A所带来的风险降低在男性、鳞状细胞癌患者、轻度吸烟者或已戒烟者以及60岁以上人群中最为明显。