Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Int J Cancer. 2024 Sep 1;155(5):828-838. doi: 10.1002/ijc.34959. Epub 2024 May 3.
We previously demonstrated that intake of low-fat dairy, but not high-fat dairy, was associated with a decreased colorectal cancer (CRC) recurrence risk. These risks, however, may differ by sex, primary tumour location, and disease stage. Combining data from two similar prospective cohort studies of people with stage I-III CRC enabled these subgroup analyses. Participants completed a food frequency questionnaire at diagnosis (n = 2283). We examined associations between low- and high-fat dairy intake and recurrence risk using multivariable Cox proportional hazard models, stratified by sex, and primary tumour location (colon and rectum), and disease stage (I/II and III). Upper quartiles were compared to lower quartiles of intake, and recurrence was defined as a locoregional recurrence and/or metastasis. During a median follow-up of 5.0 years, 331 recurrences were detected. A higher intake of low-fat dairy was associated with a reduced risk of recurrence (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.43-0.83), which seemed more pronounced in men (HR: 0.51, 95% CI: 0.34-0.77) than in women (HR: 0.84, 95% CI: 0.47-1.49). A higher intake of high-fat dairy was associated with an increased risk of recurrence in participants with colon cancer (HR: 1.60, 95% CI: 1.03-2.50), but not rectal cancer (HR: 0.88, 95% CI: 0.54-1.45). No differences in associations were observed between strata of disease stage. Concluding, our findings imply that dietary advice regarding low-fat dairy intake may be especially important for men with CRC, and that dietary advice regarding high-fat dairy intake may be specifically important in people with colon cancer.
我们之前的研究表明,摄入低脂乳制品与结直肠癌(CRC)复发风险降低相关,而摄入高脂乳制品则无此作用。然而,这些风险可能因性别、原发肿瘤部位和疾病分期而异。我们结合了两项针对 I-III 期 CRC 患者的类似前瞻性队列研究的数据,进行了这些亚组分析。参与者在诊断时完成了一份食物频率问卷(n=2283)。我们使用多变量 Cox 比例风险模型,按性别和原发肿瘤部位(结肠和直肠)以及疾病分期(I/II 期和 III 期)对低脂和高脂乳制品摄入与复发风险之间的关系进行了研究。将摄入量的上四分位数与下四分位数进行比较,复发定义为局部复发和/或转移。在中位随访 5.0 年期间,共检测到 331 例复发。较高的低脂乳制品摄入量与复发风险降低相关(风险比[HR]:0.60,95%置信区间[CI]:0.43-0.83),这种关联在男性中更为明显(HR:0.51,95% CI:0.34-0.77),而在女性中则不明显(HR:0.84,95% CI:0.47-1.49)。较高的高脂乳制品摄入量与结肠癌患者的复发风险增加相关(HR:1.60,95% CI:1.03-2.50),但与直肠癌患者无关(HR:0.88,95% CI:0.54-1.45)。在疾病分期的不同亚组中,未观察到关联存在差异。综上,我们的研究结果表明,对于男性 CRC 患者,低脂乳制品摄入方面的饮食建议可能尤为重要,而对于结肠癌患者,高脂乳制品摄入方面的饮食建议可能尤为重要。