Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea.
Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.
Cancer Med. 2024 Aug;13(16):e70053. doi: 10.1002/cam4.70053.
Determining the effect of dietary factors on cancer is a crucial issue when accounting for the effect of other major risks, such as smoking and drinking.
A total of 15,563 adults from the Korean National Cancer Center Community Cohort were analyzed to determine and to compare the effect of dietary factors on stomach and colorectal cancer in overall and in the subgroup of non-smokers (or urinary cotinine concentrations <5 ng/mg) and non-drinkers with Cox proportional-hazard models.
During the mean follow-up (13.7 years), 469 and 299 cases of stomach and colorectal cancer were identified, respectively. The preventive effect of vegetable, fish, and soybean/tofu intake on colorectal cancer was found in women after adjustment for smoking, drinking, BMI, and sociodemographic factors. In the subgroup analysis of non-smokers and non-drinkers, the effect on colorectal cancer was increased in women (≥1 time/week vs. almost never, vegetables: hazard ratio (HR) 0.30, 95% confidence interval (CI) 0.13-0.69; fish: HR 0.46, 95% CI 0.26-0.83), and the fresh fish intake effect on stomach cancer was newly identified in men (HR 0.36, 95% CI 0.15-0.86). These effects were more pronounced and additionally shown in other dietary factors such as soybean or tofu in women and vegetables and fish in men, when subjects with <5 ng/mg urinary cotinine concentrations applied.
The protective effect of healthy eating on the risk of stomach and colorectal cancer were different by smoking and drinking status. Rigorous control of smoking and drinking effects is necessary when measuring the effect of dietary factors on cancer, properly.
在考虑其他主要风险（如吸烟和饮酒）的影响时，确定饮食因素对癌症的影响是一个关键问题。
对来自韩国国家癌症中心社区队列的 15563 名成年人进行分析，以确定和比较饮食因素对胃癌和结直肠癌的影响，并使用 Cox 比例风险模型进行总体比较和非吸烟者（或尿中可替宁浓度<5ng/mg）和非饮酒者的亚组比较。
在平均随访（13.7 年）期间，分别确定了 469 例和 299 例胃癌和结直肠癌病例。在调整了吸烟、饮酒、BMI 和社会人口因素后，发现蔬菜、鱼类和大豆/豆腐摄入对女性结直肠癌有预防作用。在非吸烟者和非饮酒者的亚组分析中，女性的结直肠癌效应增加（每周≥1 次与几乎从不，蔬菜：风险比（HR）0.30，95%置信区间（CI）0.13-0.69；鱼类：HR 0.46，95% CI 0.26-0.83），并且在男性中首次发现了新鲜鱼类摄入对胃癌的影响（HR 0.36，95% CI 0.15-0.86）。当受试者尿中可替宁浓度<5ng/mg 时，这些效应在其他饮食因素（如女性的大豆或豆腐以及男性的蔬菜和鱼类）中更为明显和显著。
健康饮食对胃癌和结直肠癌风险的保护作用因吸烟和饮酒状况而异。在衡量饮食因素对癌症的影响时，需要严格控制吸烟和饮酒的影响。
