Le Marchand L, Hankin J H, Bach F, Kolonel L N, Wilkens L R, Stacewicz-Sapuntzakis M, Bowen P E, Beecher G R, Laudon F, Baque P
Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu 96813, USA.
Int J Cancer. 1995 Sep 27;63(1):18-23. doi: 10.1002/ijc.2910630105.
Incidence rates of lung cancer have been markedly lower for Fiji than for other South Pacific countries, despite similar rates of smoking. We conducted population-based surveys in several island nations of the South Pacific (Cook Islands, Fiji, Tahiti and New Caledonia) and used data from Caucasian, Japanese, Hawaiian, Filipino and Chinese controls in a case-control study of lung cancer in Hawaii to investigate the role of diet in explaining differences in lung cancer incidence among 20 ethnic-sex groups. In a stepwise linear regression of lung cancer rates on smoking, diet and other variables, smoking, as expected, explained the majority (61%) of the variability in incidence. However, several dietary components also explained significant portions of the variance. Lutein intake explained 14% and vitamin E intake, cholesterol intake and height explained 5-7% each of the remaining variance in incidence. Associations with lutein and vitamin E were inverse, whereas those with cholesterol and height were direct. Dietary beta-carotene intake was not associated with lung cancer incidence. These ecological data provide evidence for a protective effect of lutein against lung cancer. A protective effect of dietary vitamin E and a risk-enhancing effect of dietary cholesterol are also suggested.
尽管斐济的吸烟率与其他南太平洋国家相似，但其肺癌发病率却明显低于这些国家。我们在南太平洋的几个岛国（库克群岛、斐济、塔希提岛和新喀里多尼亚）开展了基于人群的调查，并在夏威夷进行的一项肺癌病例对照研究中使用了来自白种人、日本人、夏威夷人、菲律宾人和华人对照的数据，以调查饮食在解释20个种族性别群体肺癌发病率差异方面的作用。在对肺癌发病率与吸烟、饮食及其他变量进行的逐步线性回归分析中，正如预期的那样，吸烟解释了发病率变异性的大部分（61%）。然而，几种饮食成分也解释了相当一部分的方差。叶黄素摄入量解释了14%，维生素E摄入量、胆固醇摄入量和身高分别解释了发病率剩余方差的5 - 7%。与叶黄素和维生素E的关联呈负相关，而与胆固醇和身高的关联呈正相关。饮食中β-胡萝卜素的摄入量与肺癌发病率无关。这些生态学数据为叶黄素对肺癌的保护作用提供了证据。同时也表明了饮食中维生素E的保护作用以及饮食中胆固醇的风险增强作用。
