Toniolo P, Riboli E, Shore R E, Pasternack B S
Nelson Institute of Environmental Medicine, New York University Medical Center, NY 10010.
Epidemiology. 1994 Jul;5(4):391-7. doi: 10.1097/00001648-199407000-00003.
Epidemiologic studies have focused on the association between diet and breast cancer with conflicting results. Whereas a majority of case-control studies indicate a role for the intake of total fat and saturated fat, most prospective cohort studies either are negative or indicate very modest associations. Only a few authors have examined the role of meat intake in relation to breast cancer risk. The aim of this study was to examine the relation between risk of breast cancer and dietary intake of meat, animal products, fat, and protein. Between 1985 and 1991, we recruited 14,291 New York City women in a prospective cohort study of endogenous hormones, diet, and cancer in which they reported on their recent diet using a food frequency questionnaire self-administered at enrollment. From the cohort, 180 invasive breast cancer cases diagnosed before December 1990 and five times as many controls, individually matched by age, calendar time at enrollment, menopausal status, and, if premenopausal, phase of menstrual cycle, were included in a nested case-control study. There was an evident increase in the relative risk (RR) of breast cancer for increasing consumption of meat. Women in the upper quintile of meat consumption, as compared with the lowest quintile, had an energy-adjusted RR of 1.87 (95% confidence interval = 1.09-3.21). There was a modest RR increase in the upper quintile of total and saturated fat and no apparent association for other types of fat, protein, dairy products, poultry, or fish.(ABSTRACT TRUNCATED AT 250 WORDS)
流行病学研究聚焦于饮食与乳腺癌之间的关联,结果相互矛盾。虽然大多数病例对照研究表明总脂肪和饱和脂肪的摄入起了作用,但大多数前瞻性队列研究要么是否定结果,要么显示关联非常微弱。只有少数作者研究了肉类摄入与乳腺癌风险的关系。本研究的目的是探讨乳腺癌风险与肉类、动物产品、脂肪和蛋白质的饮食摄入之间的关系。1985年至1991年间,我们招募了14291名纽约市女性参与一项关于内源性激素、饮食和癌症的前瞻性队列研究,她们在入组时通过自行填写食物频率问卷报告近期饮食情况。在该队列中,180例1990年12月前确诊的浸润性乳腺癌病例以及五倍数量的对照被纳入一项巢式病例对照研究,对照按年龄、入组日历时间、绝经状态以及(如果是绝经前)月经周期阶段进行个体匹配。随着肉类消费增加,乳腺癌的相对风险(RR)明显上升。与最低五分位数组相比,肉类消费处于最高五分位数组的女性,经能量调整后的RR为1.87(95%置信区间 = 1.09 - 3.21)。总脂肪和饱和脂肪处于最高五分位数组时RR有适度增加,而其他类型的脂肪、蛋白质、乳制品、家禽或鱼类则无明显关联。(摘要截断于250字)