Chow W H, Gridley G, McLaughlin J K, Mandel J S, Wacholder S, Blot W J, Niwa S, Fraumeni J F
Division of Cancer Etiology, National Cancer Institute, Bethesda, Md.
J Natl Cancer Inst. 1994 Aug 3;86(15):1131-9. doi: 10.1093/jnci/86.15.1131.
Renal cell cancer, although still relatively uncommon, has been increasing in incidence in the United States and other countries around the world.
Since previous studies have suggested an association with high intake of meat, we sought to further examine the role of diet in renal cell cancer risk.
Patients with histologically confirmed renal cell cancer that had been diagnosed between July 1, 1988, and December 31, 1990, were identified through the Minnesota Cancer Surveillance System, a statewide cancer registry. The patients eligible for inclusion in this study were white residents of Minnesota between 20 and 79 years of age. Control subjects were selected from the general population of Minnesota residents; subjects under age 65 were selected by use of a random-digit-dialing method and those 65 years or older were sampled from the Health Care Financing Administration files. Population-based control subjects were frequency-matched to cases by sex and 5-year age groups. A total of 690 patients and 707 control subjects were interviewed. Patients and control subjects were similar in distribution by sex, age, and educational level. Usual adult dietary intakes were assessed by questionnaire, and odds ratios were calculated by logistic regression analyses.
Significantly increased risks of renal cell cancer were observed with increasing consumption of several food groups, including red meat (P for trend = .05), high-protein foods (P = .01), and staple (grains, breads, and potatoes) foods (P = .009). When examined by macronutrient status, risks increased monotonically with the amount of protein intake, from 1.2 (95% confidence interval [CI] = 0.7-1.9) to 1.4 (95% CI = 0.8-2.5) and 1.9 (95% CI = 1.0-3.6) (P for trend = .03) in the second, third, and fourth quartiles of intake, respectively, after adjustment for age, sex, caloric intake, body mass index, and cigarette smoking. No significant or consistent associations were detected with the intake of other dietary nutrients or beverages.
Although an independent effect of dietary protein has not been previously associated with renal cell cancer, high protein consumption has been related to development of other chronic renal conditions that may predispose an individual to this cancer.
These findings should prompt further study of dietary protein and its potential contribution to the origins of renal cell cancer.
肾细胞癌虽然仍然相对不常见,但在美国和世界其他国家的发病率一直在上升。
由于先前的研究表明肾细胞癌与大量摄入肉类有关,我们试图进一步研究饮食在肾细胞癌风险中的作用。
通过明尼苏达州癌症监测系统(一个全州范围的癌症登记处)确定了1988年7月1日至1990年12月31日期间经组织学确诊的肾细胞癌患者。本研究纳入的患者为年龄在20至79岁之间的明尼苏达州白人居民。对照对象从明尼苏达州居民的普通人群中选取;65岁以下的对象采用随机数字拨号法选取,65岁及以上的对象从医疗保健财务管理局的档案中抽样。以人群为基础的对照对象按性别和5岁年龄组与病例进行频率匹配。共对690名患者和707名对照对象进行了访谈。患者和对照对象在性别、年龄和教育水平分布上相似。通过问卷调查评估成年人的日常饮食摄入量,并通过逻辑回归分析计算比值比。
随着几种食物组摄入量的增加,肾细胞癌风险显著增加,包括红肉(趋势P值 = 0.05)、高蛋白食物(P = 0.01)和主食(谷物、面包和土豆)类食物(P = 0.009)。按常量营养素状况检查时,在调整年龄、性别、热量摄入、体重指数和吸烟因素后,风险随着蛋白质摄入量的增加而单调增加,在摄入量的第二、第三和第四四分位数中,风险分别为1.2(95%置信区间[CI] = 0.7 - 1.9)、1.4(95% CI = 0.8 - 2.5)和1.9(95% CI = 1.0 - 3.6)(趋势P值 = 0.03)。未发现与其他膳食营养素或饮料的摄入量有显著或一致的关联。
虽然膳食蛋白质的独立作用以前未被认为与肾细胞癌有关,但高蛋白消费与其他慢性肾脏疾病的发生有关,这些疾病可能使个体易患这种癌症。
这些发现应促使对膳食蛋白质及其对肾细胞癌起源的潜在贡献进行进一步研究。