Risch H A, Jain M, Marrett L D, Howe G R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510.
J Natl Cancer Inst. 1994 Sep 21;86(18):1409-15. doi: 10.1093/jnci/86.18.1409.
Evidence exists that dietary fat may be a contributory factor in the development of hormone-related cancers such as ovarian cancer. Previous studies have demonstrated significantly higher circulating-estrogen levels among nonvegetarian women than among vegetarian women; the increase correlated directly with consumption of saturated fat. However, the contribution that dietary fat plays in the development of hormone-related cancers remains unresolved.
Our purpose was to evaluate whether saturated fat intake increases the risk of ovarian cancer development.
Population-based sampling was used to acquire cases and controls over a 3-year period from the study area, which included the highly populated region surrounding the western end of Lake Ontario, Canada. From the Ontario Cancer Registry, all histologically confirmed, primary malignant or borderline malignant epithelial ovarian tumors first diagnosed from November 1989 through October 1992 among study-area residents aged 35-79 years were determined. In total, 631 eligible case subjects were identified, of whom 450 (71.3%) were interviewed concerning reproduction and diet; 564 randomly selected population control subjects were similarly interviewed. From the quantitative diet-history information, average daily intakes of macronutrients and micronutrients were calculated. Unconditional continuous logistic regression methods were used for analysis, with adjustment for age at interview, number of full-term pregnancies, years of oral contraceptive use, and total daily caloric intake.
Saturated fat consumption was associated with increasing risk of ovarian cancer (odds ratio [OR] = 1.20 for each 10 g/day of intake; 95% confidence interval [CI] = 1.03-1.40; one-sided P = .0082). No relationship was seen with intake of unsaturated fats. Egg consumption also appeared related to increased risk (OR = 1.42 for each 100 mg of egg cholesterol per day; 95% CI = 1.18-1.72; two-sided P = .0002), though this association may have resulted from disease-related changes in the dietary practices of case subjects prior to diagnosis. Consumption of vegetable fiber (but not fruit or cereal fiber) was associated with decreased risk (OR = 0.63 for each 10 g/day; 95% CI = 0.49-0.80; two-sided P = .0001). All three nutrients (saturated fat, egg cholesterol, and vegetable fiber) remained statistically significant when included in the same regression model.
Diet may contribute to risk of ovarian cancer development.
If confirmed in further studies, this association may allow women to appreciably lower their risk of ovarian cancer through dietary modifications: reducing the intake of saturated fats and eating more vegetables.
有证据表明,膳食脂肪可能是导致激素相关癌症(如卵巢癌)的一个促成因素。先前的研究表明,非素食女性的循环雌激素水平显著高于素食女性;这种增加与饱和脂肪的摄入量直接相关。然而,膳食脂肪在激素相关癌症发生过程中所起的作用仍未明确。
我们的目的是评估饱和脂肪摄入量是否会增加卵巢癌发生的风险。
采用基于人群的抽样方法,在3年时间里从研究区域获取病例和对照,该区域包括加拿大安大略湖西端周围人口密集的地区。从安大略癌症登记处确定了1989年11月至1992年10月期间首次诊断出的、年龄在35 - 79岁的研究区域居民中所有经组织学确诊的原发性恶性或交界性恶性上皮性卵巢肿瘤。总共确定了631名符合条件的病例受试者,其中450名(71.3%)接受了关于生殖和饮食的访谈;同样对564名随机选择的人群对照受试者进行了访谈。根据定量饮食史信息,计算了常量营养素和微量营养素的平均每日摄入量。采用无条件连续逻辑回归方法进行分析,并对访谈时的年龄、足月妊娠次数、口服避孕药使用年限和每日总热量摄入进行了调整。
饱和脂肪的摄入量与卵巢癌风险增加相关(每摄入10克/天的优势比[OR] = 1.20;95%置信区间[CI] = 1.03 - 1.40;单侧P = .0082)。未发现与不饱和脂肪摄入量有关。鸡蛋摄入量似乎也与风险增加有关(每天每100毫克鸡蛋胆固醇的OR = 1.42;95% CI = 1.18 - 1.72;双侧P = .0002),不过这种关联可能是由于病例受试者在诊断前饮食行为的疾病相关变化所致。蔬菜纤维(而非水果或谷物纤维)的摄入与风险降低有关(每10克/天OR = 0.63;95% CI = 0.49 - 0.80;双侧P = .0001)。当这三种营养素(饱和脂肪、鸡蛋胆固醇和蔬菜纤维)纳入同一回归模型时,它们在统计学上均具有显著性。
饮食可能会增加卵巢癌发生的风险。
如果在进一步研究中得到证实,这种关联可能使女性通过饮食调整显著降低卵巢癌风险:减少饱和脂肪的摄入并多吃蔬菜。