Goldbohm R A, van den Brandt P A, van 't Veer P, Brants H A, Dorant E, Sturmans F, Hermus R J
Department of Nutrition, TNO-Toxicology and Nutrition Institute, Zeist, The Netherlands.
Cancer Res. 1994 Feb 1;54(3):718-23.
The high incidence of colon cancer in affluent societies has often been attributed to a high fat diet and, more in particular, the consumption of meat. The association of the consumption of meat and the intake of fat with risk of colon cancer was investigated in a prospective cohort study on diet and cancer, which is being conducted in the Netherlands since 1986 among 120,852 men and women, aged 55-69. The analysis was based on 215 incident cases of colon cancer (105 men and 110 women) accumulated in 3.3 years of follow-up, excluding cases diagnosed in the first year of follow-up. Dietary habits were assessed at baseline with a 150-item semiquantitative food frequency questionnaire. No trends in relative rates of colon cancer were detected for intake of energy or for the energy-adjusted intake of fats, protein, fat from meat, and protein from meat. Consumption of total fresh meat, beef, pork, minced meat, chicken, and fish was not associated with risk of colon cancer either. Processed meats, however, were associated with an increased risk in men and women (relative rate, 1.17 per increment of 15 g/day; 95% confidence interval, 1.03-1.33). The increased risk appeared to be attributable to one of the five questionnaire items on processed meat, which comprised mainly sausages. This study does not support a role of fresh meat and dietary fat in the etiology of colon cancer in this population. As an exception, some processed meats may increase the risk, but the mechanism is not yet clear.
富裕社会中结肠癌的高发病率常常被归因于高脂肪饮食,尤其是肉类的消费。在一项自1986年起在荷兰对120852名年龄在55至69岁之间的男性和女性进行的饮食与癌症前瞻性队列研究中,调查了肉类消费和脂肪摄入与结肠癌风险之间的关联。分析基于在3.3年随访中积累的215例结肠癌新发病例(105名男性和110名女性),排除随访第一年诊断的病例。在基线时用一份包含150项的半定量食物频率问卷评估饮食习惯。未发现能量摄入或能量调整后的脂肪、蛋白质、肉类脂肪和肉类蛋白质摄入的结肠癌相对发病率有趋势。总鲜肉、牛肉、猪肉、碎肉、鸡肉和鱼类的消费也与结肠癌风险无关。然而,加工肉类与男性和女性的风险增加有关(相对发病率,每增加15克/天为1.17;95%置信区间,1.03 - 1.33)。风险增加似乎归因于加工肉类问卷中的五个项目之一,主要包括香肠。这项研究不支持鲜肉和膳食脂肪在该人群结肠癌病因中的作用。作为一个例外,一些加工肉类可能会增加风险,但机制尚不清楚。