Ji B T, Chow W H, Gridley G, Mclaughlin J K, Dai Q, Wacholder S, Hatch M C, Gao Y T, Fraumeni J F
Division of Epidemiology Columbia University, School of Public Health, New York, New York 10032, USA.
Cancer Epidemiol Biomarkers Prev. 1995 Dec;4(8):885-93.
In Shanghai, China, age-adjusted incidence rates for pancreatic cancer have increased steadily, beginning in the early 1970s. To examine the effects of diet on this cancer, a population-based case-control study was conduct. Cases (n = 451) were permanent residents of Shanghai, 30-74 years of age, newly diagnosed with pancreatic cancer between October 1, 1990 and June 30, 1993. Decreased cases (19%) were excluded from the study. Controls (n = 1552) were selected among Shanghai residents, frequency matched to cases by gender and age. Information on usual adult dietary intake was obtained by trained interviewers in person, using a food frequency questionnaire. Dietary associations were measured by odds ratios and 95% confidence intervals. Risks of pancreatic cancer were inversely associated with consumption of vegetables (P for trend among men = 0.03; among women = 0.15) and fruits (P among men = 0.02; among women = 0.08). Reductions in risk were related also to intake of dietary fiber and micronutrients abundant in plant sources, such as vitamins C and E and carotene. There was also an inverse association with egg consumption (P for trend among men = 0.08; among women = 0.001). No consistent positive associations were observed with intake of other food groups, including preserved animal foods, fresh red meat, organ meat, poultry, and staple foods. On the other hand, risks increased with frequency of consumption of preserved vegetables and foods that were deep fried, grilled, cured, or smoked, providing clues to the possible role of nitrosamines, polycyclic aromatic hydrocarbons, and heterocyclic aromatic amines. The inverse associations observed with intake of dietary fat and protein in our study were unexpected, although these findings were based on consumptions well below the average intake in Western countries, where most previous studies on pancreatic cancer were conducted. Our results suggest that dietary variations have contributed little to the rising trends of pancreatic cancer in Shanghai. However, given the improving food availability and changing dietary patterns in China, further study of dietary and nutritional risk factors for pancreatic cancer appears warranted.
在中国上海，自20世纪70年代初以来，胰腺癌的年龄调整发病率稳步上升。为了研究饮食对这种癌症的影响，开展了一项基于人群的病例对照研究。病例（n = 451）为上海常住居民，年龄在30至74岁之间，于1990年10月1日至1993年6月30日期间新诊断为胰腺癌。减少的病例（19%）被排除在研究之外。对照（n = 1552）从上海居民中选取，按性别和年龄与病例进行频数匹配。由经过培训的访员通过个人访谈，使用食物频率问卷获取关于成年人通常饮食摄入量的信息。通过比值比和95%置信区间来衡量饮食关联。胰腺癌风险与蔬菜（男性趋势P值 = 0.03；女性 = 0.15）和水果（男性P值 = 0.02；女性 = 0.08）的摄入量呈负相关。风险降低还与膳食纤维以及植物来源丰富的微量营养素（如维生素C、维生素E和胡萝卜素）的摄入有关。鸡蛋摄入量也呈负相关（男性趋势P值 = 0.08；女性 = 0.001）。未观察到与其他食物组的摄入量有一致的正相关，包括腌制动物性食品、新鲜红肉、内脏肉、家禽和主食。另一方面，胰腺癌风险随着腌制蔬菜以及油炸、烤制、腌制或烟熏食品的食用频率增加而升高，这为亚硝胺、多环芳烃和杂环芳烃的可能作用提供了线索。我们研究中观察到的饮食脂肪和蛋白质摄入量与胰腺癌风险的负相关出乎意料，尽管这些发现基于远低于西方国家平均摄入量的消费情况，此前大多数关于胰腺癌的研究都是在西方国家进行的。我们的研究结果表明，饮食差异对上海胰腺癌上升趋势的影响较小。然而，鉴于中国食物供应情况的改善和饮食模式的变化，进一步研究胰腺癌的饮食和营养风险因素似乎是必要的。
