Lindblad P, Wolk A, Bergström R, Adami H O
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
Cancer Epidemiol Biomarkers Prev. 1997 Apr;6(4):215-23.
In a few previous studies on diet and renal cell cancer, an inconsistent positive association with meat, milk, and protein and a negative association with vegetable and fruit consumption have been found. Whereas earlier studies have dealt with recent diet only, our study explored the effect of foods consumed both during the usual adult lifetime and 20 years prior to interview. The study included 379 individuals with incident histologically verified renal cell cancer and 350 control subjects residing in eight counties in Sweden between June 1989 and December 1991. Usual adult dietary intake and dietary habits 20 years prior to interview were assessed by a structured face-to-face interview and a self-administered questionnaire, respectively. Odds ratios were estimated through unconditional logistic regression. We have not observed an association of renal cell cancer with milk or total meat consumption per se; however, frequent intake of fried/sautéed meat increased the risk of renal cell cancer by about 60%; frequent consumption of poultry was also associated with an increased risk (P for trend, 0.05). A significantly protective effect on risk of renal cell cancer was observed with increasing consumption of fruit (P for trend, 0.05). When analyzed by smoking status, total fruit and especially citrus fruit consumption among nonsmokers showed an even stronger protective effect; the highest quartiles of total fruit, apple, and citrus fruit consumption entailed a 50-60% reduction in risk of renal cell cancer compared with the lowest quartiles. There was a suggestion of a protective effect of high total vegetable consumption. A protective effect of vitamin C and alpha-tocopherol was also more pronounced in nonsmokers (P for trend, 0.004 and 0.007, respectively). Our study adds to the evidence that diet may have an important role in the etiology of renal cell cancer.
在先前一些关于饮食与肾细胞癌的研究中，发现肉类、牛奶和蛋白质与之存在不一致的正相关，而与蔬菜和水果的摄入量呈负相关。早期研究仅涉及近期饮食，而我们的研究探讨了成年期日常饮食以及访谈前20年所摄入食物的影响。该研究纳入了379例经组织学证实为新发肾细胞癌的患者以及350名对照受试者，他们于1989年6月至1991年12月期间居住在瑞典的8个县。通过结构化面对面访谈和自行填写问卷，分别评估了访谈前20年的成年期日常饮食摄入量和饮食习惯。通过无条件逻辑回归估计比值比。我们未观察到肾细胞癌与牛奶或总肉类摄入量本身之间存在关联；然而，频繁摄入煎/炒肉类使肾细胞癌风险增加约60%；频繁食用家禽也与风险增加相关（趋势P值为0.05）。随着水果摄入量增加，对肾细胞癌风险具有显著的保护作用（趋势P值为0.05）。按吸烟状况分析时，非吸烟者中总水果尤其是柑橘类水果的摄入量显示出更强的保护作用；与最低四分位数相比，总水果、苹果和柑橘类水果摄入量最高的四分位数使肾细胞癌风险降低50 - 60%。高蔬菜总摄入量有显示出保护作用的迹象。维生素C和α - 生育酚的保护作用在非吸烟者中也更为明显（趋势P值分别为0.004和0.007）。我们的研究进一步证明饮食可能在肾细胞癌的病因学中起重要作用。
