Clavel-Chapelon F, Niravong M, Joseph R R
National Institute of Health and Medical Research U351, Gustave-Roussy Institute, Villejuif, France.
Cancer Detect Prev. 1997;21(5):426-40.
The relationship between diet and breast cancer has been analyzed by animal, ecologic, migrant, and epidemiologic studies. The 14 cohort and 33 case-control studies that have been published to date are reviewed in this article. Factors considered in these studies include caloric intake, as well as fat, protein, fiber, beta-carotene, and vitamin E and C consumption. The results of the published studies are summarized, and the point estimates of the risks corresponding to the highest category of consumption as compared to the lowest are presented in figures. Some of the disagreements among studies could be explained by the methodologic difficulties inherent in dietary investigations, such as the establishment of an accurate dietary history, or insufficient diversity in exposure. Further studies taking these points into account and minimizing biases inherent to a case-control design might help to elucidate the relationship between diet and breast cancer, and to define dietary recommendations. Only large long-term cohort studies such as are now in progress can help to resolve the still unanswered questions concerning the contribution of these dietary factors to the risk of breast cancer. We suggest the establishment of new dietary cohorts and the continued follow-up of the existing cohorts.
动物研究、生态学研究、移民研究和流行病学研究均对饮食与乳腺癌之间的关系进行了分析。本文对迄今为止已发表的14项队列研究和33项病例对照研究进行了综述。这些研究中考虑的因素包括热量摄入，以及脂肪、蛋白质、纤维、β-胡萝卜素、维生素E和维生素C的摄入量。总结了已发表研究的结果，并以图表形式呈现了与最低摄入量相比，最高摄入量类别对应的风险点估计值。研究之间的一些分歧可以通过饮食调查中固有的方法学困难来解释，比如准确饮食史的建立，或者暴露的多样性不足。进一步考虑这些要点并尽量减少病例对照设计中固有偏差的研究，可能有助于阐明饮食与乳腺癌之间的关系，并确定饮食建议。只有目前正在进行的大型长期队列研究，才能有助于解决这些饮食因素对乳腺癌风险的影响这一仍未得到解答的问题。我们建议建立新的饮食队列，并对现有队列继续进行随访。
