Launoy G, Milan C, Day N E, Pienkowski M P, Gignoux M, Faivre J
Registre des cancers digestifs du Calvados (CJF INSERM 9603), Caen, France.
Int J Cancer. 1998 Mar 30;76(1):7-12. doi: 10.1002/(sici)1097-0215(19980330)76:1<7::aid-ijc2>3.0.co;2-4.
An increasing number of reports suggest that diet has an impact on oesophageal cancer risk in Western countries, where alcohol and tobacco are held to be the major determinants of the risk. The aim of our study was to identify dietary factors influencing the risk of oesophageal cancer in France and to determine whether certain of these could explain some of the geographical variations. We conducted a multicentre case-control study in 3 regions expected to have different diet and drinking habits (Normandy, Burgundy and Midi Pyrénées). Two hundred eight cases and 399 controls, all males, were interviewed about their eating, drinking and smoking habits. After proper adjustment for drinking and smoking, high consumption of butter and low consumption of fresh fish, vegetables and fruits were associated strongly and independently with an increase in oesophageal-cancer risk. Consistently, cholesterol appeared as a risk factor and vitamin E, vitamin D and phosphorus as independent protective factors. The protective effect of citrus and other fresh fruits (vitamin C) was confined strictly to heavy drinkers. Our findings suggest that more than one-third of the high incidence of oesophageal cancer in northwest France could be explained by the local excess in butter consumption, whereas geographical variations in consumption of dietary protective factors could explain no more than 10% of it. Overall, a large proportion (57%) of the excess incidence of oesophageal cancer in northwest France could be explained by local dietary habits, e.g., drinking hot Calvados liquor and excessive consumption of butter.
越来越多的报告表明，在西方国家，饮食对食管癌风险有影响，而在这些国家，酒精和烟草被认为是风险的主要决定因素。我们研究的目的是确定影响法国食管癌风险的饮食因素，并确定其中某些因素是否可以解释部分地理差异。我们在3个预计有不同饮食习惯和饮酒习惯的地区（诺曼底、勃艮第和南比利牛斯）开展了一项多中心病例对照研究。对208例病例和399例对照（均为男性）进行了饮食、饮酒和吸烟习惯的访谈。在对饮酒和吸烟进行适当调整后，黄油的高摄入量以及新鲜鱼类、蔬菜和水果的低摄入量与食管癌风险的增加密切且独立相关。同样，胆固醇表现为一个风险因素，而维生素E、维生素D和磷则为独立的保护因素。柑橘类水果和其他新鲜水果（维生素C）的保护作用严格限于重度饮酒者。我们的研究结果表明，法国西北部食管癌高发率中超过三分之一可由当地黄油消费过量来解释，而饮食保护因素消费的地理差异对其解释不超过10%。总体而言，法国西北部食管癌额外发病率的很大一部分（57%）可由当地饮食习惯来解释，例如饮用热的卡尔瓦多斯酒和黄油消费过量。
