Diet-wide association study of 92 foods and nutrients and lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study
Heath, Alicia K; Muller, David C; van den Brandt, Piet A; Critselis, Elena; Gunter, Marc; Vineis, Paolo; Weiderpass, Elisabete; Boeing, Heiner; Ferrari, Pietro; Merritt, Melissa A; Rostgaard-Hansen, Agnetha L; Tjønneland, Anne; Overvad, Kim; Katzke, Verena; Srour, Bernard; Masala, Giovanna; Sacerdote, Carlotta; Ricceri, Fulvio; Pasanisi, Fabrizio; Bueno-de-Mesquita, Bas; Downward, George S; Skeie, Guri; Sandanger, Torkjel M; Crous-Bou, Marta; Rodríguez-Barranco, Miguel; Amiano, Pilar; Huerta, José María; Ardanaz, Eva; Drake, Isabel; Johansson, Mikael; Johansson, Ingegerd; Key, Tim; Papadimitriou, Nikos; Riboli, Elio; Tzoulaki, Ioanna; Tsilidis, Konstantinos K
(2022) International Journal of Cancer, volume 151, issue 11, pp. 1935 - 1946
(Article)
Abstract
It is unclear whether diet, and in particular certain foods or nutrients, are associated with lung cancer risk. We assessed associations of 92 dietary factors with lung cancer risk in 327 790 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox regression yielded adjusted hazard ratios (HRs) and
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95% confidence intervals (CIs) per SD higher intake/day of each food/nutrient. Correction for multiple comparisons was performed using the false discovery rate and identified associations were evaluated in the Netherlands Cohort Study (NLCS). In EPIC, 2420 incident lung cancer cases were identified during a median of 15 years of follow-up. Higher intakes of fibre (HR per 1 SD higher intake/day = 0.91, 95% CI 0.87-0.96), fruit (HR = 0.91, 95% CI 0.86-0.96) and vitamin C (HR = 0.91, 95% CI 0.86-0.96) were associated with a lower risk of lung cancer, whereas offal (HR = 1.08, 95% CI 1.03-1.14), retinol (HR = 1.06, 95% CI 1.03-1.10) and beer/cider (HR = 1.04, 95% CI 1.02-1.07) intakes were positively associated with lung cancer risk. Associations did not differ by sex and there was less evidence for associations among never smokers. None of the six associations with overall lung cancer risk identified in EPIC were replicated in the NLCS (2861 cases), however in analyses of histological subtypes, inverse associations of fruit and vitamin C with squamous cell carcinoma were replicated in the NLCS. Overall, there is little evidence that intakes of specific foods and nutrients play a major role in primary lung cancer risk, but fruit and vitamin C intakes seem to be inversely associated with squamous cell lung cancer.
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Keywords: cohort study, diet, foods, lung cancer, nutrients, Oncology, Cancer Research
ISSN: 0020-7136
Publisher: Wiley-Liss Inc.
Note: Funding Information: Associazione Italiana per la Ricerca sul Cancro; Bundesministerium für Bildung und Forschung; Cancer Research UK, Grant/Award Numbers: 14136, C8221/A29017; Cancerfonden; Catalan Institute of Oncology‐ICO; Centre International de Recherche sur le Cancer; Compagnia di SanPaolo; Consiglio Nazionale delle Ricerche; County Councils of Skåne and Västerbotten; Deutsche Krebshilfe; Deutsches Krebsforschungszentrum; Dutch Prevention Funds; German Institute of Human Nutrition Potsdam‐Rehbruecke; Health Research Fund (FIS)‐Instituto de Salud Carlos III (ISCIII); Institut Gustave Roussy; Institut National de la Santé et de la Recherche Médicale; Kræftens Bekæmpelse; Ligue Contre le Cancer; LK Research Funds; Medical Research Council, Grant/Award Numbers: 1000143, MR/M012190/1; Ministerie van Volksgezondheid, Welzijn en Sport; Mutuelle Générale de l'Education Nationale; Netherlands Cancer Registry; NIHR Imperial Biomedical Research Centre; Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra; School of Public Health, Imperial College London; Statistics Netherlands; Vetenskapsrådet; World Cancer Research Fund, Grant/Award Number: WCRF 2014/1180; Zorg Onderzoek Nederland Funding information Funding Information: The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam‐Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) ‐ Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra and the Catalan Institute of Oncology ‐ ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC‐Norfolk; C8221/A29017 to EPIC‐Oxford), Medical Research Council (1000143 to EPIC‐Norfolk; MR/M012190/1 to EPIC‐Oxford) (United Kingdom). Funding Information: The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). Publisher Copyright: © 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
(Peer reviewed)