TitleDietary Fat Intake and Lung Cancer Risk: A Pooled Analysis.
Publication TypeJournal Article
Year of Publication2017
AuthorsYang, JJeong, Yu, D, Takata, Y, Smith-Warner, SA, Blot, W, White, E, Robien, K, Park, Y, Xiang, Y-B, Sinha, R, Lazovich, DA, Stampfer, M, Tumino, R, Aune, D, Overvad, K, Liao, L, Zhang, X, Gao, Y-T, Johansson, M, Willett, W, Zheng, W, Shu, X-O
JournalJ Clin Oncol
Volume35
Issue26
Pagination3055-3064
Date Published09/2017
ISSN1527-7755
KeywordsAdult, Aged, Aged, 80 and over, Cohort Studies, Dietary Fats, Female, Humans, Lung Neoplasms, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk, Young Adult
Abstract
 

Purpose Dietary fat may play a role in lung carcinogenesis. Findings from epidemiologic studies, however, remain inconsistent. In this pooled analysis of 10 prospective cohort studies from the United States, Europe, and Asia, we evaluated the associations of total and specific types of dietary fat with lung cancer risk. Methods Cox regression was used to estimate hazard ratios (HRs) and 95% CIs in each cohort. Study-specific risk estimates were pooled by random- or fixed-effects meta-analysis. The first 2 years of follow-up were excluded to address potential influence of preclinical dietary changes. Results Among 1,445,850 participants, 18,822 incident cases were identified (mean follow-up, 9.4 years). High intakes of total and saturated fat were associated with an increased risk of lung cancer (for highest v lowest quintile: HR, 1.07 and 1.14, respectively; 95% CI, 1.00 to 1.15 and 1.07 to 1.22, respectively; P for trend for both < .001). The positive association of saturated fat was more evident among current smokers (HR, 1.23; 95% CI, 1.13 to 1.35; P for trend < .001) than former/never smokers ( P for interaction = .004), and for squamous cell and small cell carcinoma (HR, 1.61 and 1.40, respectively; 95% CI, 1.38 to 1.88 and 1.17 to 1.67, respectively; P for trend for both < .001) than other histologic types ( P for heterogeneity < .001). In contrast, a high intake of polyunsaturated fat was associated with a decreased risk of lung cancer (HR, 0.92; 95% CI, 0.87 to 0.98 for highest v lowest quintile; P for trend = .02). A 5% energy substitution of saturated fat with polyunsaturated fat was associated with a 16% to 17% lower risk of small cell and squamous cell carcinoma. No associations were found for monounsaturated fat. Conclusion Findings from this large, international cohort consortium suggest that modifying dietary fat intake (ie, replacing saturated fat with polyunsaturated fat) may reduce lung cancer risk, particularly among smokers and for squamous cell and small cell carcinoma.

DOI10.1200/JCO.2017.73.3329
Alternate JournalJ. Clin. Oncol.
PubMed ID28742456
PubMed Central IDPMC5590804
Grant ListR03 CA183021 / CA / NCI NIH HHS / United States
UM1 CA173640 / CA / NCI NIH HHS / United States
UM1 CA182910 / CA / NCI NIH HHS / United States