TitlePrediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies.
Publication TypeJournal Article
Year of Publication2017
AuthorsYu, D, Takata, Y, Smith-Warner, SA, Blot, W, Sawada, N, White, E, Freedman, N, Robien, K, Giovannucci, E, Zhang, X, Park, Y, Gao, Y-T, Chlebowski, RT, Langhammer, A, Yang, G, Severi, G, Manjer, J, Khaw, K-T, Weiderpass, E, Liao, LM, Caporaso, N, Krokstad, S, Hveem, K, Sinha, R, Ziegler, R, Tsugane, S, Xiang, Y-B, Johansson, M, Zheng, W, Shu, X-O
JournalCancer Epidemiol Biomarkers Prev
Date Published07/2017
KeywordsAged, Calcium, Dietary, Diet Surveys, Dietary Supplements, Feeding Behavior, Female, Follow-Up Studies, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Survival Rate

Lung cancer is the leading cause of cancer death. Little is known about whether prediagnostic nutritional factors may affect survival. We examined the associations of prediagnostic calcium intake from foods and/or supplements with lung cancer survival. The present analysis included 23,882 incident, primary lung cancer patients from 12 prospective cohort studies. Dietary calcium intake was assessed using food-frequency questionnaires at baseline in each cohort and standardized to caloric intake of 2,000 kcal/d for women and 2,500 kcal/d for men. Stratified, multivariable-adjusted Cox regression was applied to compute hazard ratios (HR) and 95% confidence intervals (CI). The 5-year survival rates were 56%, 21%, and 5.7% for localized, regional, and distant stage lung cancer, respectively. Low prediagnostic dietary calcium intake (<500-600 mg/d, less than half of the recommendation) was associated with a small increase in risk of death compared with recommended calcium intakes (800-1,200 mg/d); HR (95% CI) was 1.07 (1.01-1.13) after adjusting for age, stage, histology, grade, smoking status, pack-years, and other potential prognostic factors. The association between low calcium intake and higher lung cancer mortality was evident primarily among localized/regional stage patients, with HR (95% CI) of 1.15 (1.04-1.27). No association was found for supplemental calcium with survival in the multivariable-adjusted model. This large pooled analysis is the first, to our knowledge, to indicate that low prediagnostic dietary calcium intake may be associated with poorer survival among early-stage lung cancer patients. This multinational prospective study linked low calcium intake to lung cancer prognosis. .

Alternate JournalCancer Epidemiol. Biomarkers Prev.
PubMed ID28264875
PubMed Central IDPMC5500413
Grant ListR01 CA082729 / CA / NCI NIH HHS / United States
R37 CA070867 / CA / NCI NIH HHS / United States
G1000143 / / Medical Research Council / United Kingdom
UM1 CA173640 / CA / NCI NIH HHS / United States
R03 CA183021 / CA / NCI NIH HHS / United States
14136 / / Cancer Research UK / United Kingdom
G0401527 / / Medical Research Council / United Kingdom
UM1 CA182910 / CA / NCI NIH HHS / United States