Red Meat and Lung Cancer Risk in Heavy Smokers
Red Meat and Lung Cancer Risk in Heavy Smokers
Background: To assess whether intake of selected foods and food groups and adherence to a Mediterranean diet are associated with lung cancer risk in heavy smokers.
Patients and methods: In the context of a lung cancer screening programme, we invited asymptomatic volunteers, aged 50 years or more, current smokers or recent quitters, who had smoked at least 20 pack-years, to undergo annual low-dose computed tomography. We assessed participants' diet at baseline using a self-administered food frequency questionnaire and calculated their average daily food intake using an ad hoc computer program and determined their alternate Mediterranean diet (aMED) score. We used Cox proportional hazards regression to assess the association between selected food items, beverages and the aMED score and lung cancer risk.
Results: During a mean screening period of 5.7 years, 178 of 4336 participants were diagnosed with lung cancer. At multivariable analysis, red meat consumption was associated with an increased risk of lung cancer [hazard ratio (HR) Q4 versus Q1, 1.73; 95% confidence interval (CI) 1.15–2.61; P-value for trend 0.002], while tea consumption (HR for one or more cup/day versus none, 0.56; 95% CI 0.31–0.99; P-value for trend 0.04) and adherence to a Mediterranean diet (HR for aMED≥8 versus ≤1, 0.10; 95% CI 0.01–0.77) were significantly associated with reduced lung cancer risk.
Conclusions: Among heavy smokers, high red meat consumption and low adherence to a Mediterranean diet are associated with increased risk of lung cancer.
Worldwide, lung cancer is among the most common forms of cancer in men and women and the leading cause of cancer death. Most lung cancers are attributable to exposure to tobacco smoke and a small proportion to exposure to other occupational or environmental carcinogens, while the role of diet still remains controversial. The World Cancer Research Fund reported probable risk reduction with increasing fruits consumption and only little evidence of an association with non-starchy vegetables, red and processed meat or butter.
In the context of the Italian COSMOS (Continuous Observation of Smoking Subjects) study, a screening programme for the early diagnosis of lung cancer in high-risk asymptomatic individuals using annual low-dose computed tomography (LD-CT), we previously found significant inverse associations with vegetable fat and adherence to the 'vitamin and fibre' nutrient pattern, supporting a potential protection of dietary antioxidants. Dietary antioxidants may be particularly important for smokers, because cigarette smoke contains free radicals and causes oxidative DNA damage in lung epithelial cells. According to a recent meta-analysis, Mediterranean diet reduces overall mortality, cancer incidence and mortality. In a large European study, this apparent inverse association was stronger for smoking-related cancers.
Our aim was to evaluate whether consumption of specific food items and food groups and adherence to a Mediterranean diet are associated with lung cancer risk in our screened population.
Abstract and Introduction
Abstract
Background: To assess whether intake of selected foods and food groups and adherence to a Mediterranean diet are associated with lung cancer risk in heavy smokers.
Patients and methods: In the context of a lung cancer screening programme, we invited asymptomatic volunteers, aged 50 years or more, current smokers or recent quitters, who had smoked at least 20 pack-years, to undergo annual low-dose computed tomography. We assessed participants' diet at baseline using a self-administered food frequency questionnaire and calculated their average daily food intake using an ad hoc computer program and determined their alternate Mediterranean diet (aMED) score. We used Cox proportional hazards regression to assess the association between selected food items, beverages and the aMED score and lung cancer risk.
Results: During a mean screening period of 5.7 years, 178 of 4336 participants were diagnosed with lung cancer. At multivariable analysis, red meat consumption was associated with an increased risk of lung cancer [hazard ratio (HR) Q4 versus Q1, 1.73; 95% confidence interval (CI) 1.15–2.61; P-value for trend 0.002], while tea consumption (HR for one or more cup/day versus none, 0.56; 95% CI 0.31–0.99; P-value for trend 0.04) and adherence to a Mediterranean diet (HR for aMED≥8 versus ≤1, 0.10; 95% CI 0.01–0.77) were significantly associated with reduced lung cancer risk.
Conclusions: Among heavy smokers, high red meat consumption and low adherence to a Mediterranean diet are associated with increased risk of lung cancer.
Introduction
Worldwide, lung cancer is among the most common forms of cancer in men and women and the leading cause of cancer death. Most lung cancers are attributable to exposure to tobacco smoke and a small proportion to exposure to other occupational or environmental carcinogens, while the role of diet still remains controversial. The World Cancer Research Fund reported probable risk reduction with increasing fruits consumption and only little evidence of an association with non-starchy vegetables, red and processed meat or butter.
In the context of the Italian COSMOS (Continuous Observation of Smoking Subjects) study, a screening programme for the early diagnosis of lung cancer in high-risk asymptomatic individuals using annual low-dose computed tomography (LD-CT), we previously found significant inverse associations with vegetable fat and adherence to the 'vitamin and fibre' nutrient pattern, supporting a potential protection of dietary antioxidants. Dietary antioxidants may be particularly important for smokers, because cigarette smoke contains free radicals and causes oxidative DNA damage in lung epithelial cells. According to a recent meta-analysis, Mediterranean diet reduces overall mortality, cancer incidence and mortality. In a large European study, this apparent inverse association was stronger for smoking-related cancers.
Our aim was to evaluate whether consumption of specific food items and food groups and adherence to a Mediterranean diet are associated with lung cancer risk in our screened population.
