Prediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies

Yu, Danxia; Takata, Yumie; Smith‐Warner, Stephanie A.; Blot, William J.; Sawada, Norie; White, Emily; Freedman, Neal D.; Robien, Kim; Giovannucci, Edward; Zhang, Xuehong; Park, Yikyung; Gao, Yu Tang; Chlebowski, Rowan T.; Yang, Gong; Severi, Gianluca; Manjer, Jonas; Khaw, Kay Tee; Weiderpass, Elisabete; Liao, Linda M.; Caporaso, Neil E.; Krokstad, Steinar; Hveem, Kristian; Sinha, Rashmi; Ziegler, Regina G.; Tsugane, Shoichiro; Xiang, Yong Bing; Johansson, Mattias; Wang, Zheng; Shu, Xiao Ou

doi:10.1158/1055-9965.epi-16-0863

Cited by 11 publications

(9 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, another large cohort study reported a higher mortality benefit in patients ingesting 800–1,000 mg/d of supplemental calcium. 83 One meta-analysis failed to report similar associations 34 (Table 3). The effects of calcium on lung carcinogenesis remain controversial due to the complexity of the process.…”

Section: Resultsmentioning

confidence: 99%

Association of various dietary habits and risk of lung cancer: an updated comprehensive literature review

Fakhri

Assaad

Tfayli

2020

Tumori

View full text Add to dashboard Cite

Lung cancer remains the leading cause of cancer death in both men and women worldwide. Tobacco smoking remains the single most important factor. Recent research has focused on the role of nutrition and dietary habits on lung tumorigenesis. With many individual reports on separate dietary aspects, no single review is available in the literature that summarizes the updated studies. To our knowledge, this is the first review that comprehensively reviews the updated literature on the effect of dietary habits on lung cancer. This review was concluded in February 2019 and included all meta-analyses, systematic reviews, and literature reviews. Thirty studies were retrieved in total. Items in the diet that offer a protective effect on lung parenchyma are fruits, vegetables, fish, nuts, soy, B vitamins, vitamin D, vitamin E, vitamin C, and zinc. Changing dietary habits to decrease the risk of lung cancer can be performed in parallel with smoking cessation programs. There is a need for future studies with large sample sizes to accurately evaluate some aspects of nutrition and their effect on lung cancer risk. Physicians are encouraged to provide nutritional advice to their patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Association of various dietary habits and risk of lung cancer: an updated comprehensive literature review

Fakhri

Assaad

Tfayli

2020

Tumori

View full text Add to dashboard Cite

show abstract

“…We harmonized de-identified, individual participant data from 11 cohorts ( 16 , 17 ), including 7 US cohorts (National Institute of Health–American Association of Retired Persons Diet and Health Study; Health Professionals Follow-up Study; Nurses’ Health Study; Iowa Women’s Health Study; Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; Southern Community Cohort Study; and VITamins And Lifestyle Study), 2 European cohorts (European Prospective Investigation into Cancer and Nutrition and Trøndelag Health Study), and 2 Asian cohorts (Shanghai Men’s Health Study and Shanghai Women’s Health Study). All studies were approved by the institutional review boards and ethics committees of the hosting institutes.…”

Section: Methodsmentioning

confidence: 99%

“…Potential confounders were selected a priori based on literature review and risk factors found in our study populations ( 16 , 17 ). Included were age at diagnosis (continuous), sex, race and ethnicity (Asian, Black, Other [Hispanic and Latino, American Indian, and other racial or ethnic group] and White), smoking status (never, former, current), smoking pack-years (continuous), education (less than high school, high school graduation, vocational education, college, university or higher), alcohol consumption (none, moderate drinking up to 1 and 2 drinks per day, heavy drinking >1 and >2 drinks per day for women and men, respectively; 1 drink = 14 grams of ethanol), history of diabetes (yes, no), body mass index (BMI; <18.5, 18.5-24.9, 25.0-29.9, and ≥30.0 kg/m 2 ), and hormone therapy in women (yes, no)—all of which were assessed at LTPA assessment.…”

Section: Methodsmentioning

confidence: 99%

“…Included were age at diagnosis (continuous), sex, race and ethnicity (Asian, Black, Other [Hispanic and Latino, American Indian, and other racial or ethnic group] and White), smoking status (never, former, current), smoking pack-years (continuous), education (less than high school, high school graduation, vocational education, college, university or higher), alcohol consumption (none, moderate drinking up to 1 and 2 drinks per day, heavy drinking >1 and >2 drinks per day for women and men, respectively; 1 drink = 14 grams of ethanol), history of diabetes (yes, no), body mass index (BMI; <18.5, 18.5-24.9, 25.0-29.9, and ≥30.0 kg/m 2 ), and hormone therapy in women (yes, no)—all of which were assessed at LTPA assessment. Missing covariates were independently imputed by cohort ( 16 ). Established prognostic factors were further included: tumor stage (localized, regional, distant, unknown), histological type (adenocarcinoma, squamous cell carcinoma, other non-small cell carcinoma, small cell carcinoma, unspecified or unknown), and grade (well, moderately, and poorly differentiated; undifferentiated; unknown).…”

Section: Methodsmentioning

confidence: 99%

“…P values were corrected for multiple comparisons by controlling the false-discovery rate. A series of sensitivity analyses were conducted using another LTPA categorization (cohort- and sex-specific quartiles and common quartiles across total participants), excluding participants with long time intervals between LTPA assessment and cancer diagnosis (over median years), further adjusting for dietary calcium intake statistically significantly associated with lung cancer survival in our populations ( 16 ), and excluding 1 cohort at a time from analyses. All procedures were performed using SAS 9.4 (SAS Institute, Inc, Cary, NC), and 2-sided P -values less than .05 were considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Prediagnosis Leisure-Time Physical Activity and Lung Cancer Survival: A Pooled Analysis of 11 Cohorts

Yang

White

et al. 2022

JNCI Cancer Spectrum

Self Cite

View full text Add to dashboard Cite

Background Little is known about the association between physical activity before cancer diagnosis and survival among lung cancer patients. In this pooled analysis of 11 prospective cohorts, we investigated associations of pre-diagnosis leisure-time physical activity (LTPA) with all-cause and lung cancer-specific mortality among incident lung cancer patients. Methods Using self-reported data on regular engagement in exercise/sports activities collected at study enrollment, we assessed metabolic equivalent hours (MET-h) of pre-diagnosis LTPA per week. According to the Physical Activity Guidelines for Americans, pre-diagnosis LTPA was classified into inactivity, <8.3, and ≥8.3 MET-h/week (the minimum recommended range). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence interval (CIs) for all-cause and lung cancer-specific mortality after adjustment for major prognostic factors and lifetime smoking history. Results Of 20,494 incident lung cancer cases, 16,864 died, including 13,596 deaths from lung cancer (overall 5-year relative survival rate=20.9%, 95% CI = 20.3%-21.5%). Compared with inactivity, pre-diagnosis LTPA ≥8.3 MET-h/week was associated with a lower hazard of all-cause mortality (multivariable-adjusted HR = 0.93, 95% CI = 0.88-0.99), but not with lung cancer-specific mortality (multivariable-adjusted HR = 0.99, 95% CI = 0.95-1.04), among the overall population. Additive interaction was found by tumor stage ( p-interaction=0.008 for all-cause mortality and 0.003 for lung cancer-specific mortality). When restricted to localized cancer, pre-diagnosis LTPA ≥8.3 MET-h/week linked to 20% lower mortality: multivariable-adjusted HRs were 0.80 (95% CI = 0.67-0.97) for all-cause mortality and 0.80 (95% CI = 0.65-0.99) for lung cancer-specific mortality. Conclusions Regular participation in LTPA that met or exceeded the minimum Physical Activity Guidelines was associated with reduced hazards of mortality among lung cancer patients, especially those with early-stage cancer.

show abstract

Association of Dietary Fiber and Yogurt Consumption With Lung Cancer Risk

Yang

Xiang

et al. 2020

JAMA Oncol

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Dietary fiber (the main source of prebiotics) and yogurt (a probiotic food) confer various health benefits via modulating the gut microbiota and metabolic pathways. However, their associations with lung cancer risk have not been well investigated. OBJECTIVE To evaluate the individual and joint associations of dietary fiber and yogurt consumption with lung cancer risk and to assess the potential effect modification of the associations by lifestyle and other dietary factors. DESIGN, SETTING, AND PARTICIPANTS This pooled analysis included 10 prospective cohorts involving 1 445 850 adults from studies that were conducted in the United States, Europe, and Asia. Data analyses were performed between November 2017 and February 2019. Using harmonized individual participant data, hazard ratios and 95% confidence intervals for lung cancer risk associated with dietary fiber and yogurt intakes were estimated for each cohort by Cox regression and pooled using random-effects meta-analysis. Participants who had a history of cancer at enrollment or developed any cancer, died, or were lost to follow-up within 2 years after enrollment were excluded. EXPOSURES Dietary fiber intake and yogurt consumption measured by validated instruments. MAIN OUTCOMES AND MEASURES Incident lung cancer, subclassified by histologic type (eg, adenocarcinoma, squamous cell carcinoma, and small cell carcinoma). RESULTS The analytic sample included 627 988 men, with a mean (SD) age of 57.9 (9.0) years, and 817 862 women, with a mean (SD) age of 54.8 (9.7) years. During a median follow-up of 8.6 years, 18 822 incident lung cancer cases were documented. Both fiber and yogurt intakes were inversely associated with lung cancer risk after adjustment for status and pack-years of smoking and other lung cancer risk factors: hazard ratio, 0.83 (95% CI, 0.76-0.91) for the highest vs lowest quintile of fiber intake; and hazard ratio, 0.81 (95% CI, 0.76-0.87) for high vs no yogurt consumption. The fiber or yogurt associations with lung cancer were significant in never smokers and were consistently observed across sex, race/ethnicity, and tumor histologic type. When considered jointly, high yogurt consumption with the highest quintile of fiber intake showed more than 30% reduced risk of lung cancer than nonyogurt consumption with the lowest quintile of fiber intake (hazard ratio, 0.67 [95% CI, 0.61-0.73] in total study populations; hazard ratio, 0.69 [95% CI, 0.54-0.89] in never smokers), suggesting potential synergism. CONCLUSIONS AND RELEVANCE Dietary fiber and yogurt consumption was associated with reduced risk of lung cancer after adjusting for known risk factors and among never smokers. Our findings suggest a potential protective role of prebiotics and probiotics against lung carcinogenesis.

show abstract

Prediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies

Cited by 11 publications

References 64 publications

Association of various dietary habits and risk of lung cancer: an updated comprehensive literature review

Association of various dietary habits and risk of lung cancer: an updated comprehensive literature review

Prediagnosis Leisure-Time Physical Activity and Lung Cancer Survival: A Pooled Analysis of 11 Cohorts

Association of Dietary Fiber and Yogurt Consumption With Lung Cancer Risk

Contact Info

Product

Resources

About