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Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT

  • NUTRITIONAL EPIDEMIOLOGY
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Abstract

The role of nutrients in lung cancer aetiology remains controversial and has never been evaluated in the context of screening. Our aim was to investigate the role of single nutrients and nutrient patterns in the aetiology of lung cancer in heavy smokers. Asymptomatic heavy smokers (≥20 pack-years) were invited to undergo annual low-dose computed tomography. We assessed diet using a self-administered food frequency questionnaire and collected information on multivitamin supplement use. We performed principal component analysis identifying four nutrient patterns and used Cox proportional Hazards regression to assess the association between nutrients and nutrients patterns and lung cancer risk. During a mean follow-up of 5.7 years, 178 of 4,336 participants were diagnosed with lung cancer by screening. We found a significant risk reduction of lung cancer with increasing vegetable fat consumption (HR for highest vs. lowest quartile = 0.50, 95 % CI = 0.31–0.80; P-trend = 0.02). Participants classified in the high “vitamins and fiber” pattern score had a significant risk reduction of lung cancer (HR = 0.57; 95 % CI = 0.36–0.90, P-trend = 0.01). Among heavy smokers enrolled in a screening trial, high vegetable fat intake and adherence to the “vitamin and fiber” nutrient pattern were associated with reduced lung cancer incidence.

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Acknowledgments

This work was supported by the Italian Association for Cancer Research (AIRC), the Italian Foundation for Cancer Research (FIRC) and the European Institute of Oncology (IEO). We thank Giovanna Ciambrone for general management of COSMOS volunteers, William Russel-Edu for help with the literature, Simonetta Salvini for help with the decodification of the food-frequency questionnaires.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ramusio 1, Milan, 20141, Italy

    Patrizia Gnagnarella & Patrick Maisonneuve

  2. Division of Radiology, European Institute of Oncology, Milan, Italy

    Massimo Bellomi & Cristiano Rampinelli

  3. School of Medicine, University of Milan, Milan, Italy

    Massimo Bellomi & Lorenzo Spaggiari

  4. Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy

    Raffaella Bertolotti, Lorenzo Spaggiari & Giulia Veronesi

  5. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy

    Domenico Palli

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  1. Patrizia Gnagnarella
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  2. Patrick Maisonneuve
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Correspondence to Patrizia Gnagnarella.

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Gnagnarella, P., Maisonneuve, P., Bellomi, M. et al. Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT. Eur J Epidemiol 28, 503–511 (2013). https://doi.org/10.1007/s10654-013-9803-1

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  • DOI: https://doi.org/10.1007/s10654-013-9803-1

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