Lower rates of cancer and all-cause mortality in an Adventist cohort compared with a US Census population
Lower rates of cancer and all-cause mortality in an Adventist cohort compared with a US Census population
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DOI：
10.1002/cncr.32571
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发表时间：
2019-11-25
期刊：
影响因子：
6.2
通讯作者：
Altekruse, Sean F.
中科院分区：
文献类型：
--
作者：
Fraser, Gary E.;Cosgrove, Candace M.;Altekruse, Sean F.
背景以前的研究表明，基督复临安息日会教徒，谁经常遵循素食，寿命更长，有许多癌症的风险比其他人低，但没有全国性的数据和黑人受试者的比较数据很少公布。方法本研究比较了美国普查人群中全国性复临健康研究2（AHS-2）和非吸烟者之间的全因死亡率和癌症发病率：全国纵向死亡率研究（NLMS）及其监测，流行病学和最终结果子研究。分析使用比例风险回归调整年龄，性别，种族，吸烟史和教育。结果黑人AHS-2人群的全因死亡率和所有癌症的发病率显著低于黑人NLMS人群（死亡率的风险比[HR]为0.64; 95%CI [CI]为0.59-0.69;发病率的风险比[HR]为0.78; 95%CI为0.68-0.88）。当种族合并时，AHS-2人群65岁时的估计全因死亡率也显著较低（HR，0.67; 95% CI，0.64-0.69）和85岁时（HR，0.78; 95%CI，0.75-0.81），癌症死亡率也是如此;这也适用于所有癌症合并发生率（HR，0.70; 95% CI，0.67-0.74）以及乳腺癌、结直肠癌和肺癌的发病率。生存曲线证实了死亡率结果，并显示在男性中，AHS-2黑人的生存时间长于白色美国受试者。结论基督复临安息日会信徒的全因死亡率和癌症发病率明显较低，这可能与生活方式的影响有关，尤其是饮食对这些健康问题的病因有影响。在黑人AHS-2和NLMS受试者的比较中也发现了与合并人群中观察到的趋势相似的趋势。
Background Previous research suggests that Adventists, who often follow vegetarian diets, live longer and have lower risks for many cancers than others, but there are no national data and little published comparative data for black subjects. Methods This study compared all-cause mortality and cancer incidence between the nationally inclusive Adventist Health Study 2 (AHS-2) and nonsmokers in US Census populations: the National Longitudinal Mortality Study (NLMS) and its Surveillance, Epidemiology, and End Results substudy. Analyses used proportional hazards regression adjusting for age, sex, race, cigarette smoking history, and education. Results All-cause mortality and all-cancer incidence in the black AHS-2 population were significantly lower than those for the black NLMS populations (hazard ratio [HR] for mortality, 0.64; 95% confidence interval [CI], 0.59-0.69; HR for incidence, 0.78; 95% CI, 0.68-0.88). When races were combined, estimated all-cause mortality was also significantly lower in the AHS-2 population at the age of 65 years (HR, 0.67; 95% CI, 0.64-0.69) and at the age of 85 years (HR, 0.78; 95% CI, 0.75-0.81), as was cancer mortality; this was also true for the rate of all incident cancers combined (HR, 0.70; 95% CI, 0.67-0.74) and the rates of breast, colorectal, and lung cancers. Survival curves confirmed the mortality results and showed that among males, AHS-2 blacks survived longer than white US subjects. Conclusions Substantially lower rates of all-cause mortality and cancer incidence among Adventists have implications for the effects of lifestyle and perhaps particularly diet on the etiology of these health problems. Trends similar to those seen in the combined population are also found in comparisons of black AHS-2 and NLMS subjects.