A prospective study of dietary folate intake and risk of colorectal cancer: Modification by caffeine intake and cigarette smoking
A prospective study of dietary folate intake and risk of colorectal cancer: Modification by caffeine intake and cigarette smoking
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DOI：
10.1158/1055-9965.epi-04-0581
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发表时间：
2005-03-01
影响因子：
3.8
通讯作者：
Wolk, A
中科院分区：
文献类型：
--
作者：
Larsson, SC;Giovannucci, E;Wolk, A
流行病学证据表明叶酸摄入量与结直肠癌风险呈负相关，但这种相关性是否会因摄入咖啡因（咖啡和茶中的咖啡因）或吸烟（可能干扰叶酸的因素）而改变尚未研究。因此，我们研究了饮食中叶酸摄入量与结直肠癌发病率之间的关系是否会因咖啡因摄入量和吸烟而改变。考克斯比例风险模型用于估计1987年至1990年招募到瑞典乳腺X线摄影队列的61，433名年龄在40至75岁的女性中饮食叶酸摄入量与结直肠癌发病率的比率。从1987年3月到2004年6月，共诊断出805例结肠直肠癌病例。在控制了年龄和其他潜在的混杂因素后，我们观察到膳食叶酸摄入量与结肠癌风险之间存在负相关性（最高与最低五分位数的率比，0.61; 95%置信区间，0.41-0.91; P趋势= 0.02），但不是直肠癌（率比，0.93; 95%置信区间，0.55-1.56; P趋势= 0.97）。膳食叶酸摄入量与结肠癌风险之间的负相关在吸烟者中最为明显（P-交互作用= 0.03）。我们没有发现咖啡因摄入量对风险有明显的影响。这项基于人群的队列研究的结果支持膳食叶酸摄入量与结肠癌风险之间的负相关，并表明吸烟者可能从高膳食叶酸摄入量中获益最多。
Epidemiologic evidence indicates an inverse association of folate intake with risk of colorectal cancer, but whether this association is modified by intake of caffeine (in coffee and tea) or cigarette smoking-factors that possibly interfere with folate-has not been studied. Thus, we examined whether the association between dietary folate intake and incidence of colorectal cancer is modified by caffeine intake and smoking. Cox proportional hazards modeling was used to estimate rate ratios relating dietary folate intake to colorectal cancer incidence among 61,433 women ages 40 to 75 years at recruitment into the Swedish Mammography Cohort in 1987 to 1990. From March 1987 through June 2004, a total of 805 incident cases of colorectal cancer were diagnosed. After controlling for age and other potential confounders, we observed an inverse association between dietary folate intake and risk of colon cancer (rate ratio for the highest versus the lowest quintile, 0.61; 95% confidence interval, 0.41-0.91; P-trend = 0.02), but not of rectal cancer (rate ratio, 0.93; 95% confidence interval, 0.55-1.56; P-trend = 0.97). The inverse association between dietary folate intake and colon cancer risk was most pronounced among smokers (P-interaction = 0.03). We found no apparent modification of risk by caffeine intake. Findings from this population-based cohort study support an inverse association between dietary folate intake and risk of colon cancer and suggest that smokers might benefit most from a high dietary folate intake.