Diet-wide association study of 92 foods and nutrients and lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study

Research output: Contribution to journalJournal articleResearchpeer-review

  • Alicia K Heath
  • David C Muller
  • Piet A van den Brandt
  • Elena Critselis
  • Marc Gunter
  • Paolo Vineis
  • Elisabete Weiderpass
  • Heiner Boeing
  • Pietro Ferrari
  • Melissa A Merritt
  • Kim Overvad
  • Verena Katzke
  • Bernard Srour
  • Giovanna Masala
  • Carlotta Sacerdote
  • Fulvio Ricceri
  • Fabrizio Pasanisi
  • Bas Bueno-de-Mesquita
  • George S Downward
  • Guri Skeie
  • Torkjel M Sandanger
  • Marta Crous-Bou
  • Miguel Rodríguez-Barranco
  • Pilar Amiano
  • José María Huerta
  • Eva Ardanaz
  • Isabel Drake
  • Mikael Johansson
  • Ingegerd Johansson
  • Tim Key
  • Nikos Papadimitriou
  • Elio Riboli
  • Ioanna Tzoulaki
  • Konstantinos K Tsilidis

It is unclear whether diet, and in particular certain foods or nutrients, are associated with lung cancer risk. We assessed associations of 92 dietary factors with lung cancer risk in 327 790 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) per SD higher intake/day of each food/nutrient. Correction for multiple comparisons was performed using the false discovery rate and identified associations were evaluated in the Netherlands Cohort Study (NLCS). In EPIC, 2420 incident lung cancer cases were identified during a median of 15 years of follow-up. Higher intakes of fibre (HR per 1 SD higher intake/day = 0.91, 95% CI 0.87-0.96), fruit (HR = 0.91, 95% CI 0.86-0.96) and vitamin C (HR = 0.91, 95% CI 0.86-0.96) were associated with a lower risk of lung cancer, whereas offal (HR = 1.08, 95% CI 1.03-1.14), retinol (HR = 1.06, 95% CI 1.03-1.10) and beer/cider (HR = 1.04, 95% CI 1.02-1.07) intakes were positively associated with lung cancer risk. Associations did not differ by sex and there was less evidence for associations among never smokers. None of the six associations with overall lung cancer risk identified in EPIC were replicated in the NLCS (2861 cases), however in analyses of histological subtypes, inverse associations of fruit and vitamin C with squamous cell carcinoma were replicated in the NLCS. Overall, there is little evidence that intakes of specific foods and nutrients play a major role in primary lung cancer risk, but fruit and vitamin C intakes seem to be inversely associated with squamous cell lung cancer.

Original languageEnglish
JournalInternational Journal of Cancer
Volume151
Issue number11
Pages (from-to)1935-1946
Number of pages12
ISSN0020-7136
DOIs
Publication statusPublished - 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

    Research areas

  • Cohort study, Diet, Foods, Lung cancer, Nutrients

ID: 324234754