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Cancer Epidemiol Biomarkers Prev. 2017 Jul;26(7):1060-1070. doi: 10.1158/1055-9965.EPI-16-0863. Epub 2017 Mar 6.

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

Author information

1
Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
2
College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.
3
Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
4
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
5
Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.
6
Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
7
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
8
Dana Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
9
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
10
Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
11
Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, Torrance, California.
12
HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
13
Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
14
Gustave Roussy, Villejuif, France.
15
Human Genetics Foundation, Torino, Italy.
16
Cancer Council Victoria and University of Melbourne, Australia.
17
Department of Surgery, Lund University, University Hospital Malmö, Malmö, Sweden.
18
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, United Kingdom.
19
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
20
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
21
Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
22
Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
23
Genetic Epidemiology Group, International Agency for Research on Cancer, Lyons, France.
24
Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee. xiao-ou.shu@vanderbilt.edu.

Abstract

Background: Lung cancer is the leading cause of cancer death. Little is known about whether prediagnostic nutritional factors may affect survival. We examined the associations of prediagnostic calcium intake from foods and/or supplements with lung cancer survival.Methods: The present analysis included 23,882 incident, primary lung cancer patients from 12 prospective cohort studies. Dietary calcium intake was assessed using food-frequency questionnaires at baseline in each cohort and standardized to caloric intake of 2,000 kcal/d for women and 2,500 kcal/d for men. Stratified, multivariable-adjusted Cox regression was applied to compute hazard ratios (HR) and 95% confidence intervals (CI).Results: The 5-year survival rates were 56%, 21%, and 5.7% for localized, regional, and distant stage lung cancer, respectively. Low prediagnostic dietary calcium intake (<500-600 mg/d, less than half of the recommendation) was associated with a small increase in risk of death compared with recommended calcium intakes (800-1,200 mg/d); HR (95% CI) was 1.07 (1.01-1.13) after adjusting for age, stage, histology, grade, smoking status, pack-years, and other potential prognostic factors. The association between low calcium intake and higher lung cancer mortality was evident primarily among localized/regional stage patients, with HR (95% CI) of 1.15 (1.04-1.27). No association was found for supplemental calcium with survival in the multivariable-adjusted model.Conclusions: This large pooled analysis is the first, to our knowledge, to indicate that low prediagnostic dietary calcium intake may be associated with poorer survival among early-stage lung cancer patients.Impact: This multinational prospective study linked low calcium intake to lung cancer prognosis. Cancer Epidemiol Biomarkers Prev; 26(7); 1060-70. ©2017 AACR.

PMID:
28264875
PMCID:
PMC5500413
DOI:
10.1158/1055-9965.EPI-16-0863
[Indexed for MEDLINE]
Free PMC Article

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