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J Clin Oncol. 2017 Sep 10;35(26):3055-3064. doi: 10.1200/JCO.2017.73.3329. Epub 2017 Jul 25.

Dietary Fat Intake and Lung Cancer Risk: A Pooled Analysis.

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Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France.


Purpose Dietary fat may play a role in lung carcinogenesis. Findings from epidemiologic studies, however, remain inconsistent. In this pooled analysis of 10 prospective cohort studies from the United States, Europe, and Asia, we evaluated the associations of total and specific types of dietary fat with lung cancer risk. Methods Cox regression was used to estimate hazard ratios (HRs) and 95% CIs in each cohort. Study-specific risk estimates were pooled by random- or fixed-effects meta-analysis. The first 2 years of follow-up were excluded to address potential influence of preclinical dietary changes. Results Among 1,445,850 participants, 18,822 incident cases were identified (mean follow-up, 9.4 years). High intakes of total and saturated fat were associated with an increased risk of lung cancer (for highest v lowest quintile: HR, 1.07 and 1.14, respectively; 95% CI, 1.00 to 1.15 and 1.07 to 1.22, respectively; P for trend for both < .001). The positive association of saturated fat was more evident among current smokers (HR, 1.23; 95% CI, 1.13 to 1.35; P for trend < .001) than former/never smokers ( P for interaction = .004), and for squamous cell and small cell carcinoma (HR, 1.61 and 1.40, respectively; 95% CI, 1.38 to 1.88 and 1.17 to 1.67, respectively; P for trend for both < .001) than other histologic types ( P for heterogeneity < .001). In contrast, a high intake of polyunsaturated fat was associated with a decreased risk of lung cancer (HR, 0.92; 95% CI, 0.87 to 0.98 for highest v lowest quintile; P for trend = .02). A 5% energy substitution of saturated fat with polyunsaturated fat was associated with a 16% to 17% lower risk of small cell and squamous cell carcinoma. No associations were found for monounsaturated fat. Conclusion Findings from this large, international cohort consortium suggest that modifying dietary fat intake (ie, replacing saturated fat with polyunsaturated fat) may reduce lung cancer risk, particularly among smokers and for squamous cell and small cell carcinoma.

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