title: Estimating the effect of dietary fat on the risk of lung cancer in nonsmoking women.
abstract: In 1992, approximately 13 000 lung cancers occurred in nonsmoking U.S. women but the cause of these highly fatal tumors is not well understood. As the rate of smoking declines in many developed countries, the interest in identifying lung cancer risk factors other than tobacco smoking is increasing. A population-based, case-control study of incident lung cancer among nonsmoking women in Missouri was conducted between 1986 and 1992 to assess the effect of a comprehensive list of potential risk factors. Dietary information on 429 case subjects and 1021 control subjects was obtained by personal interview, or next-of-kin interviews (36% and 64%, respectively) and the relationship of diet to lung cancer risk is the focus of this investigation. Odds ratios and population attributable risks (PAR) for dietary fat and dietary saturated fat were computed among lifetime nonsmokers and long-term ex-smokers. The mean age at lung cancer diagnosis was 71 years old, and nearly 50% of the lung cancers were histologically confirmed adenocarcinomas. Dietary intake of saturated fat was the leading identified cause of lung cancer among lifetime nonsmokers and former smokers in Missouri. The etiologic link between dietary saturated fat and lung cancer has not been examined in many other studies and the studies published to date are not completely consistent with the hypothesis so a cautious interpretation of the population attributable risks for these exposures is warranted. Nonetheless, a growing number of studies arising from around the world purport to show a link between fat, saturated fat and/or cholesterol or food groups containing relatively high amounts of these macronutrients (i.e. dairy products, eggs and/or red meat consumption) and lung cancer, and these recent studies add support to this hypothesis. If the results from Missouri are valid and applicable to other Americans, 23% of lung cancer cases among lifetime nonsmokers in the United States could be prevented if the saturated fat consumption of the upper half of saturated fat intake continuum could be reduced to the level consumed by the lower half. Even greater reductions in risk could be achieved if saturated fat consumption were reduced to even lower levels (i.e. 20th percentile of consumption as shown in this paper). However, additional etiologic research and evaluation is needed before specific dietary recommendations concerning fat and saturated fat and lung cancer prevention can be made.
authors.affiliation: Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Alavanja
authors.forename: R C
authors.initials: RC
authors.lastname: Brownson
authors.forename: J
authors.initials: J
authors.lastname: Benichou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects; D004041:Dietary Fats / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D004041:Dietary Fats