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Prediagnostic calcium intake and lung cancer survival : A pooled analysis of 12 cohort studies

Yu, Danxia; Takata, Yumie; Smith-Warner, Stephanie A.; Blot, William; Sawada, Norie; White, Emily; Freedman, Neal; Robien, Kim; Giovannucci, Edward and Zhang, Xuehong, et al. (2017) In Cancer Epidemiology Biomarkers and Prevention 26(7). p.1060-1070
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%,... (More)

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.

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Cancer Epidemiology Biomarkers and Prevention
volume
26
issue
7
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11 pages
publisher
American Association for Cancer Research
external identifiers
  • scopus:85022329485
  • wos:000415229200010
ISSN
1055-9965
DOI
10.1158/1055-9965.EPI-16-0863
language
English
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yes
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8f6de3d8-e8c4-4931-8ade-d90d71d963ba
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2017-08-07 15:31:39
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2018-01-16 13:22:25
@article{8f6de3d8-e8c4-4931-8ade-d90d71d963ba,
  abstract     = {<p>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 (&lt;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.</p>},
  author       = {Yu, Danxia and Takata, Yumie and Smith-Warner, Stephanie A. and Blot, William and Sawada, Norie and White, Emily and Freedman, Neal and Robien, Kim and Giovannucci, Edward and Zhang, Xuehong and Park, Yikyung and Gao, Yu-Tang and Chlebowski, Rowan T. and Langhammer, Arnulf and Yang, Gong and Severi, Gianluca and Manjer, Jonas and Khaw, Kay Tee and Weiderpass, Elisabete and Liao, Linda M. and Caporaso, Neil E and Krokstad, Steinar and Hveem, Kristian and Sinha, Rashmi and Ziegler, Regina G. and Tsugane, Shoichiro and Xiang, Yong-Bing and Johansson, Mattias and Zheng, Wei and Shu, Xiao-Ou},
  issn         = {1055-9965},
  language     = {eng},
  month        = {07},
  number       = {7},
  pages        = {1060--1070},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers and Prevention},
  title        = {Prediagnostic calcium intake and lung cancer survival : A pooled analysis of 12 cohort studies},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-16-0863},
  volume       = {26},
  year         = {2017},
}