Abstract
Reducing lung cancer risk by modifying diet is highly desirable. We investigated whether different U.S. dietary patterns were associated with lung cancer risk. Dietary patterns were derived using exploratory factor analysis for 2139 non-small cell lung cancer (NSCLC) cases and 2163 frequency-matched controls. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Highest adherence (highest vs. lowest quintile) to the “Tex-Mex”, “fruits and vegetables”, and “American/Western” patterns was associated with a 55% reduced (OR = 0.45; 95% CI = 0.37–0.56; P < 0.001), 32% reduced (OR = 0.68; 95% CI = 0.55–0.85; P = 0.001), and 45% increased (OR = 1.45; 95% CI = 1.18–1.78; P < 0.001) risk of lung cancer, respectively. The effects were stronger for squamous cell carcinoma and ever smokers for the “fruits and vegetables” pattern, and stronger for other non-small cell lung cancer and never smokers for the “American/Western” pattern. Among six genome-wide association (GWA) studies-identified lung cancer susceptibility loci assessed, a variant (rs2808630) of the C-reactive protein gene modified the associations for the “fruits and vegetables” (P for interaction = 0.03) and “American/Western” (P for interaction = 0.02) patterns. Our study first showed that the “Tex-Mex” dietary pattern was associated with a reduced lung cancer risk. Also, the “fruits and vegetables” and “American/Western” patterns affected lung cancer risk, and the effects were further modified by host genetic background.
Highlights
Lung cancer is the second most common cancer in both men and women in the U.S.1
No statistically significant interactions (P for interaction > 0.05) were found between dietary patterns and the other five selected variants (Supplementary Table 2). In this large Texas-based case-control study, we identified three dietary patterns using factor analysis: “fruits and vegetables”, “American/Western”, and “Texas Mexican cuisine (Tex-Mex)”
We found that the “fruits and vegetables” pattern was associated with a reduced risk and the protective effects were more evident for squamous cell carcinoma and among ever smokers
Summary
Lung cancer is the second most common cancer in both men and women in the U.S.1. Smoking is the most important risk factor for lung cancer[1]. Due to the complex gene-diet interaction, the association of dietary patterns and lung cancer risk may be modified by host genetic background, which has not been investigated in previous studies. Previous genome-wide association (GWA) studies have identified multiple lung cancer susceptibility loci among individuals of European ancestry[11,12,13,14,15,16], and two of the identified loci are mapped to the C-reactive protein (CRP) gene and interleukin 1 receptor accessory protein (IL1RAP) gene, respectively We investigated the associations between three dietary patterns derived by factor analysis (“fruits and vegetables”, “American/Western”, and “Tex-Mex”) and non-small cell lung cancer (NSCLC) risk using data from a large ongoing Texas-based case-control study. We investigated whether the associations differed by major histological types of NSCLC and whether the associations could be modified by host smoking status and lung cancer susceptibility loci identified in previous GWA studies
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