Dietary fat intake & lung cancer risk: A pooled analysis

Jae Jeong Yang, Danxia Yu, Yumie Takata, Stephanie A. Smith-Warner, William Blot, Emily White, Kim Robien, Yikyung Park, Yong Bing Xiang, Rashmi Sinha, De Ann Lazovich, Meir Stampfer, Rosario Tumino, Dagfinn Aune, Kim Overvad, Linda Liao, Xuehong Zhang, Yu Tang Gao, Mattias Johansson, Walter WillettWei Zheng, Xiao Ou Shu

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44 Scopus citations


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.

Original languageEnglish
Pages (from-to)3055-3064
Number of pages10
JournalJournal of Clinical Oncology
Issue number26
StatePublished - Sep 10 2017


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