American Journal of Epidemiology Vol. 133, No. 7: 683-693
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Diet and Lung Cancer in California Seventh-day Adventists
1Center for Health Research, Loma Linda University Loma Linda, CA
2Loma Linda University Loma Linda, CA
Reprint requests to Dr. Gary E. Fraser, Center for Health Research, Loma Linda University, Loma Linda, CA 92350
The Adventist Health Study, a cohort study of 34,198 California Seventh-day Adventists, identified 61 cases of new primary lung cancer over 6 years of follow-up (1977–1982). The population studied was unique in that only 4% admitted to current cigarette smoking and about half were lacto-ovovegetarlans. A total of 36% of the lung tumors were adenocarcinomas, and 19% were squamous cell carcinomas. The expected associations with cigarette smoking were noted for Kreyberg group I tumors (squamous cell, large cell, and small cell carcinoma; relative risk (AR) = 53.2 for current smokers and 7.07 for past smokers), but much lesser associations were noted for Kreyberg group II tumors (adenocarcinorna and bronchoalveolar carcinoma; AR = 1.99 for current smokers and 1.59 for past smokers). In this study, fruit consumption was the dietary constituent that showed a strong, statistically significant protective association with lung cancer that was independent of smoking (fruit consumption <3 times/week, RR = 1.0; 3–7 times/week, RR = 0.30; 
times/day, RR = 0.26). This association was somewhat stronger for Kreyberg group II tumors, but similar trends were also noted for Kreyberg group I tumors. Confounding with smoking seems unlikely in a population with very few current smokers and where both stratification and Cox modeling methods of analysis led to similar conclusions.
diet; fruit; lung neoplasms; risk factors; smoking; vegetarianism
* Diseased.
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