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Calcium Intake and Lung Cancer Risk: A Pooled Analysis of 12 Prospective Cohort Studies.

About this Publication
Title
Calcium Intake and Lung Cancer Risk: A Pooled Analysis of 12 Prospective Cohort Studies.
Pubmed ID
36907443 (View this publication on the PubMed website)
Digital Object Identifier
Publication
J Nutr. 2023 Jul; Volume 153 (Issue 7): Pages 2051-2060
Authors
Takata Y, Yang JJ, Yu D, Smith-Warner SA, Blot WJ, White E, Robien K, Prizment A, Wu K, Sawada N, Lan Q, Park Y, Gao YT, Cai Q, Song M, Zhang X, Pan K, Agudo A, Panico S, Liao LM, ...show more Tsugane S, Chlebowski RT, Nøst TH, Schulze MB, Johannson M, Zheng W, Shu XO
Affiliations
  • College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States. Electronic address: yumie.takata@oregonstate.edu.
  • Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
  • Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
  • Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
  • Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
  • Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.
  • Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
  • Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
  • Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States.
  • Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States.
...show more
  • Department of Epidemiology, Cancer Institute of Shanghai Jiao Tong University, Shanghai, China.
  • Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
  • Department of Hematology/Oncology, Southern California Kaiser Permanente, Downey, CA, United States.
  • Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain; Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
  • Department of Medicine and Surgery, Federico II University, Naples, Italy.
  • Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
  • Lundquist Institute for Biomedical Innovation at Harbor-University of California, Los Angeles (UCLA) Medical Center, Torrance, CA, United States.
  • Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
  • Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
  • Genetic Epidemiology Group, International Agency for Research on Cancer, Lyons, France.
Abstract

BACKGROUND: Previous studies on calcium intake and lung cancer risk reported inconsistent associations, possibly due to the differences in intake amounts and contributing sources of calcium and smoking prevalence.

OBJECTIVES: We investigated the associations of lung cancer risk with intake of calcium from foods and/or supplements and major calcium-rich foods in 12 studies.

METHODS: Data from 12 prospective cohort studies conducted in the United States, Europe, and Asia were pooled and harmonized. We applied the DRI to categorize calcium intake based on the recommendations and quintile distribution to categorize calcium-rich food intake. We ran multivariable Cox regression by each cohort and pooled risk estimates to compute overall HR (95% CI).

RESULTS: Among 1,624,244 adult men and women, 21,513 incident lung cancer cases were ascertained during a mean follow-up of 9.9 y. Overall, the dietary calcium intake was not significantly associated with lung cancer risk; the HRs (95% CI) were 1.08 (0.98-1.18) for higher (>1.5 RDA) and 1.01 (0.95-1.07) for lower intake (<0.5 RDA) comparing with recommended intake (EAR to RDA). Milk and soy food intake were positively or inversely associated with lung cancer risk [HR (95% CI) = 1.07 (1.02-1.12) and 0.92 (0.84-1.00)], respectively. The positive association with milk intake was significant only in European and North American studies (P-interaction for region = 0.04). No significant association was observed for calcium supplements.

CONCLUSIONS: In this largest prospective investigation, overall, calcium intake was not associated with risk of lung cancer, but milk intake was associated with a higher risk. Our findings underscore the importance of considering food sources of calcium in studies of calcium intake.

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