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A cohort study of tobacco use, diet, occupation, and lung cancer mortality

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Abstract

In 1966, a cohort of White males aged 35 or over, who were policy-holders with the Lutheran Brotherhood Insurance Society (United States), completed a mail questionnaire on tobacco use, diet, and demographic characteristics. During the 20 years of follow-up, 219 lung cancer deaths occurred. Besides the strong relationship with cigarette smoking, we observed an effect on lung cancer risk among current users of cigars or pipes who were nonsmokers of cigarettes (relative risk [RR]=3.5, 95 percent confidence interval[CI]=1.0–12.6) or who were past/occasional users of cigarettes (RR=2.7, CI=1.4–5.3). In addition, elevated risks (from 1.5 to 2.6) of lung cancer were found among craftsmen and laborers, with the highest risks among subjects who worked in the mining or manufacturing industry. No association between current (as of 1966) use of beer or hard liquor and lung cancer was observed, although past users were at elevated risk. An inverse association between lung cancer and intake of fruits was observed, and risks of lung cancer were lower among persons in the highest dietary intake quintiles of vitamins A and C. Except for oranges, however, none of the inverse associations with fruits or dietary nutrients had statistically significant trends. The findings from this cohort study add to the evidence of an adverse effect of cigar/pipe smoking and possibly protective effect of dietary factors on lung cancer risk.

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References

  1. American Cancer Society. Cancer Facts & Figures. Atlanta, GA: ACS, 1991.

    Google Scholar 

  2. US Department of Health, Education, and Welfare. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. Bethesda, MD: Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989; DHHS Pub. No. (CDC) 89–8411.

    Google Scholar 

  3. Higgins ITT, Mahan CM, Wynder EL. Lung cancer among cigar and pipe smokers. Prev Med 1988; 17: 116–28.

    Google Scholar 

  4. Lubin JH, Richter BS, Blot WJ. Lung cancer risk with cigar and pipe use. JNCI 1984; 73: 377–81.

    Google Scholar 

  5. Vineis P, Thomas T, Hayes RB, et al. Proportion of lung cancers in males, due to occupation, in different areas of the USA. Int J Cancer 1988; 42: 851–6.

    Google Scholar 

  6. Colditz GA, Stampfer MJ, Willett WC. Diet and lung cancer: a review of the epidemiologic evidence in humans. Arch Intern Med 1987; 147: 157–60.

    Google Scholar 

  7. Fontham ETH. Protective dietary factors and lung cancer. Int J Epidemiol 1990; 19 (Suppl 1): S32-S42.

    Google Scholar 

  8. Snowdon DA. Alcohol use and mortality from cancer and heart disease among members of the Lutheran Brotherhood cohort. PhD dissertation, University of Minnesota, 1981.

  9. National Center for Health Statistics. Plan and operation of the second National Health and Nutrition Examination Survey, 1976–1980. Vital and Health Statistics. Programs and Collection Procedures. Series 1, No. 15. Hyattsville, MD: US Department of Health and Human Services, 1981.

    Google Scholar 

  10. United States Department of Agriculture. Composition of foods: raw, processed, prepared. Agriculture Handbook Nos 8–1 to 8–10. Washington, DC: US Government Printing Office, 1976–1983.

    Google Scholar 

  11. Preston DL, Kopecky KJ, Kato H. Analysis of mortality and disease incidence among atomic bomb survivors. In: Blot WJ, Hirayama Y, Hoel DG, eds. Statistical Methods in Cancer Epidemiology. Hiroshima, Japan: Radiation Effects Research Foundation, 1985.

    Google Scholar 

  12. Breslow NE, Day NE. Statistical Methods in Cancer Research, Vol. 2. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 82: 120–76.

    Google Scholar 

  13. Bjelke E, Schuman LS, Gart JJ. Dietary factors and lung cancer mortality. The Lutheran Brotherhood Study 1966–1977 (Abstract). Proceedings of the 13th International Cancer Congress. Seattle, Washington, September, 1982: 175.

  14. Wynder EL, Higgins IT, Harris RE. The wish bias. J Clin Epidemiol 1990; 43: 619–21.

    Google Scholar 

  15. Fiore MC, Novotny TE, Pierce JP, et al. Trends in cigarette smoking in the United States. JAMA 1989; 261: 49–55.

    Google Scholar 

  16. Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J 1976; 2: 1525–36.

    Google Scholar 

  17. Alderson M. Occupational Cancer. Boston: Butter-worths, 1986: 166–7.

    Google Scholar 

  18. Blot WJ, Fraumeni JF, Jr. The epidemiology of lung and pleural cancer. In: Schottenfeld D, Fraumeni JF Jr, eds. Cancer, Epidemiology, and Prevention. 2nd edn. Philadelphia, PA: W. B. Saunders (in press).

  19. Saftlas AF, Blair A, Cantor KP, et al. Cancer and other causes of death among Wisconsin farmers. Am J Ind Med 1987; 11: 119–29.

    Google Scholar 

  20. Blair A, Malker H, Cantor KP, et al. Cancer among farmers: a review. Scand J Work Environ Health 1985; 11: 397–407.

    Google Scholar 

  21. Blair A, Zahm SH. Cancer among farmers. Occup Med: State of the Art Reviews 1991; 6: 335–54.

    Google Scholar 

  22. Blair A, Grauman DJ, Lubin JH, et al. Lung cancer and other causes of death among licensed pesticide applicatiors. JNCI 1983; 71: 31–7.

    Google Scholar 

  23. McDuffie HH, Klaassen DJ, Cockcroft DW, et al. Farming and exposure to chemicals in male lung cancer patients and their siblings. J Occup Med 1988; 30: 55–9.

    Google Scholar 

  24. Jacobsen BK, Bjelke E, Kvale G, et al. Coffee drinking, mortality, and cancer incidence: results from a Norwegian prospective study. JNCI 1986; 76: 823–31.

    Google Scholar 

  25. Nomura A, Heilbrun LK, Stemmermann GN. Prospective study of coffee consumption and the risk of cancer. JNCI 1986; 76: 587–90.

    Google Scholar 

  26. Mettlin C. Milk drinking, other beverage habits, and lung cancer risk. Int J Cancer 1989; 43: 608–12.

    Google Scholar 

  27. Gibson R, Schuman L, Bjelke E. A prospective study of coffee consumption and mortality from cancer (Abstract). Am J Epidemiol 1985; 122: 520.

    Google Scholar 

  28. International Agency for Research on Cancer. Alcohol Drinking. Lyon, France: IARC, 1988; IARC Monogr Eval Carcinog Risk Humans vol. 44: 232–40.

    Google Scholar 

  29. Potter JD, Sellers TA, Folson AR. Beer and lung cancer in older women: the Iowa Women's Health Study (Abstract). Am J Epidemiol 1990; 132: 784.

    Google Scholar 

  30. Bandera EV, Graham S, Freudenheim JL, et al. Alcohol consumption and lung cancer (Abstract). Am J Epidemiol 1991; 134: 725.

    Google Scholar 

  31. Kolonel LN, Hankin JH, Lee J, et al. Nutrient intakes in relation to cancer incidence in Hawaii. Br J Cancer 1981; 44: 332–9.

    Google Scholar 

  32. Wynder EL, Hebert JR, Kabat GC. Association of dietary fat and lung cancer. JNCI 1987; 79: 631–7.

    Google Scholar 

  33. Xie J, Lesaffre E, Kesteloot H. The relationship between animal fat intake, cigarette smoking, and lung cancer. Cancer Causes Control 1991; 2: 79–83.

    Google Scholar 

  34. Jain M, Burch JD, Howe GR, et al. Dietary factors and risk of lung cancer: results from a case-control study, Toronto, 1981–1985. Int J Cancer 1990; 45: 287–93.

    Google Scholar 

  35. Goodman MT, Kolonel LN, Yoshizawa CN, et al. The effect of dietary cholesterol and fat on the risk of lung cancer in Hawaii. Am J Epidemiol 1988; 128: 1241–55.

    Google Scholar 

  36. Hinds MW, Kolonel LN, Hankin JH, et al. Dietary cholesterol and lung cancer risk in a multi-ethnic population in Hawaii. Int J Cancer 1983; 32: 727–32.

    Google Scholar 

  37. Byers TE, Graham S, Haughey BP, et al. Diet and lung cancer risk: findings from the Western New York Diet Study. Am J Epidemiol 1987; 125: 351–63.

    Google Scholar 

  38. Prentice RL, Sheppard L. Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1990; 1: 81–97.

    Google Scholar 

  39. Heilbrun LK, Nomura AMY, Stemmermann GN. Dietary cholesterol and lung cancer risk among Japanese men in Hawaii. Am J Clin Nutr 1984; 39: 375–9.

    Google Scholar 

  40. Shekelle RB, Rossof AH, Stamler J. Dietary cholesterol and incidence of lung cancer: the Western Electric Study. Am J Epidemiol 1991; 134: 480–4.

    Google Scholar 

  41. Bjelke E. Dietary vitamin A and human lung cancer. Int J Cancer 1975; 15: 561–5.

    Google Scholar 

  42. Ziegler RG. Epidemiologic studies of vitamins and cancer of the lung, esophagus, and cervix. Adv Exp Med Biol 1986; 206: 11–26.

    Google Scholar 

  43. Willett W. Vitamin A and lung cancer. In: Willett W. Nutritional Epidemiology. New York: Oxford University Press, 1990.

    Google Scholar 

  44. Ziegler RG, Mason TJ, Stemhagen A, et al. Carotenoid intake, vegetables, and the risk of lung cancer among White men in New Jersey. Am J Epidemiol 1986; 123: 1080–93.

    Google Scholar 

  45. Hinds MW, Kolonel LN, Hankin JH, et al. Dietary vitamin A, carotene, vitamin C, and risk of lung cancer incidence in Hawaii. Am J Epidemiol 1984; 119: 227–36.

    Google Scholar 

  46. Fontham ETH, Pickle LW, Haenszel W, et al. Dietary vitamins A and C and lung cancer risk in Louisiana. Cancer 1988; 62: 2267–73.

    Google Scholar 

  47. LeMarchand L, Yoshizawa CN, Kolonel LN, et al. Vegetable consumption and lung cancer risk: a population-based case-control study in Hawaii. JNCI 1989; 81: 1158–64.

    Google Scholar 

  48. Wu AH, Henderson BE, Pike MC, et al. Smoking and other risk factors for lung cancer in women. JNCI 1985; 74: 747–51.

    Google Scholar 

  49. Knekt P, Jarvinen R, Seppanen R, et al. Dietary antioxidants and the risk of lung cancer. Am J Epidemiol 1991; 134: 471–9.

    Google Scholar 

  50. Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.

    Google Scholar 

  51. Wang L, Hammond EC. Lung cancer, fruit, green salad and vitamin pills. Chinese Med J 1985; 98: 206–10.

    Google Scholar 

  52. Fraser GE, Beeson WL, Phillips RL. Diet and lung cancer in California Seventh-day Adventists. Am J Epidemiol 1991; 133: 683–93.

    Google Scholar 

  53. Henson DE, Block G, Levine M. Ascorbic acid: biologic functions and relation to cancer. JNCI 1991; 83: 547–50.

    Google Scholar 

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Authors and Affiliations

  1. National Cancer Institute, 6130 Executive Blvd, EPN Room 407, 20892, Rockville, MD, USA

    Wong-Ho Chow

  2. Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, Bethesda, MD, USA

    Wong-Ho Chow, Joseph K. McLaughlin, Gloria Gridley & Sholom Wacholder

  3. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Leonard M. Schuman

  4. Center for Epidemiologic Research, University of Bergen, Norway

    Erik Bjelke

  5. Westat, Inc., Rockville, MD, USA

    Harvey T. Co Chien

Authors
  1. Wong-Ho Chow
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  2. Leonard M. Schuman
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  3. Joseph K. McLaughlin
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  4. Erik Bjelke
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  5. Gloria Gridley
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  6. Sholom Wacholder
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  7. Harvey T. Co Chien
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  8. William J. Blot
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Chow, WH., Schuman, L.M., McLaughlin, J.K. et al. A cohort study of tobacco use, diet, occupation, and lung cancer mortality. Cancer Causes Control 3, 247–254 (1992). https://doi.org/10.1007/BF00124258

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  • DOI: https://doi.org/10.1007/BF00124258

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