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Diet quality and lung cancer incidence in a low-income population in the United States

British Journal of Cancer volume 129, pages 626–635 (2023)Cite this article

Subjects

Abstract

Background

Although tobacco smoking is the leading cause of lung cancer, interest in the relationship of diet quality on risk has been growing.

Methods

We examined the association between Healthy Eating Index-2010 (HEI-10) at enrollment and lung cancer incidence among 70,802 participants in a predominantly African American and low-income prospective cohort in the southern United States. Outcomes were ascertained through linkages with state cancer registries and the National Death Index (NDI). Hazard ratios by HEI-10 quartiles were assessed using Cox proportional hazard models adjusted for potential confounders.

Results

During ≤16 years of follow-up, 1454 incident lung cancers were identified. The lowest HEI-10 quartile compared to the highest was adversely associated with lung cancer risk (HR: 1.89, 95% CI 1.16–3.07) among male former smokers and female never smokers (HR: 2.58, 95% CI 1.06–6.28).

Conclusions

Low-quality diet was associated with increased lung cancer risk among male former smokers and female never smokers but cautious interpretation of the findings should be taken due to the small number of lung cancers among never smokers and the possibility of residual confounding by smoking in ever smokers.

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Data availability

Requests for data are to be made at www.southerncommunitystudy.org.

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Acknowledgements

The authors wish to thank the Southern Community Cohort Study (SCCS) team members who have contributed to the SCCS.

Funding

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U01CA202979 and R01CA092447. Biomarker assays were partially supported by NIH grant P50CA090949. Biospecimens and data collection and use as well as cytokine assays were conducted by the Survey and Biospecimen Shared Resource, which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485).

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Authors and Affiliations

  1. International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN, USA

    Heather M. Munro & Martha J. Shrubsole

  2. Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA

    Danxia Yu, Wei Zheng, William J. Blot, Qiuyin Cai & Martha J. Shrubsole

  3. International Epidemiology Institute, Rockville, MD, USA

    William J. Blot

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Contributions

HMM and MJS conceived the work that led to the submission. DY, WZ, WJ, and QC acquired data. All authors played an important role in interpreting the results, drafted or revised the manuscript, approved the final version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Martha J. Shrubsole.

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Competing interests

WZ and MJS receive research support from Pfizer, Inc which is unrelated to the contents of this manuscript. HMM, DY, WJB, and QC declare no competing interests.

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All study participants provided written informed consent. The study was approved by the Institutional Review Board at Vanderbilt University and Meharry Medical College. The study was performed in accordance with the Declaration of Helsinki.

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Munro, H.M., Yu, D., Zheng, W. et al. Diet quality and lung cancer incidence in a low-income population in the United States. Br J Cancer 129, 626–635 (2023). https://doi.org/10.1038/s41416-023-02342-7

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