30 september 2005: Bron: Medscape en JAMA 2005;294:1493-1510,1550-1551.en JAMA. 2005 Sep 28;294(12):1493-504

Minder roken en een voedingspatroon met veel groenten en fruit kan kans op longkanker met tientallen procenten verminderen blijkt uit twee recent gepubliceerde studies. In een cohort studie met een follow-up van 31 jaar onder 19.714 mensen bljikt dat ook het verminderen van roken, dus minder sigaretten per dag de kans op longkanker ook doet afnemen. Helemaal stoppen is nog altijd het beste maar rokers die van een pakje per dag naar zeg 7 sigaretten per dag gaan, verminderen daarmee ook het risico op longkanker met tot 50%. In een andere gerandomiseerde studie onder 1674 longkankerpatiënten tegenover 1735 'gezonde mensen' bleek dat de patiënten met de laagste inname van phyto oestrogenen - coumesterol, isoflavonen en ligans (zit in lijnzaad) -- en phytosterols (fruit en groenten zijn de grootste leveranciers van al deze genoemde stofjes.) dat er een significant verschil bleek te bestaan in negatieve zin voor deze groep. In de groep longkankerpatiënten waren meer mensen met een lage inname van phyto oestrogenen enz. Terwijl mensen met de hoogste inname van phyto oestrogneen het minst vertegenwoordigd waren in de longkankergroep. Mensen die nog nooit gerookt hadden profiteerden het meest van het fruit en groentenrijke voedingspatroon (phyto oestrogenen enz. ) Belangrijk van deze studies is natuurljik dat in het voorkomen van uitzaaiïngen of voorkomen van een recideif deze aanpak ook effectief kan zijn en daarmee ook naast een preventief effect ook een therapeutische aanvulling kan zijn. Achtereenvolgens hier het artikel uit Medscape over deze twee studies en het uitgebreide abstract van de studie over het effect van phyto oestrogenen.

Smoking Reduction, Dietary Phytoestrogens May Reduce Lung Cancer Risk

NEW YORK (Reuters Health) Sept 27 - Heavy smokers can decrease their risk of lung cancer if they substantially cut down the number of cigarettes they smoke per day, investigators report in the Journal of the American Medical Association for September 28. The results of a second Journal study suggest that a diet high in phytoestrogens is associated with a lower risk of lung cancer, in both nonsmokers and smokers.

Dr. Nina S. Godtfredsen, from Hvidovre Hospital, and her associates in Denmark conducted a population-based cohort study among 19,714 subjects with up to 31 years of follow-up. Subjects who reduced their tobacco consumption from 20 to 10 cigarettes per day experienced a 27% reduced risk for lung cancer compared with unchanged heavy smokers.

Among subjects who were light smokers throughout (average 9 cigarettes per day), the risk was reduced by 56% compared with heavy smokers, while those who quit reduced their risk by 50%. The risk among those who never smoked was 91% less than among heavy smokers. Clearly, smoking cessation is the best method for decreasing harm from tobacco, Drs. Lawrence J. Dacey and David W. Johnstone, from Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, point out in a related editorial. "Nonetheless," they write, "because only a minority of smokers are able to quit smoking completely, it is important to inform them that the more they can reduce the number of cigarettes they smoke, the more they will decrease their risk of lung cancer." In the second Journal report, Dr. Margaret R. Spitz and colleagues at the University of Texas M. D. Anderson Cancer Center in Houston conducted a case-control study of 1674 patients with lung cancer and 1735 matched healthy control subjects. Food frequency questionnaires were used to assess intake of several classes of phytoestrogens.

Patients with lung cancer tended to consume lower amounts of phytoestrogens than controls (median 265.1 versus 390.3 mg/day, p < 0.001). Men appear to benefit more phytoestrogen intake than did women, with p values of < 0.001 and of 0.06, respectively. In women, only intake of phytoestrogens from food sources (excluding coffee and tea) significantly affected risk (p = 0.01). For each individual class of phytoestrogens -- coumesterol, isoflavone and ligans -- and for phytosterols, men appeared to benefit significantly from increased intake (p = 0.004 to > 0.001). Although there were trends toward reduced risk in women, the associations did not reach statistical significance. The protective effects of phytoestrogens were strongest for never smokers, although current smokers also appeared to benefit. Protective effects were not statistically significant in previous smokers. "Patients should be informed that they may further reduce their risk of developing cancer by adopting a diet rich in fruits and vegetables," Dr. Dacey and Johnstone remark in their editorial.

JAMA 2005;294:1493-1510,1550-1551.

JAMA. 2005 Sep 28;294(12):1493-504.

Dietary phytoestrogens and lung cancer risk.

Schabath MB, Hernandez LM, Wu X, Pillow PC, Spitz MR.
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston 77230-1439, USA.

CONTEXT: Despite lung-specific in vitro and in vivo studies that support a chemopreventive role for phytoestrogens, there has been little epidemiologic research focused on dietary intake of phytoestrogens and risk of lung cancer.

OBJECTIVE: To examine the relationship between dietary intake of phytoestrogens and risk of lung cancer.

DESIGN, SETTING, AND PARTICIPANTS: Ongoing US case-control study of 1674 patients with lung cancer (cases) and 1735 matched healthy controls. From July 1995 through October 2003, participants were personally interviewed with epidemiologic and food frequency questionnaires to collect demographic information and to quantify dietary intake of 12 individual phytoestrogens.

MAIN OUTCOME MEASURE: Risk of lung cancer, estimated using unconditional multivariable logistic regression analyses stratified by sex and smoking status and adjusted for established and putative lung cancer risk factors.

RESULTS: Reductions in risk of lung cancer tended to increase with each increasing quartile of phytoestrogen intake. The highest quartiles of total phytosterols, isoflavones, lignans, and phytoestrogens were each associated with reductions in risk of lung cancer ranging from 21% for phytosterols (odds ratio , 0.79; 95% confidence interval , 0.64-0.97; P = .03 for trend) to 46% for total phytoestrogens from food sources only (OR, 0.54; 95% CI, 0.42-0.70; P<.001 for trend). Sex-specific effects were also apparent. For men, statistically significant trends for decreasing risk with increasing intake were noted for each phytoestrogen group, with protective effects for the highest quartile of intake ranging from 24% for phytosterols (OR, 0.76; 95% CI, 0.56-1.02; P = .04 for trend) to 44% for isoflavones (OR, 0.56; 95% CI, 0.41-0.76; P<.001 for trend), while in women, significant trends were only present for intake of total phytoestrogens from food sources only, with a 34% (OR, 0.66; 95% CI, 0.46-0.96; P = .01 for trend) protective effect for the highest quartile of intake. The apparent benefits of high phytoestrogen intake were evident in both never and current smokers but less apparent in former smokers. In women, statistically significant joint effects were evident between hormone therapy use and phytoestrogen intake. Specifically, high intake of the lignans enterolactone and enterodiol and use of hormone therapy were associated with a 50% (OR, 0.50; 95% CI, 0.31-0.68; P = .04 for interaction) reduction in risk of lung cancer.

CONCLUSIONS: While there are limitations and concerns regarding case-control studies of diet and cancer, these data provide further support for the limited but growing epidemiologic evidence that phytoestrogens are associated with a decrease in risk of lung cancer. Confirmation of these findings is still required in large-scale, hypothesis-driven, prospective studies.

PMID: 16189362 [PubMed - in process]

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