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

Yumie Takata, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States. Electronic address: yumie.takata@oregonstate.edu.
Jae Jeong Yang, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Danxia Yu, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Stephanie A. Smith-Warner, 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.
William J. Blot, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Emily White, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
Kimberly Robien, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Anna Prizment, Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.
Kana Wu, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Norie Sawada, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Qing Lan, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States.
Yikyung Park, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States.
Yu-Tang Gao, Department of Epidemiology, Cancer Institute of Shanghai Jiao Tong University, Shanghai, China.
Qiuyin Cai, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Mingyang Song, 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.
Xuehong Zhang, 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.
Kathy Pan, Department of Hematology/Oncology, Southern California Kaiser Permanente, Downey, CA, United States.
Antonio Agudo, Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO; and Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program; Bellvitge Biomedical Research Institute-IDIBELL; L'Hospitalet de Llobregat, Barcelona, Spain.
Salvatore Panico, Department of Medicine and surgery, Federico II University, Naples, Italy.
Linda M. Liao, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States.
Shoichiro Tsugane, 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.
Rowan T. Chlebowski, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States.
Therese Haugdahl Nøst, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Matthias B. Schulze, Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
Mattias Johannson, Genetic Epidemiology Group, IARC, Lyons, France.
Wei Zheng, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Xiao-Ou Shu, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.

Document Type

Journal Article

Publication Date

3-11-2023

Journal

The Journal of nutrition

DOI

10.1016/j.tjnut.2023.03.011

Keywords

calcium; dairy products; diet; lung cancer; milk; pooled analysis; prospective studies; soy products; supplements

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 an 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 [>1500 (men) or >1,800 (women) mg/d] and 1.01 (0.95-1.07) for lower intake [≤500 (men) or ≤600 (women) mg/d] comparing with recommended intake (800-1200 mg/d). 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 United States 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.

Department

Exercise and Nutrition Sciences

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