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Dietary Fat and Risk of Lung Cancer in a Pooled Analysis of Prospective Studies¹

Harvard School of Public Health, Departments of Nutrition [S. A. S-W., D. J. H., G. C., E. G., W. C. W.], Epidemiology [J. R., D. J. H., E. G., W. C. W.], Biostatistics [J. R.], and Environmental Health [F. E. S.], Boston, Massachusetts 02115; Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115 [D. J. H., G. C., E. G., F. E. S., W. C. W.]; Harvard Center for Cancer Prevention, Boston, Massachusetts 02115 [D. J. H., G. C., W. C. W.]; Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland 20892 [D. A.]; The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, California 92350 [W. L. B., G. E. F.]; Department of Epidemiology, Maastricht University, 6200 MD Maastricht, the Netherlands [P. A. v. d. B.]; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454 [A. R. F.]; Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, New York 14214 [J. L. F., S. G.]; Department of Epidemiology, TNO Nutrition and Food Research Institute, 3700 AJ Zeist, the Netherlands [R. A. G.]; Division of Research, Kaiser Permanente, Oakland, CA 94612 [L. H. K.]; Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, D-69120 Heidelberg, Germany [A. B. M.]; Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York 10461 [T. E. R.]; and Department of Epidemiology and Health Promotion, National Public Health Institute, FIN-00300 Helsinki, Finland [J. V.]

Lung cancer rates are highest in countries with the greatest fat intakes. In several case-control studies, positive associations have been observed between lung cancer and intakes of total and saturated fat, particularly among nonsmokers. We analyzed the association between fat and cholesterol intakes and lung cancer risk in eight prospective cohort studies that met predefined criteria. Among the 280,419 female and 149,862 male participants who were followed for up to 6–16 years, 3,188 lung cancer cases were documented. Using the Cox proportional hazards model, we calculated study-specific relative risks that were adjusted for smoking history and other potential risk factors. Pooled relative risks were computed using a random effects model. Fat intake was not associated with lung cancer risk. For an increment of 5% of energy from fat, the pooled multivariate relative risks were 1.01 [95% confidence interval (CI), 0.98–1.05] for total, 1.03 (95% CI, 0.96–1.11) for saturated, 1.01 (95% CI, 0.93–1.10) for monounsaturated, and 0.99 (95% CI, 0.90–1.10) for polyunsaturated fat. No associations were observed between intakes of total or specific types of fat and lung cancer risk among never, past, or current smokers. Dietary cholesterol was not associated with lung cancer incidence [for a 100-mg/day increment, the pooled multivariate relative risk was 1.01 (95% CI, 0.97–1.05)]. There was no statistically significant heterogeneity among studies or by sex. These data do not support an important relation between fat or cholesterol intakes and lung cancer risk. The means to prevent this important disease remains avoidance of smoking.

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