Table 3.
Association Between Fatty Acid Intake and Lung Cancer Risk in the SWHS and SMHS, Stratified Analysis by Lung Cancer Type and Smoking Statusa
| By Lung Cancer Type (SWHS + SMHS)
|
By Smoking Status (SWHS + SMHS)
|
|||||||
|---|---|---|---|---|---|---|---|---|
| Squamous Cell | Adenocarcinoma | Ever Smoking | Never Smoking | |||||
|
|
|
|||||||
| # | HR (95%CI) | # | HR (95%CI) | # | HR (95%CI) | # | HR (95%CI) | |
| Total Fatty Acid | ||||||||
| Q1 | 16 | Ref. | 119 | Ref. | 120 | Ref. | 194 | Ref. |
| Q2 | 28 | 1.75 (0.95-3.25) | 136 | 1.15 (0.90-1.47) | 128 | 1.02 (0.79-1.31) | 174 | 0.95 (0.77-1.16) |
| Q3 | 21 | 1.30 (0.67-2.50) | 107 | 0.92 (0.70-1.19) | 125 | 1.00 (0.77-1.28) | 152 | 0.85 (0.69-1.06) |
| Q4 | 32 | 1.83 (1.00-3.36) | 134 | 1.14 (0.89-1.47) | 142 | 1.08 (0.84-1.38) | 166 | 0.96 (0.78-1.18) |
| Q5 | 30 | 1.55 (0.84-2.88) | 120 | 1.02 (0.79-1.32) | 152 | 1.07 (0.84-1.37) | 143 | 0.88 (0.70-1.09) |
| Ptrend | 0.23 | 0.90 | 0.48 | 0.31 | ||||
| Pinteraction | 0.99* | |||||||
| Saturated Fatty Acid | ||||||||
| Q1 | 17 | Ref. | 120 | Ref. | 118 | Ref. | 198 | Ref. |
| Q2 | 22 | 1.33 (0.71-2.51) | 123 | 1.04 (0.81-1.34) | 135 | 1.11 (0.87-1.43) | 164 | 0.88 (0.72-1.09) |
| Q3 | 33 | 1.92 (1.07-3.47) | 119 | 1.02 (0.79-1.32) | 140 | 1.16 (0.91-1.49) | 156 | 0.87 (0.71-1.08) |
| Q4 | 23 | 1.27 (0.67-2.39) | 123 | 1.05 (0.81-1.36) | 128 | 1.01 (0.78-1.30) | 161 | 0.92 (0.74-1.14) |
| Q5 | 32 | 1.69 (0.93-3.08) | 131 | 1.13 (0.87-1.45) | 146 | 1.13 (0.88-1.44) | 150 | 0.91 (0.73-1.13) |
| Ptrend | 0.16 | 0.40 | 0.64 | 0.49 | ||||
| Pinteraction | 0.89* | |||||||
| Monounsaturated Fatty Acida | ||||||||
| Q1 | 18 | Ref. | 114 | Ref. | 123 | Ref. | 184 | Ref. |
| Q2 | 22 | 1.19 (0.64-2.23) | 126 | 1.12 (0.86-1.44) | 112 | 0.85 (0.65-1.09) | 188 | 1.08 (0.88-1.32) |
| Q3 | 26 | 1.45 (0.79-2.65) | 120 | 1.08 (0.83-1.39) | 137 | 1.06 (0.83-1.35) | 152 | 0.90 (0.73-1.12) |
| Q4 | 32 | 1.58 (0.88-2.83) | 131 | 1.19 (0.92-1.53) | 142 | 1.04 (0.82-1.32) | 168 | 1.06 (0.86-1.30) |
| Q5 | 29 | 1.36 (0.75-2.47) | 125 | 1.15 (0.89-1.49) | 153 | 1.07 (0.84-1.35) | 137 | 0.94 (0.75-1.17) |
| Ptrend | 0.20 | 0.24 | 0.23 | 0.58 | ||||
| Pinteraction | 0.85* | |||||||
| Polyunsaturated Fatty Acid | ||||||||
| Q1 | 22 | Ref. | 131 | Ref. | 135 | Ref. | 188 | Ref. |
| Q2 | 17 | 0.72 (0.38-1.35) | 117 | 0.89 (0.70-1.15) | 114 | 0.80 (0.63-1.03) | 156 | 0.86 (0.69-1.06) |
| Q3 | 28 | 1.20 (0.69-2.11) | 136 | 1.03 (0.81-1.31) | 133 | 0.92 (0.72-1.17) | 180 | 0.99 (0.81-1.22) |
| Q4 | 29 | 1.15 (0.66-2.00) | 114 | 0.85 (0.66-1.10) | 136 | 0.90 (0.70-1.14) | 152 | 0.83 (0.67-1.03) |
| Q5 | 31 | 1.04 (0.60-1.82) | 118 | 0.85 (0.66-1.09) | 149 | 0.88 (0.69-1.11) | 153 | 0.82 (0.66-1.02) |
| Ptrend | 0.43 | 0.19 | 0.56 | 0.08 | ||||
| Pinteraction | 0.90* | |||||||
| Linoleic Acid | ||||||||
| Q1 | 23 | Ref. | 127 | Ref. | 136 | Ref. | 176 | Ref. |
| Q2 | 18 | 0.73 (0.39-1.35) | 110 | 0.94 (0.73-1.20) | 111 | 0.77 (0.60-0.99) | 168 | 0.97 (0.78-1.20) |
| Q3 | 24 | 0.98 (0.55-1.74) | 133 | 1.03 (0.81-1.31) | 136 | 0.93 (0.73-1.18) | 170 | 0.97 (0.79-1.20) |
| Q4 | 30 | 1.10 (0.64-1.91) | 116 | 0.88 (0.68-1.14) | 135 | 0.86 (0.67-1.09) | 164 | 0.93 (0.75-1.16) |
| Q5 | 32 | 1.02 (0.59-1.75) | 120 | 0.87 (0.68-1.12) | 149 | 0.84 (0.66-1.07) | 151 | 0.83 (0.67-1.04) |
| Ptrend | 0.49 | 0.25 | 0.37 | 0.11 | ||||
| Pinteraction | 0.91* | |||||||
| Linolenic Acid | ||||||||
| Q1 | 21 | Ref. | 116 | Ref. | 138 | Ref. | 180 | Ref. |
| Q2 | 25 | 1.17 (0.66-2.10) | 132 | 1.15 (0.90-1.48) | 125 | 0.89 (0.70-1.13) | 161 | 0.94 (0.76-1.16) |
| Q3 | 26 | 1.17 (0.66-2.09) | 124 | 1.08 (0.63-1.39) | 127 | 0.89 (0.70-1.13) | 173 | 1.02 (0.82-1.25) |
| Q4 | 24 | 1.10 (0.61-1.98) | 129 | 1.12 (0.87-1.44) | 126 | 0.89 (0.70-1.13) | 165 | 0.97 (0.71-1.20) |
| Q5 | 31 | 1.32 (0.75-2.32) | 115 | 0.99 (0.76-1.28) | 151 | 1.05 (0.83-1.33) | 150 | 0.88 (0.71-1.10) |
| Ptrend | 0.44 | 0.85 | 0.69 | 0.39 | ||||
| Pinteraction | 0.75* | |||||||
| Arachidonic Acid | ||||||||
| Q1 | 23 | Ref. | 116 | Ref. | 138 | Ref. | 197 | Ref. |
| Q2 | 22 | 1.02 (0.57-1.84) | 127 | 1.14 (0.89-1.47) | 131 | 0.97 (0.76-1.23) | 185 | 1.04 (0.85-1.28) |
| Q3 | 28 | 1.21 (0.70-2.11) | 140 | 1.28 (1.00-1.64) | 133 | 0.99 (0.78-1.26) | 178 | 1.06 (0.86-1.30) |
| Q4 | 26 | 1.20 (0.68-2.12) | 112 | 1.04 (0.80-1.36) | 125 | 0.93 (0.73-1.19) | 135 | 0.84 (0.67-1.05) |
| Q5 | 28 | 1.17 (0.67-2.06) | 121 | 1.15 (0.89-1.50) | 140 | 1.03 (0.81-1.30) | 134 | 0.92 (0.74-1.15) |
| Ptrend | 0.47 | 0.51 | 0.94 | 0.16 | ||||
| Pinterac | 0.16* | |||||||
| Timnodonic Acid-EPA | ||||||||
| Q1 | 20 | Ref. | 108 | Ref. | 134 | Ref. | 169 | Ref. |
| Q2 | 27 | 1.34 (0.75-2.40) | 102 | 0.96 (0.73-1.26) | 143 | 1.03 (0.81-1.30) | 156 | 0.97 (0.78-1.21) |
| Q3 | 27 | 1.33 (0.74-2.38) | 138 | 1.37 (1.06-1.76) | 136 | 1.06 (0.83-1.35) | 189 | 1.30 (1.05-1.60) |
| Q4 | 28 | 1.54 (0.86-2.75) | 152 | 1.59 (1.24-2.04) | 120 | 1.02 (0.80-1.31) | 170 | 1.29 (1.04-1.60) |
| Q5 | 25 | 1.37 (0.75-2.50) | 116 | 1.26 (0.96-1.64) | 134 | 1.21 (0.95-1.54) | 145 | 1.19 (0.95-1.49) |
| Ptrend | 0.26 | 0.001 | 0.18 | 0.01 | ||||
| Pinteraction | 0.29* | |||||||
| DHA | ||||||||
| Q1 | 25 | Ref. | 104 | Ref. | 139 | Ref. | 156 | Ref. |
| Q2 | 25 | 0.96 (0.55-1.66) | 102 | 0.99 (0.75-1.30) | 136 | 0.92 (0.73-1.17) | 162 | 1.08 (0.87-1.34) |
| Q3 | 25 | 1.00 (0.57-1.74) | 141 | 1.44 (1.12-1.86) | 135 | 1.01 (0.79-1.28) | 187 | 1.37 (1.11-1.70) |
| Q4 | 28 | 1.22 (0.71-2.10) | 147 | 1.58 (1.23-2.04) | 125 | 1.02 (0.80-1.30) | 170 | 1.37 (1.10-1.71) |
| Q5 | 24 | 1.06 (0.60-1.87) | 122 | 1.36 (1.04-1.77) | 132 | 1.13 (0.88-1.44) | 154 | 1.34 (1.07-1.68) |
| Ptrend | 0.57 | 0.003 | 0.23 | 0.0009 | ||||
| Pinteraction | 0.44* | |||||||
| Total n-3 PUFAc | ||||||||
| Q1 | 22 | Ref. | 119 | Ref. | 145 | Ref. | 183 | Ref. |
| Q2 | 25 | 1.12 (0.63-2.00) | 124 | 1.06 (0.82-1.36) | 113 | 0.76 (0.59-0.97) | 169 | 0.98 (0.79-1.21) |
| Q3 | 22 | 0.97 (0.54-1.76) | 128 | 1.10 (0.85-1.41) | 127 | 0.87 (0.68-1.10) | 158 | 0.93 (0.75-1.15) |
| Q4 | 29 | 1.28 (0.73-2.25) | 126 | 1.09 (0.84-1.40) | 135 | 0.93 (0.73-1.18) | 168 | 1.01 (0.81-1.24) |
| Q5 | 29 | 1.22 (0.69-2.14) | 119 | 1.03 (0.79-1.33) | 147 | 1.02 (0.81-1.29) | 151 | 0.93 (0.75-1.16) |
| Ptrend | 0.41 | 0.78 | 0.42 | 0.63 | ||||
| Pinteraction | 0.92* | |||||||
| Total n-3 HUFAc | ||||||||
| Q1 | 24 | Ref. | 112 | Ref. | 145 | Ref. | 168 | Ref. |
| Q2 | 26 | 1.09 (0.62-1.90) | 91 | 0.84 (0.64-1.11) | 130 | 0.88 (0.70-1.12) | 152 | 0.97 (0.78-1.21) |
| Q3 | 26 | 1.13 (0.65-1.97) | 144 | 1.41 (1.10-1.80) | 138 | 1.02 (0.81-1.29) | 186 | 1.31 (1.06-1.62) |
| Q4 | 26 | 1.18 (0.67-2.07) | 148 | 1.52 (1.19-1.95) | 118 | 0.94 (0.74-1.21) | 171 | 1.32 (1.06-1.64) |
| Q5 | 25 | 1.19 (0.67-2.10) | 121 | 1.29 (0.99-1.67) | 136 | 1.15 (0.91-1.46) | 152 | 1.27 (1.02-1.59) |
| Ptrend | 0.51 | 0.0003 | 0.22 | 0.002 | ||||
| Pinteraction | 0.36* | |||||||
| Total n-6 PUFA | ||||||||
| Q1 | 23 | Ref. | 127 | Ref. | 135 | Ref. | 179 | Ref. |
| Q2 | 18 | 0.73 (0.39-1.35) | 119 | 0.93 (0.72-1.20) | 111 | 0.78 (0.60-1.00) | 164 | 0.93 (0.75-1.15) |
| Q3 | 24 | 0.98 (0.55-1.74) | 131 | 1.01 (0.79-1.30) | 136 | 0.94 (0.74-1.19) | 169 | 0.95 (0.77-1.18) |
| Q4 | 30 | 1.11 (0.64-1.91) | 121 | 0.92 (0.72-1.18) | 137 | 0.87 (0.69-1.11) | 168 | 0.94 (0.76-1.17) |
| Q5 | 32 | 1.02 (0.59-1.76) | 118 | 0.86 (0.67-1.11) | 148 | 0.85 (0.67-1.07) | 149 | 0.81 (0.65-1.01) |
| Ptrend | 0.48 | 0.28 | 0.41 | 0.11 | ||||
| Pinteraction | 0.90* | |||||||
| Ratio n-6 PUFA/n-3 PUFA | ||||||||
| Q1 | 24 | Ref. | 147 | Ref. | 135 | Ref. | 179 | Ref. |
| Q2 | 32 | 1.47 (0.86-2.50) | 140 | 0.96 (0.76-1.21) | 140 | 1.12 (0.88-1.42) | 175 | 0.96 (0.78-1.18) |
| Q3 | 24 | 1.18 (0.67-2.08) | 122 | 0.83 (0.65-1.06) | 128 | 1.08 (0.85-1.38) | 150 | 0.79 (0.64-0.98) |
| Q4 | 23 | 1.06 (0.60-1.88) | 103 | 0.68 (0.53-0.88) | 117 | 0.94 (0.73-1.20) | 162 | 0.81 (0.65-1.00) |
| Q5 | 24 | 0.92 (0.52-1.64) | 104 | 0.62 (0.48-0.80) | 147 | 0.92 (0.73-1.17) | 163 | 0.70 (0.57-0.87) |
| Ptrend | 0.42 | <0.0001 | 0.22 | 0.003 | ||||
| Pinteraction | 0.17* | |||||||
Abbreviations: BMI, body mass index; CI, confidence interval; HUFA, highly unsaturated fatty acid; HR, hazard ratio; PUFA, polyunsaturated fatty acid; SMHS, Shanghai Men’s Health Study; SWHS, Shanghai Women’s Health Study;
a
Model adjusted for: age, smoking packs-year (SMHS only), ever drinking status, physical activity status, total energy (kcal/day), vitamin supplemental use, menopausal status, hormone replacement therapy (SWHS only).
*
Pinteraction were calculated in Shanghai Men’s Health Study (SMHS) only