Tomatoes and lung cancer.
Lung cancer risk: Data about tomatoes in relation with lung cancer risk was provided by a pooled analysis of 7 cohorts and an additional 5 cohorts including a
total of 4,191 cases.
A significant protective effect was found in one cohort of small size including 73 cases, but no adjustments were made for possible confounders (28).
A nonsignificant protective effect was found in the pooled analysis including 2,994 cases (24). No other associations were found. The average RR = 0.83 (excluding
incomplete data from Neuhouser ML [22], Liu Y [25]).
Data about tomato sauce or tomato juice in relation with lung cancer risk was provided by a pooled analysis of 2 cohorts (14). A significant protective effect of
tomato sauce was found, but no association was found with tomato juice.
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 28) Bae JM (2007) | The Seoul Male Cancer Cohort Study | 73 | RR = 0.42 (0.23-0.76; P = 0.01). |
| 25) Liu Y (2004) | The JPHC Study | 251 | No association. |
| 24) Smith-Warner SA (2003) | Pooled analysis of 7 cohorts | 2,994 | RR = 0.83 (0.67-1.03; P = 0.10). |
| 22) Neuhouser ML (2003) | The CARET | 742 | No association. |
| 7) Fraser GE (1991) | The Adventist Health Study | 55 | RR = 1.24 (0.51-2.99; P = 0.79). |
| 2) Kvale G (1983) | No cohort name defined | 76 | RO = 0.87 (P = 0.48). |
| Total number of cases: 4,191 | Average RR = 0.83 |
Lung cancer mortality: Data about lung cancer mortality was provided by one cohort (17). A significant protective effect was found among men, but not women.
Conclusion: A nonsignificant protective effect of tomatoes against lung cancer risk was found in a pooled analysis of 7 studies including 71% of the cases from
all cohorts combined, and a significant protective effect was found in another cohort. No (non)significantly increased risks were found in the remaining cohorts.
Since the main associations were nonsignificant, evidence was judged suggestive for a protective effect at consumption of ≥ 0.5 tomato/day against lung cancer risk (- 17%).
A significant protective effect of tomato sauce against lung cancer risk was found in a pooled analysis of 2 cohorts of moderate-large size. Tomato sauce possibly protects
against lung cancer risk. No level of consumption could be defined for this effect.
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 28) Bae JM. (2007) | The Seoul Male Cancer Cohort Study. | 14,272 men aged 40-59 (Korea) | 10 (1993-2002) | 73 | Lung cancer risk | Tomato |
RR = 0.42 (0.23-0.76; P = 0.01) for the highest vs lowest quartile of consumption. Amount specific data (Quartiles not defined): Q1: RR = 1. Q2: RR = 0.56 (0.29-1.11). Q3: RR = 0.71 (0.39-1.28). Q4: RR = 0.42 (0.23-0.76). | Univariate analysis. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 25) Liu Y (2004) | Cohort II of The JPHC Study | 51,114 (aged 40-69) subjects. (Japan) | 7 (1993-1999) | 251? | lung cancer risk | Tomato | Inverse associations between lung cancer and specific individual vegetables were not observed (no data shown). | age, gender, area, sports, frequency of alcohol intake, BMI, vitamin supplement use, salted fish and meat, pickled vegetables, smoking duration, and number of cigarettes per day among ever smokers. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 24) Smith-Warner SA (2003) | Pooled analysis of 7 prospective studies. | 379,765 | 6-13 | 2,994 | Lung cancer risk | Tomatoes |
INCLUSION CRITERIA:
INCLUDED STUDIES (Follow-up years/No. of lung cancer cases):
RELATIVE RISK: RR = 0.83 (0.67-1.03; P = 0.10) for the highest vs lowest quartile of consumption. Amount specific data (servings): 0: RR = 1. > 0 to < 1/week: RR = 0.88 (0.75-1.03). > 1/week to 1/2/day: RR = 0.87 (0.74-1.02). ≥ 1/2/day: RR = 0.83 (0.67-1.03). One serving = 1 tomato. P for between-study heterogeneity: 0.53. P for between-study heterogeneity due to sex: 0.90. | Adjusted for education, BMI, alcohol intake, calories, smoking status, smoking duration for past/current smokers, amount smoked for current smokers. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 22) Neuhouser ML (2003) | The Beta-carotene And Retinol Efficacy Trial (CARET) (2003) | 14,120 current or former heavy smokers (male/female) and asbestos-exposted workers (male) aged 50-69. | 12 (1989-2001) | 742? (326 in placebo arm, and 414 in intervention arm) | Primary lung cancer risk | tomatoes, tomato juice, ketchup, mixed foods and condiments with tomatoes, and tomato sauce |
Sex, age, smoking status, total pack-years of smoking, asbestos exposure, race-ethnicity, enrollment center, and total vegetables. |
18) Holick CN (2002) | The Alpha-tocopherol, Beta-carotene Cancer Prevention Study (ATBC). | 27,084 white male smokers (≥ 5 cigarettes/day) aged 50-69. | (Finland) 14 | (1985-1998) 1,644? | Lung cancer incidence | Tomatoes/tomato juice | Low intake of tomatoes/tomato juice was associated with lung cancer (No data shown; P = < 0.05). | Age, years smoked, cigarettes per day, intervention (alpha-tocopherol, and beta-carotene supplements), supplement use (beta-carotene and vitamin A), energy intake, cholesterol and fat. |
14) Feskanich D (2000) | The Nurses' Health Study | & The Health Professionals' Follow-up Study 77,283 US women (38-63 years) and 47,778 men (40-75 years) | Women: 1984-1996. | Men: 1986-1996. 516? women, and | 258? men Total lung cancer risk | Tomatoes | Tomatoes or tomato juice: | No significant association with risk. Tomato sauce: RR for men + women combined = 0.45 (0.23-0.91) for increases of 1 serving/day. Not defined, but probably: age, follow-up cycle, smoking status,years since quitting among past smokers, cigarettes smoked/day among current smokers, age at start of smoking, total energy intake, and availability of diet data after baseline measure. |
14) Speizer FE (1999) | The Nurses' Health Study. | 89,284 women aged 34-59 years. | (USA) 12 | (1980-1992) 399? | Lung cancer risk | Tomatoes |
RR = 0.8 (No 95% CI; P = 0.46) for the highest vs the lowest quintile of consumption. | Amount specific data (Frequency of consumption): Never: RR = 1. 1/wk: RR = 0.9. 2-4/wk: RR = 0.8. 5-6/wk: RR = 1.0. ≥ 1/day: RR = 0.8. age, smoking (past, current, amount in 1980), and age of starting to smoke |
11) Voorrips LE (2000) | The Netherlands Cohort Study | 62,573 women and 58,279 men aged 55-69. | 6.3 | (1986-1992) 910? | lung cancer risk | tomatoes | RR = 1.0 (0.9-1.1; No P value) per 25 g/day increment. | age, sex, current smoker, years of smoking cigarettes, habitual number of cigarettes per day, highest educational level, family history of lung cancer and the other vegetables of the raw vegetable group. |
10) Steinmetz KA (1993) | The Iowa Women's Health Study. | 35,115 women aged 55-69. | 4 | (1986-1989) 138? | Lung cancer incidence | Tomatoes |
OR = 1.00 (0.61-1.64; P = 0.99) for the highest vs lowest tertile of consumption. | Amount specific data (servings/wk): ≤ 0.5: OR = 1. 1.0: OR = 1.57 (1.00-2.50). ≥ 3.0: OR = 1.00 (0.61-1.64). Age, energy intake, and pack-years of smoking. |
10) Steinmetz KA (1993) | The Iowa Women's Health Study. | 35,115 women aged 55-69. | 4 | (1986-1989) 138? | Lung cancer incidence | High lycopene (> 5 mg/100 g) (Tomatoes; tomato juice; tomato sauce; and V-8 juice) |
OR = 1.21 (0.69-2.10; P = 0.53) for the highest vs lowest quartile of consumption. | Amount specific data (servings/wk): ≤ 1: OR = 1. 2: OR = 1.22 (0.72-2.04). 3-4: OR = 1.25 (0.73-2.10). ≥ 5: OR = 1.21 (0.69-2.10). Age, energy intake, and pack-years of smoking. |
7) Fraser GE (1991) | The Adventist Health Study | 34,198 white California seventh-day adventists. | (USA) 6 | (1977-1982) 55 | Lung cancer risk | Tomatoes (cooked and fresh) |
RR = 1.24 (0.51-2.99; P = 0.79) for the highest vs lowest tertile of consumption. | Amount specific data (times/week): < 3: RR = 1. 3-6: RR = 1.03 (0.52-2.04). ≥ 7: RR = 1.24 (0.51-2.99). Age, sex, and smoking history |
2) Kvale G (1983) | No cohort name. | 10,602 men. | (Norway) 11.5 | (1967-1978) All: 76. | Squamous and small cell: 47. Lung cancer risk | Tomatoes |
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Age, cigarette smoking, region and urban/rural place of residence. |
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