Dietary intake and the risk of malignant mesothelioma

Our plain-English summary of Dietary intake and the risk of malignant mesothelioma, by J.E. Muscat, M. Huncharek (British Journal of Cancer, 1996).

The study

• Authors: J.E. Muscat, M. Huncharek
• Journal: British Journal of Cancer
• Published: 1996;73(9):1122-5
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A high consumption of fruit and vegetables reduces the risk of several types of cancer. There is little information on the association between dietary intake and mesothelioma. A hospital-based case-control study of 94 men and women with malignant mesothelioma and 64 control patients without cancer was conducted to determine the odds associated with consumption of carotenoid-containing fruits and vegetables. After statistical adjustment for occupational asbestos exposure, the odds ratio was 0.2 [95% confidence interval (CI) 0.1-0.8] for carrot consumption and 0.5 (95% CI 0.2-1.4) for tomato consumption. However, the frequency of consuming other foods that have a high vitamin A or carotenoid content was not associated with a decreased risk of cancer. These results provide some justification for the hypothesis that provitamin A or beta-carotene may decrease the risk of mesothelioma. The body mass index was unrelated to the risk of mesothelioma.

In plain English

This hospital-based case-control study examined diet and malignant mesothelioma. It included 94 mesothelioma patients (92 pleural, 2 peritoneal) and 64 hospital patients without cancer. All were interviewed at Memorial Sloan-Kettering Cancer Center in 1985-1993 using a 35-item food frequency questionnaire. Asbestos exposure was judged by occupation (asbestos-related jobs: 60 per cent of cases, 20 per cent of controls), which the analysis adjusted for. Carrot eating at a cut-off of one time per month (the comparison sign is unreadable in the scan) had an odds ratio of 0.2 (95% CI 0.1-0.8) versus never eating carrots. Tomato or tomato-juice consumers, compared with people who never consumed tomatoes, had a non-significant odds ratio of 0.5 (95% CI 0.2-1.4). No association was seen for spinach, broccoli, cabbage, cantaloupe, sweet potatoes, cauliflower, orange juice or red meat. Body mass index showed no clear case-control difference. The authors said the carrot finding could reflect chance, noting low statistical power and crude dietary measures. They concluded the findings suggest a possible protective effect of carotene or vitamin A, needing very cautious interpretation and justifying further research.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: hospital-based case-control study
• Who was studied: 94 patients with histologically confirmed malignant mesothelioma (92 pleural, 2 peritoneal) and 64 control patients without cancer, hospitalised for conditions unrelated to tobacco or diet, at Memorial Sloan-Kettering Cancer Center, New York, 1985 to 1993
• Exposure: Usual adult diet was measured with a 35-item food frequency questionnaire, and vitamin A and beta-carotene indices and body mass index were also calculated. Asbestos exposure was assessed through work in asbestos-related occupations (60 per cent of cases, 20 per cent of controls) and was used for adjustment. No fiber types were named.
• Main results:
  • Carrot consumption at a cut-off of one time per month (the comparison symbol is lost in the scanned text) had an adjusted odds ratio for mesothelioma of 0.2 (95% CI 0.1-0.8), compared with people who never ate carrots
  • People who consumed tomatoes or tomato juice had a reduced but non-significant risk compared with people who never consumed tomatoes (OR = 0.5, 95% CI 0.2-1.4)
  • No association was observed with consumption of spinach, broccoli, cabbage, cantaloupe, sweet potatoes, cauliflower, orange juice or red meat
  • Higher quartiles of the vitamin A and beta-carotene indices, compared with the lowest quartile, showed a reduced but non-significant risk, with no trend in the odds ratios
  • Body mass index showed no clear differences between cases and controls. People in the highest quartile had OR = 0.7 (95% CI 0.2-1.9) compared with the lowest quartile
  • Sixty per cent of cases and 20 per cent of controls worked in occupations classified as asbestos related
• The authors' conclusion: The authors concluded that the findings are suggestive of a possible chemoprotective effect of carotene or vitamin A. They said the lack of statistically significant results or trends requires very cautious interpretation, and that the results should be viewed as possible justification for further research rather than as negative findings.
• Limitations the authors state:
  • The carrot finding could reflect chance because of the multiple case-control comparisons
  • Statistical power to detect differences was relatively low, and food frequency questions are only crude measures of diet
  • The dietary assessment was limited to 35 items and did not assess portion size
  • Using occupation as a stand-in for asbestos exposure may misclassify exposure, and residual confounding from asbestos exposure cannot be ruled out
  • The adjustment for the tomato odds ratio was described as unstable because few controls never consumed tomatoes
  • All patients came from one large cancer hospital, so referral patterns may have introduced selection biases

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Case-Control Study, Asbestos Exposure, Odds Ratio, confidence interval.

Related studies

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• Protective dietary factors and lung cancer — E.T. Fontham (1990)
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• The carcinogenicity of dietary acrylamide intake: a comparative discussion of epidemiological and experimental animal research — J.G. Hogervorst, B.J. Baars, et al. (2010)
• Estimated intake of vitamin D and its interaction with vitamin A on lung cancer risk among smokers — T.Y. Cheng, G.E. Goodman, et al. (2014)
• Increased urinary 8-isoprostaglandin F(2)alpha is associated with lower plasma selenium levels and lower vegetable and fruit intake in an asbestos-exposed cohort at risk for lung cancer — E.B. Gottschall, P. Wolfe, et al. (2004)

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