Ultra-processed food consumption and risk of lung cancer: Results from a Prospective Study

Background and AimsThere is limited evidence on the link between ultra-processed food (UPF) intake and the risk of lung cancer (LC). This study examined the association between UPF and LC risk using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer trial. MethodsThis study involved PLCO participants (n = 96,607, aged [≥] 55 years) who were followed between 1998 and 2009. Food items were categorized based on the NOVA classification. Cox regression models with inverse probability of censoring weighting (IPCW) were utilized to estimate the association between UPF intake and LC risk. The joint effect of UPF and diabetes was explored using additive hazard models to calculate the additional number of LC cases. ResultsDuring a median follow-up period of 9.4 years, 1,596 incident LC cases were identified. UPF consumption (in %gram/day) showed no significant association with the overall risk of LC. However, adults with diabetes in the highest quintile of UPF intake had a significantly higher risk of LC (HR = 2.44; 95% CI: 1.27, 4.67) compared to participants without diabetes. A small excess risk due to the interaction between UPF and diabetes (0.13; 95% CI -0.32, 0.58) was observed, resulting in an additional 201 cases of LC per 105 person-years (95% CI: 70, 332) attributed to the highest UPF intake and diabetes interaction. Furthermore, a 10% increment in UPF intake (%kcal/day) increased the risk of LC by 32%. ConclusionsWhile UPF, in terms of weight contribution, is associated with a higher risk of LC in participants with diabetes, UPF (in %kcal/day), is associated with an increased risk of LC in all participants. Lowering UPF intake may help reduce the risk of LC in both diabetic patients and the general population.