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Research Article

Raw Garlic Consumption as a Protective Factor for Lung Cancer, a Population-Based Case–Control Study in a Chinese Population

Zi-Yi Jin, Ming Wu, Ren-Qiang Han, Xiao-Feng Zhang, Xu-Shan Wang, Ai-Ming Liu, Jin-Yi Zhou, Qing-Yi Lu, Zuo-Feng Zhang and Jin-Kou Zhao
Zi-Yi Jin
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Ming Wu
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Ren-Qiang Han
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Xiao-Feng Zhang
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Xu-Shan Wang
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Ai-Ming Liu
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Jin-Yi Zhou
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Qing-Yi Lu
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Zuo-Feng Zhang
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Jin-Kou Zhao
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
1Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention; 2Department of Epidemiology and Statistic, School of Public Health, Nanjing Medical University, Nanjing; 3Ganyu County Center for Disease Control and Prevention, Ganyu; 4Dafeng County Center for Disease Control and Prevention, Dafeng, Jiangsu, China; 5Center for Human Nutrition, David Geffen School of Medicine; and 6Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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DOI: 10.1158/1940-6207.CAPR-13-0015 Published July 2013
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Article Figures & Data

Tables

  • Table 1.

    Demographic information and socioeconomic status of cases and controls

    VariablesCase (%; N = 1,424)Control (%; N = 4,543)Pa
    Study area
     Dafeng625 (43.9)2,533 (55.8)
     Ganyu799 (56.1)2,010 (44.2)
    Gender
     Male995 (69.9)3,415 (75.2)
     Female429 (30.1)1,128 (24.8)<0.001
    Age, y
     Mean (SD)63.3 (11.1)64.0 (11.3)0.037
     <50166 (11.7)499 (11.0)
     50-328 (23.0)989 (21.8)
     60-468 (32.9)1,440 (31.7)
     70-387 (27.2)1,309 (28.8)
     ≥8075 (5.3)306 (6.7)0.173
    Education level
     Illiteracy706 (49.6)2,309 (50.8)
     Primary466 (32.7)1,393 (30.7)
     Middle197 (13.8)644 (14.2)
     High44 (3.1)174 (3.8)
     College11 (0.8)23 (0.5)0.300
    Income 10 years ago (Yuan/year)
     Mean (SD)2,260 (2170)2,220 (2481)0.565
     <1,000284 (19.9)959 (21.1)
     1,000-266 (18.7)843 (18.6)
     1,500-380 (26.7)1,234 (27.2)
     ≥2500494 (34.7)1,507 (33.2)0.670
    BMIb
     Mean (SD)22.2 (4.3)22.8 (3.6)<0.001
     <18.5204 (14.3)307 (6.8)
     18.5–23.9862 (60.5)2,881 (63.4)
     24.0–27.9285 (20.0)1,103 (24.3)
     ≥28.073 (5.1)252 (5.5)<0.001
    • ↵aOn the basis of χ2 testing; t testing for the mean.

    • ↵bChinese recommend standard was used for the cutoff points of overweight and obesity: low weight (BMI < 18.5), overweight (BMI ≥ 24.0 and BMI < 28.0), obesity (BMI ≥ 28.0).

  • Table 2.

    The distribution of major factors and their associations with lung cancer risk

    VariablesCase (%; N = 1,424)Control (%; N = 4,543)Crude OR (95% CI)Adjusted OR (95% CI)a
    Ever smoking
     No394 (27.7)1,860 (40.9)1.001.00
     Yes1,030 (72.3)2,683 (59.1)1.81 (1.59–2.07)2.54 (2.17–2.99)
    Pack-years of smoking
     Never smoker394 (27.7)1,860 (40.9)1.001.00
     <30 y262 (18.4)1,088 (23.9)1.14 (0.96–1.35)1.60 (1.32–1.94)
     ≥30 y768 (53.9)1,595 (35.1)2.27 (1.98–2.61)3.68 (3.08–4.40)
     Ptrend<0.001<0.001
    Alcohol drinking status
     Never or seldom837(58.8)2,782 (61.2)1.001.00
     Often587(41.2)1,761 (38.8)1.11 (0.98–1.25)1.04 (0.90–1.19)
    Factory nearby
     No1 216 (86.7)4,021 (89.9)1.001.00
     Yes186 (13.3)450 (10.1)1.37 (1.14–1.64)1.55 (1.28–1.89)
    High-temperature cooking oil
     No911 (64.0)3,194 (70.3)1.001.00
     Yes513 (36.0)1,349 (29.7)1.33 (1.18–1.51)1.26 (1.10–1.43)
    Consumption of fried food
     No651 (45.7)2,539 (55.9)1.001.00
     Yes773 (54.3)2,004 (44.1)1.50 (1.34–1.70)1.32 (1.15–1.52)
    Poor ventilation in kitchen
     No558 (39.2)1,944 (42.8)1.001.00
     Yes866 (60.8)2,599 (57.2)1.16 (1.03–1.31)1.12 (0.98–1.28)
    Family history of lung cancer
     No1,356 (95.2)4,433 (97.6)1.001.00
     Yes68 (4.8)110 (2.4)2.02 (1.49–2.75)1.98 (1.42–2.74)
    Green tea drinking
     No952 (71.2)3,028 (71.9)1.001.00
     Yes386 (28.8)1,186 (28.1)1.04 (0.90–1.19)0.85 (0.73–1.00)
    Exercise ten years ago
     No1,111 (78.0)3,543 (78.0)1.001.00
     Yes313 (22.0)1,000 (22.0)1.00 (0.87–1.15)0.82 (0.70–0.96)
    • ↵aAdjusted on age (continuous), gender (male = 1, female = 0), education level (illiteracy = 1, primary = 2, middle = 3, high = 4, college = 5), income (Yuan/year) 10 years ago (continuous), BMI (continuous), family history of lung cancer (yes = 1, no = 0), pack-year of smoking (continuous, except for variable of ever smoking), ethanol consumption (mL/week, continuous, except for variable of alcohol drinking status), and study area (Dafeng = 1, Ganyu = 2).

  • Table 3.

    The association between lung cancer and raw garlic consumption frequency stratified by major factors

    Nevera<2 times/week≥2 times/week
    Stratification variablesCase/controlCase/controlAdjusted OR (95% CI)bCase/controlAdjusted OR (95% CI)bPtrendb
    All raw garlic704/2,423594/1,6370.92 (0.79–1.08)126/4830.56 (0.44–0.72)<0.001
    Study area
     Dafeng515/1,954101/5200.71 (0.56–0.92)9/590.43 (0.20–0.91)0.001
     Ganyu189/469493/1,1171.15 (0.94–1.42)117/4240.66 (0.50–0.88)0.013
    Tobacco smoking
     Never smoker194/1,095165/5910.95 (0.72–1.26)35/1740.67 (0.43–1.05)0.137
     All smokers510/1,328429/1,0460.87 (0.73–1.05)91/3090.56 (0.42–0.74)0.000
     <30 y129/575119/4160.97 (0.69–1.36)14/970.42 (0.22–0.80)0.046
     ≥30 y381/753310/6300.86 (0.69–1.08)77/2120.58 (0.41–0.80)0.002
    Alcohol drinking status
     Never or seldom427/1,572343/9400.98 (0.80–1.19)67/2700.59 (0.42–0.81)0.010
     Often277/851251/6970.86 (0.67–1.10)59/2130.56 (0.38–0.82)0.005
    Factory nearby
     No571/2,076533/1,4970.98 (0.83–1.16)112/4480.60 (0.46–0.78)0.002
     Yes120/30153/1210.73 (0.45–1.17)13/280.37 (0.16–0.89)0.024
    High-temperature cooking oil
     No420/1,687410/1,1691.02 (0.84–1.24)81/3380.57 (0.41–0.78)0.006
     Yes284/736184/4680.80 (0.62–1.03)45/1450.57 (0.38–0.85)0.004
    Consumption of fried food
     No455/1,714163/6720.81 (0.65–1.02)33/1530.64 (0.41–0.98)0.016
     Yes249/709431/9650.92 (0.74–1.14)93/3300.49 (0.36–0.67)<0.001
    Poor ventilation in kitchen
     No288/1,080222/6590.92 (0.72–1.18)48/2050.52 (0.35–0.78)0.007
     Yes416/1,343372/9780.92 (0.75–1.12)78/2780.58 (0.42–0.79)0.003
    Family history of lung cancer
     No661/2,343572/1,6130.92 (0.79–1.08)123/4770.57 (0.44–0.73)<0.001
     Yes43/8022/241.09 (0.48–2.46)3/60.26 (0.04–1.63)0.430
    Green tea drinking
     No528/1,790358/9500.86 (0.71–1.04)66/2880.44 (0.32–0.60)<0.001
     Yes128/430210/5841.11 (0.83–1.50)48/1720.77 (0.50–1.19)0.410
    Exercise 10 years ago
     No608/2,074410/1,1480.84 (0.70–1.00)93/3210.54 (0.40–0.72)<0.001
     Yes96/349184/4891.28 (0.92–1.77)33/1620.67 (0.41–1.10)0.332
    • ↵aThe reference group.

    • ↵bAdjusted on age (continuous), gender (male = 1, female = 0), education level (illiteracy = 1, primary = 2, middle = 3, high = 4, college = 5), income (Yuan/year) 10 years ago (continuous), BMI (continuous), family history of lung cancer (yes = 1, no = 0, except for variable of family history of lung cancer), pack-year of smoking (continuous, except for variable of tobacco smoking), ethanol consumption (mL/week, continuous, except for variable of alcohol drinking status), and study area (Dafeng = 1, Ganyu = 2, except for variable of study area).

  • Table 4.

    The effect modification of lung cancer risk between raw garlic consumption and major risk factors

    VariablesRaw garlic consumptionCase/controlCrude OR (95% CI)Adjusted OR (95% CI)a
    Pack-years of smoking
     ≥30 yNo381/7531.001.00
     ≥30 yYesb387/8420.91 (0.77–1.08)0.68 (0.56–0.83)
     <30 yNo129/5750.44 (0.35–0.56)0.38 (0.30–0.48)
     <30 yYes133/5130.51 (0.41–0.64)0.34 (0.26–0.43)
     NeverNoc194/10950.35 (0.29–0.43)0.21 (0.17–0.27)
     NeverYes200/7650.52 (0.42–0.63)0.24 (0.19–0.31)
    InteractionaAdditive:RERI = −0.40 (95% CI, −0.60–−0.20)
    AP = −0.21 (95% CI, −0.32–−0.09)
    SI = 0.70 (95% CI, 0.57–0.85)
    Multiplicative:ROR = 0.78 (95% CI, 0.67–0.90)
    High-temperature cooking oil
     YesNob284/7361.001.00
     YesYes229/6130.97 (0.79–1.19)0.74 (0.59–0.92)
     NoNo420/1,6870.65 (0.54–0.77)0.71 (0.59–0.85)
     NoYesc491/1,5070.84 (0.71–1.00)0.68 (0.56–0.82)
    InteractionaAdditive:RERI = 0.35 (95% CI, 0.04–0.65)
    AP = 0.23 (95% CI, 0.04–0.43)
    SI = 3.56 (95% CI, 0.42–30.46)
    Multiplicative:ROR = 0.77 (95% CI, 0.59–1.00)
    Consumption of fried food
     YesNob249/7091.001.00
     YesYes524/1,2951.15 (0.97–1.38)0.91 (0.74–1.11)
     NoNo455/1,7140.76 (0.63–0.90)0.82 (0.68–1.00)
     NoYesc196/8250.68 (0.55–0.84)0.61 (0.48–0.76)
    InteractionaAdditive:RERI = −0.20 (95% CI, −0.59–0.18)
    AP = −0.12 (95% CI, −0.36–0.11)
    SI = 0.76 (95% CI, 0.47–1.23)
    Multiplicative:ROR = 1.23 (95% CI, 0.94–1.61)
    • ↵aAdjusted on age (continuous), gender (male = 1, female = 0), education level (illiteracy = 1, primary = 2, middle = 3, high = 4, college = 5), income (Yuan/year) 10 years ago (continuous), BMI (continuous), family history of lung cancer (yes = 1, no = 0), pack-year of smoking (continuous, except for variable of ever smoking), ethanol consumption (mL/week, continuous), and study area (Dafeng = 1, Ganyu = 2).

    • ↵bThe joint effects category for further estimation of additive interaction.

    • ↵cThe reference category for measures of interaction on additive scale.

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Cancer Prevention Research: 6 (7)
July 2013
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Raw Garlic Consumption as a Protective Factor for Lung Cancer, a Population-Based Case–Control Study in a Chinese Population
Zi-Yi Jin, Ming Wu, Ren-Qiang Han, Xiao-Feng Zhang, Xu-Shan Wang, Ai-Ming Liu, Jin-Yi Zhou, Qing-Yi Lu, Zuo-Feng Zhang and Jin-Kou Zhao
Cancer Prev Res July 1 2013 (6) (7) 711-718; DOI: 10.1158/1940-6207.CAPR-13-0015

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Raw Garlic Consumption as a Protective Factor for Lung Cancer, a Population-Based Case–Control Study in a Chinese Population
Zi-Yi Jin, Ming Wu, Ren-Qiang Han, Xiao-Feng Zhang, Xu-Shan Wang, Ai-Ming Liu, Jin-Yi Zhou, Qing-Yi Lu, Zuo-Feng Zhang and Jin-Kou Zhao
Cancer Prev Res July 1 2013 (6) (7) 711-718; DOI: 10.1158/1940-6207.CAPR-13-0015
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