Calcium Intake and Lung Cancer Risk Among Female Nonsmokers: A Report from the Shanghai Women's Health Study

Background: Calcium has been implicated in carcinogenesis and linked to the risk of several cancers in epidemiologic studies; however, few studies have investigated the association of calcium intake with lung cancer risk, particularly among nonsmokers. Methods: We evaluated the association of intakes of calcium and related minerals, assessed through a food frequency questionnaire, with lung cancer risk among 71,267 female nonsmokers who were cancer free at baseline in the Shanghai Women's Health Study, a population-based, prospective cohort study. Multivariate Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results: During follow-up through December 2009 (median follow-up time: 11.2 years), 428 incident lung cancer cases accrued. The median intakes of dietary calcium, magnesium, and phosphorus were 441, 266, and 935 mg/d, respectively. Intakes of calcium, phosphorus, and the calcium-to-magnesium (Ca:Mg) ratio were inversely associated with lung cancer risk. The corresponding HRs (95% CIs) for the highest compared with the lowest quartile were 0.66 (0.48, 0.91) for calcium, 0.55 (0.36, 0.85) for phosphorus, and 0.62 (0.47, 0.82) for the Ca: Mg ratio. No association was observed for dietary magnesium intake or the use of calcium- or vitamin D-containing supplements. Conclusions and Impact: Our study provides some of the first evidence suggesting a possible role for increasing dietary calcium intake in lung cancer prevention among female nonsmokers, especially in populations with relatively low calcium intake. Cancer Epidemiol Biomarkers Prey; 22(1); 50-57. (C) 2012 AACR.