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The objective of the study was to examine the prognostic effect of dietary intake of fruit and vegetables on lung cancer patients. We used data on 57,053 participants in the Danish prospective cohort study, 'Diet, Cancer and Health'. Patients in whom lung cancer was diagnosed constituted the final study cohort and were followed from the date of diagnosis until the date of death or 11 March 2004. A total of 353 participants had lung cancer. Increasing levels of intake of fruit and vegetables show a tendency toward decreased hazard of dying: the Cox proportional hazard model estimated a hazard ratio (HR) of 0.84 (95% confidence interval [CI], 0.59-1.21) for high intake of vegetables by current smokers and an HR of 0.81 (95% CI, 0.58-1.15) for high intake of fruits with low intake as the reference. In contrast, high intake of potatoes increased the hazard of dying (HR, 1.51; 95% CI, 1.12-2.23). Our study suggests that high intake of fruit and vegetables might have a favourable effect on the prognosis of lung cancer patients, but a high intake of potatoes appears to increase the hazard of dying.

The genetic susceptibility hypothesis has been used to explain why only a minority of smokers develop lung cancer. Only few studies have studied the role of polymorphisms in phase-I and II metabolizing genes, among young lung cancer patients. We have pooled the individual data of three studies from Denmark and Norway, including 320 patients diagnosed with non-small cell lung cancer at age 59 or below, and 618 age and gender matched controls. A questionnaire was used to determine relevant demographic and lifestyle characteristics, and polymorphisms in following genotypes were determined GSTM1, GSTM3, GSTP1, GSTT1, GPX1, MPO, NQO1 and NAT2. Based on the literature, the alleles of the genotypes were categorised as high- or low-risk alleles. No individual effect of the genotypes was found on the risk of lung cancer. Given a smoking exposure, the presence of high-risk alleles (or phenotypes) was generally found to increase the risk of lung cancer, although the effect modification did not reach statistical significance. A pattern of stronger protective effect was observed in carriers of more than one allele associated with lower risk of lung cancer, and a higher risk of lung cancer in carriers of one or more alleles associated with higher risk of lung cancer, but the results did not reach statistical significance. The effect modification was generally strongest at lower levels of smoking.

Recent reports have raised the question, whether the previously observed protective effects of high intake of fruit and vegetables on the risk of lung cancer were due to insufficient adjustment for smoking leading to residual confounding. Association of intake of fruit and vegetables on lung cancer risk was examined, using the Danish prospective cohort study, "Diet, Cancer and Health". Participants completed a food-frequency and lifestyle questionnaire, and age-standardized incidence rates and rate ratios were estimated for quartiles of dietary exposure. In 1993-2001, 247 out of the 54158 participants were diagnosed with lung cancer. The incidence rate of lung cancer was highest in the lowest quartile of intake of plant food (fruit, vegetables, legumes and potatoes) and the age-standardized rate ratio of lung cancer decreased significantly with increasing intake of plant food to 0.35 (95% CI, 0.27-0.45) but after control for smoking it was attenuated to 0.65 (95% CI, 0.45-0.93). The incidence rate differences of current smokers with high (> or = 400 g per day) and low (< 400 g per day) daily intake of plant food were independent of smoking intensity; assuming a true biological protective effect, 80-90 lung cancer cases per 100000 current smokers could be prevented in our cohort if all smokers had a high intake of plant food. The observed inverse association between high intakes of plant food seems chiefly to be a real protective effect, and not solely due to residual confounding., (Copyright 2004 Elsevier Ireland Ltd.)

Pulmonary neuroendocrine tumors are currently considered to consist of three grades of malignancy, ranging from typical and atypical carcinoids to large-cell neuroendocrine carcinoma and small-cell carcinoma. The study reported here is the first population-based study of the demographics of patients with neuroendocrine tumors grouped by histological subtype. A cancer registry-based analysis of patients in Denmark in whom bronchial neuroendocrine tumor was diagnosed in 1978-97 was performed and the patients were followed up to 31 December 1999. Typical carcinoid was diagnosed in 105 patients, atypical carcinoid in 192, large-cell neuroendocrine carcinoma in 50 and small-cell carcinoma in 11,998. The recorded incidence of neuroendocrine tumors other than small-cell carcinoma increased by twofold among men (from 0.24 to 0.53 per 100,000 inhabitants per year) and by threefold in women (from 0.14 to 0.41 per 100,000 inhabitants per year) during the study period, while the incidence of small-cell carcinoma decreased among men and levelled off among women. The prognosis of patients with bronchial neuroendocrine tumors varied with the degree of malignancy; the 5-year survival rate ranged from 87% for patients with typical carcinoids, to 44, 15 and 2% for patients with atypical carcinoids, large-cell neuroendocrine carcinoma and small-cell carcinoma, respectively. In Denmark, the incidence of neuroendocrine tumours is increasing. Our findings support the pathological categorization of neuroendocrine tumors into three grades of malignancy. More research is needed to establish the etiological factors in the development of pulmonary neuroendocrine tumors.

This is a registry-based analysis of 97,281 lung cancer patients diagnosed in Denmark during the period 1943-1994. The development of lung cancer incidence in Denmark in the study period is described and this information is used to predict the future trends in lung cancer in Denmark. Since 1960, lung cancer has been the most frequent type of cancer in Danish men, excluding skin cancer. The incidence in men reached its maximum in 1985, when it was 100 new cases per 100,000 inhabitants, whereafter the incidence began to level off and was 83 per 100,000 inhabitants in 1994. During the study period, the incidence of lung cancer in Danish women was somewhat lower than in men. The incidence in women has been steadily increasing since 1960 by approximately 20% per each 5-year period, and was 46 per 100,000 inhabitants in 1994. Adenocarcinoma is the most frequent histological subtype in women and the only subtype increasing in incidence in men. Taking the actual development into account, the incidence of lung cancer will continue to fall among men and rise among women, leading to a reversal of the classical gender ratio in about 15 years.