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Comment & Response
March 19, 2020

Association of Dietary Fiber and Yogurt Consumption With Lung Cancer Risk—Reply

Author Affiliations
  • 1Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA Oncol. Published online March 19, 2020. doi:10.1001/jamaoncol.2020.0270

In Reply We have carefully reviewed the letter from Wu and Leung regarding our recent JAMA Oncology article on fiber and yogurt consumption and lung cancer risk.1 We believe that there were misunderstandings and misinterpretations of the study design and results.

Their main concern about the study conclusion was related to P values we presented in the Supplement (P = .059 in eFigure 1 and P = .055 in eFigure 2).1 Wu and Leung considered these P values as evidence of statistical nonsignificance for overall findings. In fact, these P values represented significance of heterogeneity tests, indicating no statistically significant heterogeneities in lung cancer risk estimates associated with fiber and yogurt intakes across studies. The overall summary estimates for association (hazard ratios), presented in eFigures 1 and 2, were 0.83 (95% CI, 0.76-0.91) for fiber intake and 0.81 (95% CI, 0.76-0.87) for yogurt intake, which were statistically significant.1

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