F Bravi1, V Edefonti2, G Randi3, W Garavello4, C La Vecchia5, M Ferraroni2, R Talamini6, S Franceschi7, A Decarli8. 1. Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan; Section of Medical Statistics and Biometry 'G.A. Maccacaro', Department of Occupational Medicine, University of Milan, Milan. Electronic address: francesca.bravi@marionegri.it. 2. Section of Medical Statistics and Biometry 'G.A. Maccacaro', Department of Occupational Medicine, University of Milan, Milan. 3. Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan. 4. Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan; Department of Otorhinolaryngology, DNTB, University of Milano-Bicocca, Monza. 5. Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan; Section of Medical Statistics and Biometry 'G.A. Maccacaro', Department of Occupational Medicine, University of Milan, Milan. 6. Unity of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pn), Italy. 7. International Agency for Research on Cancer, Lyon, France. 8. Section of Medical Statistics and Biometry 'G.A. Maccacaro', Department of Occupational Medicine, University of Milan, Milan; S.C. Medical Statistics, Biometry and Bioinformatics, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
Abstract
BACKGROUND: The role of dietary habits on esophageal cancer risk has been rarely considered in terms of dietary patterns. PATIENTS AND METHODS: We analyzed data from an Italian case-control study, including 304 cases with squamous cell carcinoma of the esophagus and 743 hospital controls. Dietary habits were evaluated using a food frequency questionnaire. A posteriori dietary patterns were identified through principal component factor analysis performed on 28 selected nutrients. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from multiple logistic regression models applied on quartiles of factor scores, adjusting for potential confounding variables. RESULTS: We identified five major dietary patterns, named 'animal products and related components', 'vitamins and fiber', 'starch-rich', 'other polyunsaturated fatty acids and vitamin D', and 'other fats'. The 'animal products and related components' pattern was positively related to esophageal cancer (OR = 1.64, 95% CI:1.06-2.55, for the highest versus the lowest quartile of factor scores category). The 'vitamins and fiber' (OR = 0.50, 95% CI: 0.32-0.78) and the 'other polyunsaturated fatty acids and vitamin D' (OR = 0.48, 95% CI: 0.31-0.74) were inversely related to esophageal cancer. No significant association was observed for the other patterns. CONCLUSION: Our findings suggest that a diet rich in foods from animal origin and poor in foods containing vitamins and fiber increase esophageal cancer risk.
BACKGROUND: The role of dietary habits on esophageal cancer risk has been rarely considered in terms of dietary patterns. PATIENTS AND METHODS: We analyzed data from an Italian case-control study, including 304 cases with squamous cell carcinoma of the esophagus and 743 hospital controls. Dietary habits were evaluated using a food frequency questionnaire. A posteriori dietary patterns were identified through principal component factor analysis performed on 28 selected nutrients. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from multiple logistic regression models applied on quartiles of factor scores, adjusting for potential confounding variables. RESULTS: We identified five major dietary patterns, named 'animal products and related components', 'vitamins and fiber', 'starch-rich', 'other polyunsaturated fatty acids and vitamin D', and 'other fats'. The 'animal products and related components' pattern was positively related to esophageal cancer (OR = 1.64, 95% CI:1.06-2.55, for the highest versus the lowest quartile of factor scores category). The 'vitamins and fiber' (OR = 0.50, 95% CI: 0.32-0.78) and the 'other polyunsaturated fatty acids and vitamin D' (OR = 0.48, 95% CI: 0.31-0.74) were inversely related to esophageal cancer. No significant association was observed for the other patterns. CONCLUSION: Our findings suggest that a diet rich in foods from animal origin and poor in foods containing vitamins and fiber increase esophageal cancer risk.
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