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Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort

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Abstract

Few prospective studies have investigated the association between whole-grain consumption and incidence of oesophageal cancer. In the Scandinavian countries, consumption of whole grains is high and the incidence of oesophageal cancer comparably low. The aim of this paper was to study the associations between consumption of whole grains, whole-grain products and oesophageal cancer, including its two major histological subtypes. The HELGA cohort is a prospective cohort study consisting of three sub-cohorts in Norway, Sweden and Denmark. Information regarding whole-grain consumption was collected through country-specific food frequency questionnaires. Cancer cases were identified through national cancer registries. Cox proportional hazards ratios were calculated in order to assess the associations between whole grains and oesophageal cancer risk. The analytical cohort had 113,993 members, including 112 cases, and median follow-up time was 11 years. When comparing the highest tertile of intake with the lowest, the oesophageal cancer risk was approximately 45 % lower (adjusted HR 0.55, 95 % CI 0.31–0.97 for whole grains, HR 0.51, 95 % CI 0.30–0.88 for whole-grain products). Inverse associations were also found in continuous analyses. Whole-grain wheat was the only grain associated with lower risk (HR 0.32, 95 % CI 0.16–0.63 highest vs. lowest tertile). Among whole-grain products, the results were less clear, but protective associations were seen for the sum of whole-grain products, and whole-grain bread. Lower risk was seen in both histological subtypes, but particularly for squamous cell carcinomas. In this study, whole-grain consumption, particularly whole-grain wheat, was inversely associated with risk of oesophageal cancer.

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Abbreviations

CI:

Confidence interval

FFQ:

Food frequency questionnaire

HR:

Hazard rate

MJ:

Mega Joule

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Acknowledgments

The authors would like to thank Knut Hansen for assistance with data management. Some of the data in this article are from the Cancer Registry of Norway. The Cancer Registry of Norway is not responsible for the analysis or interpretation of the data presented. NordForsk Centre of Excellence Programme—HELGA, Grant No. 070015, funded this work. LAÅ was supported by a grant from the Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds. The Västerbotten Intervention Programme has been supported by the Joint Committee of the Northern Sweden Health Care Region, Västerbotten County Council, the Swedish Research Council, the Swedish Council for Working Life and Social Research, the Cancer Research Foundation in Northern Sweden.

Conflict of interest

The authors have no conflict of interest.

Ethical standards

The local medical ethics review boards and other relevant authorities in Norway, Sweden and Denmark approved the studies, and the participants provided informed consent.

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Authors and Affiliations

  1. Department of Community Medicine, University of Tromsø – The Arctic University of Norway, P.O. Box 6020, Langnes, 9037, Tromsø, Norway

    Guri Skeie, Tonje Braaten, Lene Angell Åsli, Elisabete Weiderpass & Eiliv Lund

  2. Danish Cancer Society Research Center, Copenhagen, Denmark

    Anja Olsen, Cecilie Kyrø & Anne Tjønneland

  3. Swedish University of Agricultural Sciences, Uppsala, Sweden

    Rikard Landberg

  4. Arctic Research Centre, Umeå University (Arcum), Umeå, Sweden

    Lena Maria Nilsson

  5. Nutritional Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    Lena Maria Nilsson & Maria Wennberg

  6. Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark

    Kim Overvad

  7. Department of Research, Cancer Registry of Norway, Oslo, Norway

    Elisabete Weiderpass

  8. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Elisabete Weiderpass

  9. Samfundet Folkhälsan, Helsinki, Finland

    Elisabete Weiderpass

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  1. Guri Skeie
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Correspondence to Guri Skeie.

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Skeie, G., Braaten, T., Olsen, A. et al. Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort. Eur J Epidemiol 31, 405–414 (2016). https://doi.org/10.1007/s10654-015-0057-y

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  • DOI: https://doi.org/10.1007/s10654-015-0057-y

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