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Dietary inflammatory index and risk of esophageal squamous cell cancer in a case–control study from Italy

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Abstract

Purpose

Diet and inflammation have been suggested to be important risk factors for esophageal squamous cell cancer (ESCC). In this study, we examined the association between the dietary inflammatory index (DII) and ESCC in a case–control study conducted between 1992 and 1997 in Italy.

Methods

This study included 304 ESCC cases and 743 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a reproducible and valid 78-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) conditioned on age, sex, year of interview, and area of residence and adjusted for education, smoking, alcohol drinking, BMI, physical activity, and aspirin use. Energy adjustment was performed using the residual method.

Results

Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of ESCC, with the DII being used as both a continuous variable (ORcontinuous 1.39, 95 % confidence interval, CI, 1.25–1.54; one-unit increase corresponding to ≈12 % of its range in the current study) and a categorical variable (ORquintile5vs1 2.46, 95 % CI 1.40–4.36; p trend < 0.001).

Conclusion

These results indicate that a pro-inflammatory diet is associated with a higher risk of ESCC, even after controlling for alcohol and tobacco exposure.

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Acknowledgments

This study was supported by the Italian Foundation for Research on Cancer (FIRC), the National Cancer Institute grant R01 CA39742 and the Italian Ministry of Health, General Directorat of European and International Relations. Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases.

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Authors and Affiliations

  1. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA

    Nitin Shivappa & James R. Hébert

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Nitin Shivappa & James R. Hébert

  3. SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, PN, Italy

    Antonella Zucchetto & Diego Serraino

  4. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

    Antonella Zucchetto, Marta Rossi & Carlo La Vecchia

Authors
  1. Nitin Shivappa
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  2. Antonella Zucchetto
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  3. Diego Serraino
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  5. Carlo La Vecchia
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  6. James R. Hébert
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Correspondence to Nitin Shivappa.

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Disclosure

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI. The subject matter of this paper will have no direct bearing on the work of CHI, nor has any CHI-related activity exerted any influence on this project.

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Shivappa, N., Zucchetto, A., Serraino, D. et al. Dietary inflammatory index and risk of esophageal squamous cell cancer in a case–control study from Italy. Cancer Causes Control 26, 1439–1447 (2015). https://doi.org/10.1007/s10552-015-0636-y

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  • DOI: https://doi.org/10.1007/s10552-015-0636-y

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