European Journal of Nutrition

, Volume 55, Issue 4, pp 1683–1694 | Cite as

Diet-related inflammation and oesophageal cancer by histological type: a nationwide case–control study in Sweden

  • Yunxia Lu
  • Nitin Shivappa
  • Yulan Lin
  • Jesper Lagergren
  • James R. Hébert
Original Contribution



This project sought to test the role of diet-related inflammation in modulating the risk of oesophageal cancer.


A nationwide population-based case–control study was conducted from 1 December 1994 through 31 December 1997 in Sweden. All newly diagnosed patients with adenocarcinoma of the oesophagus or gastroesophageal junction and a randomly selected half of patients with oesophageal squamous cell carcinoma were eligible as cases. Using the Swedish Registry of the Total Population, the control group was randomly selected from the entire Swedish population and frequency-matched on age (within 10 years) and sex. The literature-derived dietary inflammatory index (DII) was developed to describe the inflammatory potential of diet. DII scores were computed based on a food frequency questionnaire. Higher DII scores indicate more pro-inflammatory diets. Odds ratios and 95 % confidence intervals (CI) were computed to assess risk associated between DII scores and oesophageal cancer using logistic regression adjusted by potential confounders.


In total, 189 oesophageal adenocarcinomas, 262 gastroesophageal junctional adenocarcinomas, 167 oesophageal squamous cell carcinomas, and 820 control subjects were recruited into the study. Significant associations with DII were observed for oesophageal squamous cell carcinoma (ORQuartile4vs1 4.35, 95 % CI 2.24, 8.43), oesophageal adenocarcinoma (ORQuartile4vs1 3.59, 95 % CI 1.87, 6.89), and gastroesophageal junctional adenocarcinoma (ORQuartile4vs1 2.04, 95 % CI 1.24, 3.36). Significant trends across quartiles of DII were observed for all subtypes of oesophageal cancer.


Diet-related inflammation appears to be associated with an increased risk of oesophageal cancer, regardless of histological type.


Diet Inflammation Neoplasm Oesophagus 



We acknowledge the funding support from the Karolinska Institute and the Swedish Research Council. Dr. Hébert was supported by Grant Number U54 CA153461 [Hebert, JR (PI)] from the National Cancer Institute, and the Center to Reduce Cancer Health Disparities (Community Networks Program) to the South Carolina Cancer Disparities Community Network-II (SCCDCN-II). Both Drs. Shivappa and Hébert were supported by Grant Number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases. The contribution of each author was as follows: conceptualisation and design (Yunxia Lu, Nitin Shivappa, and James R. Hebert); data collection and data analysis (Yunxia Lu, Nitin Shivappa, Yulan Lin, Jesper Lagergren); reporting and interpreting results from data analyses (all authors); contribution to critical comments and revisions (all authors); manuscript drafting (Yunxia Lu and Nitin Shivappa); final approval of the version to be published (all authors).

Compliance with Ethical Standards

Conflict of interest

None of the authors claim a conflict of interest.

Disclosure statement

Dr. James R. Hébert owns the controlling interest in Connecting Health Innovations LLC (CHI), a company planning to licence the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smartphone applications for patient counselling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

Supplementary material

394_2015_987_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 kb)
394_2015_987_MOESM2_ESM.docx (46 kb)
Supplementary material 2 (DOCX 45 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Yunxia Lu
    • 1
    • 2
  • Nitin Shivappa
    • 3
    • 4
  • Yulan Lin
    • 1
    • 5
  • Jesper Lagergren
    • 1
    • 6
  • James R. Hébert
    • 3
    • 4
  1. 1.Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
  2. 2.Department of Epidemiology and BiostatisticsImperial College LondonLondonUK
  3. 3.Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaUSA
  4. 4.Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  5. 5.European Palliative Care Research Centre, Department of Cancer Research and Molecular MedicineNorwegian University of Science and TechnologyTrondheimNorway
  6. 6.Division of Cancer StudiesKing’s College LondonLondonUK

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