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Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett’s esophagus onset and evolution to esophageal adenocarcinoma: results from a pilot study in a high-risk population

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Abstract

Purpose

While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett’s esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle.

Methods

Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression.

Results

Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 % CI 0.37–0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 %, p = 0.001), sedentary habits (from 33.3 to 0 %, p = 0.03), fruit consumption (from 37.0 to 5.6 %, p = 0.02) and processed meat consumption (from 51.9 to 10.5 %, p = 0.002).

Conclusion

Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.

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Authors and Affiliations

  1. Digestive Endoscopy Unit, Veneto Institute of Oncology IOV – I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy

    Stefano Realdon, Alessandro Antonello & Giorgio Battaglia

  2. Venetian Institute for Molecular Medicine, Via Orus 2, 35128, Padua, Italy

    Diletta Arcidiacono, Elisa Dassie & Alfredo Alberti

  3. Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Diletta Arcidiacono

  4. Oncological Surgery Unit, Veneto Institute of Oncology IOV – I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy

    Francesco Cavallin

  5. Department of Medicine, Surgical Pathology and Cytopathology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Matteo Fassan & Massimo Rugge

  6. Clinical Nutrition Unit, Veneto Institute of Oncology IOV – I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy

    Maria Teresa Nardi

  7. Department of Molecular Medicine, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Alfredo Alberti

Authors
  1. Stefano Realdon
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  2. Alessandro Antonello
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  3. Diletta Arcidiacono
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  4. Elisa Dassie
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  5. Francesco Cavallin
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  6. Matteo Fassan
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  7. Maria Teresa Nardi
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  9. Massimo Rugge
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  10. Giorgio Battaglia
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Correspondence to Stefano Realdon.

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Realdon, S., Antonello, A., Arcidiacono, D. et al. Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett’s esophagus onset and evolution to esophageal adenocarcinoma: results from a pilot study in a high-risk population. Eur J Nutr 55, 1563–1571 (2016). https://doi.org/10.1007/s00394-015-0975-1

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  • DOI: https://doi.org/10.1007/s00394-015-0975-1

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