Abstract
Background: Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII®) and the risk of CRC and CAP in an Iranian case-control study. Methods: 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders. Results: The E-DII score ranged between −4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score). The multivariable-adjusted ORs for participants in the 3rd tertile compared to the 1st tertile was 5.08 (95%CI: 2.70–9.56; P-trend < 0.0001) for CRC and 2.33 (95% CI: 1.30–4.02; P-trend = 0.005) for CAP. Conclusions: Our findings suggest that more pro-inflammatory diets, indicated by higher E-DII scores, might increase the risk of both CRC and CAP. Future steps should include testing these associations in a prospective setting in Iran.
Highlights
As per the GLOBOCAN [i.e., International Agency for Research on Cancer (IARC)] 2018 data, it is estimated that 1.8 million cases of colorectal cancer were diagnosed in 2018
A significant body of evidence suggests that chronic inflammation and associated conditions such as inflammatory bowel disease play a central role in colorectal cancer (CRC) and colorectal adenomatous polyps (CAP) pathogenesis by stimulating cell proliferation, angiogenesis and DNA damage [9,10,11]
The Energy-adjusted DII (E-DII) scores in this study ranged from −4.23 to +3.89
Summary
As per the GLOBOCAN [i.e., International Agency for Research on Cancer (IARC)] 2018 data, it is estimated that 1.8 million cases of colorectal cancer were diagnosed in 2018. Colorectal cancer (CRC) is the 3rd most common and the 4th most deadly cancer worldwide [1]. A significant body of evidence suggests that chronic inflammation and associated conditions such as inflammatory bowel disease play a central role in CRC and colorectal adenomatous polyps (CAP) pathogenesis by stimulating cell proliferation, angiogenesis and DNA damage [9,10,11]. Several mechanisms including increasing insulin resistance [12], and activation of the COX-2 pathway could provide ways to express diet-related inflammation in CRC and CAP [13]. Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). The present study aimed to investigate the association between the dietary inflammatory index (DII® ) and the risk of CRC and CAP in an Iranian case-control study. Results: The E-DII score ranged between −4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score)
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