Abstract
The role of diet-associated inflammation in colorectal cancer is of interest. Accordingly, we aimed to examine whether the dietary inflammatory index (DII) was associated with the risk of colorectal cancer in a case-control study conducted in Korea. The DII was based on dietary intake, which was determined by a 106-item semi-quantitative food frequency questionnaire completed by 923 colorectal cancer cases and 1846 controls. Logistic regression was used to estimate odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by the anatomical site of the cancer, sex, and other risk factors. Higher DII scores were associated with an increased incidence of colorectal cancer (OR (95% CI) = 2.16 (1.71, 2.73) for highest vs. lowest tertile). The magnitude differed by anatomical site and sex. This association was slightly weaker in subjects with proximal colon cancer (1.68 (1.08, 2.61)) and was stronger in women (2.50 (1.64, 3.82)). Additionally, stronger associations were observed in subjects who were older than 50 years (p for interaction = 0.004) and engaged in physical activity (p for interaction < 0.001). Results from this study suggest that diet-associated inflammation may increase the risk of colorectal cancer, and this effect may differ by certain factors, such as anatomical site, age, sex, and lifestyle.
Highlights
Chronic inflammation is known to play an important role in cancer, in colorectal cancer [1]
This study found that a more pro-inflammatory diet was associated with an increased risk of colorectal cancer
The association between colorectal cancer risk and diet-associated inflammation may be modified by factors such as age and physical activity
Summary
Chronic inflammation is known to play an important role in cancer, in colorectal cancer [1]. Evidence suggests that chronic inflammatory bowel disease increases the risk of colorectal cancer development [2,3] and that the long-term use of aspirin and other non-steroidal anti-inflammatory agents is associated with a reduced risk of colorectal cancer [4]. The analysis of individual foods or nutrients does not allow for consideration of the complicated interactions or high inter-correlations between dietary factors, and the effect of any single nutrient may be too small to detect [8] Combining dietary factors, such as in dietary patterns, may overcome these limitations [8], but this methodology may still have difficulty explaining the underlying mechanisms and applying them to diverse populations
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