Abstract
Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60–2.32; p-trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99–1.52, p-trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26–1.74; p-trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide [1]
CRC cases compared to controls had higher energy-adjusted DII (E-DII) scores, indicating a more pro-inflammatory diet, tended to be older, heavier, and less active, and more frequently classified as having a low education and a family history of CRC (p < 0.001)
breast cancer (BC) cases compared to controls had higher E-DII scores, tended to be younger, and reported more frequently being smokers, premenopausal, and having a first-degree history of BC (p < 0.001)
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide [1]. Beyond non-modifiable risk factors such as age, male sex, family history of CRC, and genetic predisposition [2], epidemiological studies have identified a number of modifiable factors that have a direct impact on CRC risk, for example cigarette smoking, which increases risk [3], and regular use of aspirin, which decreases risk [4]. Breast cancer (BC) and CRC are the two most frequently diagnosed cancers [6,7]. BRCA1 or BRCA2 genes mutations, family history of BC or ovarian cancer, radiation, hormonal factors, physical inactivity, alcohol consumption, tobacco smoking and physical inactivity are important risk factors for BC [8,9]. The role of diet, remains controversial [9]
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