Abstract
BackgroundDietary habits influence the risk of cancer of the oesophagus and oesophago-gastric junction, but the role of proportions of the main dietary macronutrients carbohydrates, fats and proteins is uncertain.MethodsData was derived from a nationwide Swedish population-based case-control study conducted in 1995–1997, in which case ascertainment was rapid, and all cases were uniformly classified. Information on the subjects' history of dietary intake was collected in personal interviews. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression, with adjustment for potentially confounding factors.ResultsIncluded were 189 oesophageal adenocarcinomas, 262 oesophago-gastric adenocarcinomas, 167 oesophageal squamous cell carcinomas, and 820 control subjects. Regarding oesophageal or oesophago-gastric junctional adenocarcinoma, a high dietary proportion of carbohydrates decreased the risk (OR 0.50, CI 0.34–0.73), and a high portion of fat increased the risk (OR 1.96, CI 1.34–2.87), while a high proportion of protein did not influence the risk (OR 1. 08, 95% CI 0.75–1.56). Regarding oesophageal squamous cell carcinoma, the single macronutrients did not influence the risk statistically significantly.ConclusionsA diet with a low proportion of carbohydrates and a high proportion of fat might increase the risk of oesophageal adenocarcinoma.
Highlights
Oesophageal cancer is characterised by a poor prognosis and a high incidence [1]
Risk of oesophago-gastric junctional adenocarcinoma A high proportion of carbohydrate intake was associated with a more than halved risk of oesophago-gastric junctional adenocarcinoma compared to a low proportion (Table 3). 10% increase in the proportion of carbohydrates showed an adjusted Odds ratios (ORs) of 0.73
A high fat proportion intake increased the risk, and those who consumed protein in the highest quartile were at a 2-fold increased risk of oesophago-gastric junctional adenocarcinoma compared to those in the lowest quartile, with a 10% increase corresponding to an OR of 1.62 in the model with continuous exposure
Summary
Oesophageal cancer is characterised by a poor prognosis (the 5year survival rate is less than 10%) and a high incidence (the 8th most common cancer globally) [1]. The incidence of adenocarcinoma of the oesophageal and oesophagogastric junction, on the other hand, has increased rapidly in Western populations, [3] and currently adenocarcinoma is more common than squamous cell carcinoma in several industrialised populations, in white men [2]. No study has addressed how the proportions of the main dietary nutrients, i.e. carbohydrates, protein, and fat, influence the risk of these tumours. This study aimed to reveal associations between the proportions of the three main dietary nutrients and the risk of developing oesophageal cancer by histological type. Dietary habits influence the risk of cancer of the oesophagus and oesophago-gastric junction, but the role of proportions of the main dietary macronutrients carbohydrates, fats and proteins is uncertain
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