P-185 Dietary factors in gastrointestinal cancers: A hospital-based case-control study

Abstract

Cancer is the sixth leading cause of death worldwide. However, thirty-five percent of all cancer deaths may be preventable by alterations in diet. Relationship between diet and cancer has for long been an intriguing research domain but even within the hospital and population-based cancer registry networks, such relationships have only been minimally investigated due to problems with measurement of diet, long latent periods between diet and development of cancers, and complex natural history of the disease itself. A case-control study, comprised of 171 cases, 151 healthy controls, and 167 hospital controls, was conducted in Regional Cancer Centre, Jammu under the Hospital-Based Cancer Registry project to evaluate the relationship between diet and selected GI cancers (oesophageal, stomach and colorectal) using a food frequency questionnaire method. The individual analysis of food groups showed 2-3 times increased risk of gastrointestinal cancers with hot and salted tea. Alcohol consumption [OR 2.30(1.32-4)] and smoking [OR (2.77(1.77-4.33)] emerged as risk factors when comparisons were made with healthy controls among in whom freshly prepared food had a significant protective effect [OR 0.57(0.37-0.88)]. Sweet tea showed a protective effect both in hospital and healthy controls (OR 0.33 and 0.26, respectively). Intake of NSAIDS and other medications was also associated with a significantly higher risk of GI cancers (3-4 times). Consumption of dietary fibres from cereals (wheat, pulses, and rice) showed a reduced risk of gastrointestinal cancers which were significant in the case of wheat and pulses but insignificant in the case of rice. Consumption of non-vegetarian food was higher among cases across all the various non-vegetarian food groups. Consumption of green–leafy vegetables, non-green leafy vegetables, raw vegetables, and fruit showed significant protective effect ranging from 20-80% while the intake of non-vegetarian foods showed significantly higher odds of GI cancers in both hospital and healthy controls (OR ranging from 2.37- 13.4). The odds of patients with GI cancer having consumed chutneys, fruit and vegetable pickles were significantly higher in comparison to healthy controls (OR 2.06, 1.97 and 3.61 respectively) while consumption of dairy products showed some protective effect. Low and medium intake of mixed spices inclusive of curcumin indicated protection from GI cancers (OR 0.13, 0.39, respectively) while intake of red chilies was associated with 2-30 times significantly higher odds of GI cancers. We have been able to generate evidence of a relationship between certain locally consumed food items and cancers, in spite of the existence of potential confounding variables that were beyond our control. With these results, we intend to further refine the tools used in this study and plan more extensive and robust studies within the ambit of the Hospital-Based Registry Project in GMC Jammu. We also intend to use this understanding to plan IEC activities for the local population and share our understanding with other stakeholders in the state for policy planning in the context of the expansion of Cancer Control activities in Jammu and Kashmir.