An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk

S Vingeliene, D S M Chan, A R Vieira, E Polemiti, C Stevens, L Abar, D Navarro Rosenblatt, D C Greenwood, T Norat, S Vingeliene, D S M Chan, A R Vieira, E Polemiti, C Stevens, L Abar, D Navarro Rosenblatt, D C Greenwood, T Norat

Abstract

Background: In the 2007 World Cancer Research Fund/American Institute for Cancer Research Second Expert Report, the expert panel judged that there was strong evidence that alcoholic drinks and body fatness increased esophageal cancer risk, whereas fruits and vegetables probably decreased its risk. The judgments were mainly based on case-control studies. As part of the Continuous Update Project, we updated the scientific evidence accumulated from cohort studies in this topic.

Methods: We updated the Continuous Update Project database up to 10 January 2017 by searching in PubMed and conducted dose-response meta-analyses to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) using random effects model.

Results: A total of 57 cohort studies were included in 13 meta-analyses. Esophageal adenocarcinoma risk was inversely related to vegetable intake (RR per 100 g/day: 0.89, 95% CI: 0.80-0.99, n = 3) and directly associated with body mass index (RR per 5 kg/m2: 1.47, 95% CI: 1.34-1.61, n = 9). For esophageal squamous cell carcinoma, inverse associations were observed with fruit intake (RR for 100 g/day increment: 0.84, 95% CI: 0.75-0.94, n = 3) and body mass index (RR for 5 kg/m2 increment: 0.64, 95% CI: 0.56-0.73, n = 8), and direct associations with intakes of processed meats (RR for 50 g/day increment: 1.59, 95% CI: 1.11-2.28, n = 3), processed and red meats (RR for 100 g/day increment: 1.37, 95% CI: 1.04-1.82, n = 3) and alcohol (RR for 10 g/day increment: 1.25, 95% CI: 1.12-1.41, n = 6).

Conclusions: Evidence from cohort studies suggested a protective role of vegetables and body weight control in esophageal adenocarcinomas development. For squamous cell carcinomas, higher intakes of red and processed meats and alcohol may increase the risk, whereas fruits intake may play a protective role.

Keywords: anthropometry; diet; dose–response; esophageal cancer; meta-analysis.

© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Figures

Figure 1.
Figure 1.
Flow chart of the study selection.
Figure 2.
Figure 2.
Summary of the dose–response relationships for the dietary and anthropometric factors and risk of esophageal cancer, adenocarcinoma and squamous cell carcinoma. EC, esophageal cancer; AC, adenocarcinoma; SCC, squamous cell carcinoma.
Figure 3.
Figure 3.
Alcohol intake and esophageal cancer risk by histologic type, dose–response meta-analysis. AC, adenocarcinoma; SCC, squamous cell carcinoma.
Figure 4.
Figure 4.
BMI and esophageal cancer risk by histologic type, dose–response meta-analysis. AC, adenocarcinoma; SCC, squamous cell carcinoma.

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