Submitted to: International Journal of Cancer
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/29/2001
Publication Date: 1/1/2002
Citation: CHEN, H., WARD, M.H., HEINEMAN, E.F., GRAUBARD, B.I., MARKIN, R.M., POTISCHMAN, N.A., RUSSELL, R.M., WEISENBURGER, D.D., TUCKER, K.L. NUTRIENT INTAKES AND ADENOCARCINOMA OF THE ESOPHAGUS AND DISTAL STOMACH. INTERNATIONAL JOURNAL OF CANCER. 2002;42:33-40. Interpretive Summary: We investigated the association between nutrient intake and risk of esophageal adenocarcinoma (EA), a rare kind of esophageal cancer, and stomach cancer in a study conducted in eastern Nebraska. We observed significantly lower risk of EA with higher intakes of nutrients primarily from plant sources and dairy products including riboflavin (Vitamin B2) beta-cryptoxanthin, folate, vitamin C, calcium, dietary fiber, total vitamin A, and carbohydrate. For stomach cancer, greater intakes for vitamin C, dietary fiber, and carbohydrate were significantly associated with lower risk. We also found that higher fat intakes, particularly saturated fat, might relate to higher risk at both cancer sites. Our data suggest that greater intake of dietary fiber, certain carotenoids, and vitamins may be protective against EA and stomach cancer, whereas greater intake of saturated fat may increase at both cancer sites.
Technical Abstract: We studied the relationship between nutrient intakes and esophageal adenocarcinoma (EA) and distal stomach cancer (DSC) among 124 EA cases, 124 DSC cases and 499 controls in a population based case-control study in eastern Nebraska. Nutrient intake quartiles or tertiles were adjusted for energy intake, using the residual method. After further adjusting for age, gender, and respondent type, we observed significant inverse associations with risk of EA for dietary intakes of total vitamin A (highest quartile versus lowest, odds ratio (OR)=.49, p for trend (P)=.02), beta- cryptoxanthin (OR=.46, P =.0006), riboflavin (OR=.49, P=.0007), folate (OR=.44, P =.006), vitamin C (OR=.49, P=.02), calcium (OR=.47, P=.03), dietary fiber (OR=.46, P=.01) and carbohydrate (OR=.43, P=.0007). For DSC, only dietary intakes of vitamin C (OR=.55, P=.02), dietary fiber (OR=.41, P=.0007) and carbohydrate (OR=.46, P=.004) were inversely associated with risk. Further adjustment for other potential confounders did not change the results. Our analyses showed significant interaction between dietary fat intake and respondent type for both cancer sites, but not for other nutrients. Subgroup analyses among self-respondents revealed strong positive association between saturated fat intake and risk of EA(OR=1, 4.5 and 5.1 for intake tertiles, P=.008), and less so with risk of DSC (0R=1, 1.2, and 3.6 for intake tertiles, P=.03). No such associations were found among proxy respondents. Our data suggest that greater intake of dietary fiber, certain carotenoids and vitamins may decrease the risk of EA; whereas, greater intake of saturated fat my increase the risk for both EA and DSC.