Brown LM, Swanson CA, Gridley G, et al. Dietary factors and the risk of squamous cell esophageal cancer among black and white men in the United States

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7368, USA.
Cancer Causes and Control (Impact Factor: 2.74). 11/1998; 9(5):467-74. DOI: 10.1023/A:1008861806923
Source: PubMed


To investigate dietary factors for squamous cell esophageal cancer and whether these factors may contribute to the five-fold higher incidence of this cancer in the black versus white population of the United States.
Data from a food frequency questionnaire were analyzed for 114 white men and 219 black men with squamous cell esophageal cancer, and 681 white and 557 black male controls from three areas of the United States who participated in a population-based case-control study of esophageal cancer.
Protective effects were associated with intake of raw fruits and vegetables (odds ratio for high versus low consumers = 0.3 in both white and black men) and use of vitamin supplements (especially vitamin C; odds ratio for high versus low consumers = 0.4 in both races), with the frequency of consumption of raw fruits and vegetables and vitamin supplements being greater for white than black controls. In addition, elevated risks were associated with high versus low intake of red meat (OR = 2.7 for blacks and 1.5 for whites) and processed meat (OR = 1.6 for blacks and 1.7 for whites), with the levels of consumption being greater for black than white controls.
In the United States, these dietary factors may contribute in part to the much higher incidence of squamous cell esophageal cancer among black compared to white men.

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    • "Our inability to detect a significant relationship may be due to considering vitamin A intakes from both plant and animal origins together, while it has been suggested that vitamin A of plant origin is associated with decreased ESCC risk, whereas vitamin A of animal origin increases the level of risk [67,109]. In addition, the protective effect of high carotene intake observed in some of the previous studies could have been mediated through high intakes of plant-based foods, which contain different micronutrients and hence contribute to the general effect [59,61,98]. High intake of vitamin C in this study was associated with more than 60% reduction in ESCC risk. "
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    ABSTRACT: Although Iran is a high-risk region for esophageal squamous cell carcinoma (ESCC), dietary factors that may contribute to this high incidence have not been thoroughly studied. The aim of this study was to evaluate the effect of macronutrients, vitamins and minerals on the risk of ESCC. In this hospital-based case-control study, 47 cases with incident ESCC and 96 controls were interviewed and usual dietary intakes were collected using a validated food frequency questionnaire. Data were modeled through unconditional multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), controlling for age, sex, gastrointestinal reflux, body mass index, smoking history (status, intensity and duration), physical activity, and education. ESCC cases consumed significantly more hot foods and beverages and fried and barbecued meals, compared to the controls (p < 0.05). After adjusting for potential confounders, the risk of ESCC increased significantly in the highest tertiles of saturated fat [OR:2.88,95%CI:1.15-3.08], cholesterol [OR:1.53, 95%CI: 1.41-4.13], discretionary calorie [OR:1.51, 95%CI: 1.06-3.84], sodium [OR:1.49,95%CI:1.12-2.89] and total fat intakes [OR:1.48, 95%CI:1.09-3.04]. In contrast, being in the highest tertile of carbohydrate, dietary fiber and (n-3) fatty acid intake reduced the ESCC risk by 78%, 71% and 68%, respectively. The most cancer-protective effect was observed for the combination of high folate and vitamin E intakes (OR: 0.02, 95%CI: 0.00-0.87; p < 0.001). Controls consumed 623.5 times higher selenium, 5.48 times as much β-carotene and 1.98 times as much α-tocopherol as the amount ESCC cases consumed. This study suggests that high intake of nutrients primarily found in plant-based foods is associated with a reduced esophageal cancer risk. Some nutrients such as folate, vitamin E and selenium might play major roles in the etiology of ESCC and their status may eventually be used as an epidemiological marker for esophageal cancer in Iran, and perhaps other high-risk regions.
    Nutrition Journal 12/2011; 10(1):137. DOI:10.1186/1475-2891-10-137 · 2.60 Impact Factor
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    • "Previous studies have shown that the consumption of vegetables is associated with a decreased risk of oesophageal cancer (Gao et al., 1994; Tavani et al., 1994; Tzonou et al., 1996; Brown et al., 1998; Sharp et al., 2001; Cheng et al., 1995; Terry et al., 2001. Our data confirmed the protective effect of vegetable consumption. "
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    ABSTRACT: Linzhou City has one of the highest incidences of oesophageal cancer in China, and in the world. A case-control study was here conducted to investigate potential risk factors in this area. Linzhou Cancer Registry was used to identify cases of oesophageal cancer, aged between 30 and 75, diagnosed between January 1998 and April 1999. Three neighbourhood controls were selected for each case, matched according to age, sex and village of residence. A total of 211 cases and 633 controls were interviewed. A strong association was found between socio-economic status and the risk of oesophageal cancer. Increased income, residential space and education were all significantly associated with a decreased risk (OR 0.54, 0.36 and 0.30 respectively). Using a drinking water source other than tap water was significantly associated with an increased risk (OR 5.49). The consumption of beans, vegetables and vinegar all showed a protective effect with odds ratios of 0.37, 0.44 and 0.37 respectively. Preferences for a low salt diet or a high salt diet were both associated with an increased risk. It can be concluded that in Linzhou, oesophageal cancer is a disease related to poverty. Having a drinking water source other than tap water increases the risk of oesophageal cancer. As in other populations, a high consumption of vegetables and beans are associated with a decreased risk and a preference for a high salt diet is associated with an increased risk.
    Asian Pacific journal of cancer prevention: APJCP 01/2003; 4(2):119-24. · 2.51 Impact Factor
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    • "The lack of an association with the combined adenocarcinomas of the esophagus and gastric cardia in these previous studies confirms to some extent the lack of associations with adenocarcinoma of the gastric cardia in our data since the majority of cases in these studies were cardia cancers. Most previous investigations studying only squamous-cell carcinoma of the esophagus, or all esophageal cancers combined, generally show an inverse association with high intake of antioxidant vitamins C (Graham et al., 1990; Tzonou et al., 1996; Brown et al., 1998; Launoy et al., 1998). Studies of dietary beta-carotene or alpha-tocopherol in developed countries, by contrast, are few and the results have been inconsistent (Launoy et al., 1998; Nomura et al., 1997; Zheng et al., 1995; Dorgan and Schatzkin, 1991). "
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    ABSTRACT: Antioxidant vitamins have attracted considerable attention in previous studies of esophageal squamous-cell carcinoma, but dietary studies of adenocarcinoma of the esophagus and gastric cardia remain sparse. Treating these tumors as distinct diseases, we studied intakes of vitamin C, beta-carotene and alpha-tocopherol in a nationwide population-based case-control study in Sweden, with 185, 165, and 258 cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma, and gastric cardia adenocarcinoma, respectively, and 815 controls. Subjects with a high parallel intake of vitamin C, beta-carotene, and alpha-tocopherol showed a 40–50% decreased risk of both histological types of esophageal cancer compared with subjects with a low parallel intake. Antioxidant intake was not associated with the risk of gastric cardia adenocarcinoma. Separately, vitamin C and beta-carotene reduced the risk of esophageal cancers more than alpha-tocopherol. We found that antioxidant intake is associated with similar risk reductions for both main histological types of esophageal cancer. Our findings indicate that antioxidants do not explain the diverging incidence rates of the 2 histological types of esophageal cancer. Moreover, our data suggest that inverse associations with esophageal squamous-cell carcinoma and adenocarcinoma may be stronger among subjects under presumed higher oxidative stress due to smoking or gastroesophageal reflux, respectively. Our results may be relevant for the implementation of focused, cost-effective preventive measures. Int. J. Cancer 87:750–754, 2000. © 2000 Wiley-Liss, Inc.
    International Journal of Cancer 09/2000; 87(5):750 - 754. DOI:10.1002/1097-0215(20000901)87:5<750::AID-IJC19>3.0.CO;2-6 · 5.09 Impact Factor
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