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ABSTRACT
Several case-control studies have associated dietary patterns with esophageal cancer (EC) risk, but prospective studies are scarce. We investigated dietary pattern and EC mortality risk associations by smoking status. Participants were 26,562 40- to 79-yr-old Japanese men, who enrolled in the Japan Collaborative Cohort Study between 1988 and 1990. Hazard ratios (HRs) and 95% confidence intervals (CIs) for EC mortality in nonsmokers and smokers were estimated using Cox proportional models. During follow-up (1988–2009), 132 participants died of EC. Using a baseline food frequency questionnaire and factor analysis, vegetable, animal, and dairy product food patterns were identified. EC risk decreased significantly with a higher factor score for the dairy product pattern (Ptrend = 0.042) and was more pronounced in smokers [multivariable HR (4th vs. 1st quartiles) = 0.57, 95% CI: 0.30, 1.09; Ptrend = 0.021]. Neither vegetable nor animal food patterns were significant overall; however, EC risk increased with a higher factor score for the animal food pattern in nonsmokers [multivariable HR (4th vs. 1st quartiles) = 6.01, 95% CI: 1.17, 30.88; Ptrend = 0.021], although the small number of events was a limitation. Our findings suggest a dairy product pattern may reduce EC risk in Japanese men, especially smokers.
Abbreviations
| BMI | = | body mass index |
| CI | = | confidence interval |
| EA | = | esophageal adenocarcinoma |
| EC | = | esophageal cancer |
| ESCC | = | esophageal squamous cell carcinoma |
| FFQ | = | food frequency questionnaire |
| HR | = | hazard ratio |
| ICD | = | International Classification of Disease |
| JACC Study | = | Japan Collaborative Cohort Study |
Acknowledgments
The authors wish to express sincere thanks to Drs. Kunio Aoki and Yoshiyuki Ohno, Professors Emeritus of the Nagoya University School of Medicine and former chairpersons of the JACC Study. For their encouragement and support during this study, they are also greatly indebted to Dr. Haruo Sugano, former Director of the Cancer Institute, Tokyo, who made substantial contributions to the initiation of the JACC Study; Dr. Tomoyuki Kitagawa, Director Emeritus of the Cancer Institute of the Japanese Foundation for Cancer Research and former project leader of the Grant-in-Aid for Scientific Research on Priority Area “Cancer”; Dr. Kazuo Tajima, Aichi Cancer Center, who was the previous project leader of the Grant-in-Aid for Scientific Research on Priority Area of Cancer Epidemiology. This work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) (Monbusho); Grants-in-Aid for Scientific Research on Priority Areas of Cancer; and Grants-in-Aid for Scientific Research on Priority Areas of Cancer Epidemiology from MEXT (MonbuKagaku-sho) (Nos. 61010076, 62010074, 63010074, 1010068, 2151065, 3151064, 4151063, 5151069, 6279102, 11181101, 17015022, 18014011, 20014026, and 20390156).
Ethics approval
This study was approved by the Ethical Board of Nagoya University School of Medicine.
Conflict of interest
All authors declare that there are no conflicts of interests.
Funding
This study was funded by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT); Grants-in-Aid for Scientific Research on Priority Areas of Cancer; and Grants-in-Aid for Scientific Research on Priority Areas of Cancer Epidemiology from MEXT.