Abstract
Background
The association of dietary phytosterols intake with survival of esophageal squamous cell carcinoma (ESCC) remains unclear. This study was to examine the effect of dietary phytosterols intake on ESCC survival in a Chinese rural population.
Methods
A total of 942 incident ESCC patients diagnosed between 2011 and 2013 in Yanting area were followed up until March 1st, 2020. Dietary intake five years before ESCC diagnosis was collected using a food frequency questionnaire. The outcome of interest was all-cause mortality. Cox proportional hazards regression model was used to estimate hazard ratio (HR) and 95% confidence intervals (CI).
Results
When comparing the highest with lowest intake quartiles, intake of five specific and total phytosterols was not significantly associated with risk of death after adjustment for covariates, the adjusted HR (95% CI) for β-sitosterol, campesterol, stigmasterol, β-sitostanol, campestanol and total phytosterols was 0.90 (95% CI: 0.70-1.16), 0.92 (95% CI: 0.71-1.19), 0.86 (95% CI: 0.66-1.12), 0.93 (95% CI: 0.73-1.20), 0.94 (95% CI: 0.72-1.21), 0.89 (95% CI: 0.69-1.15), respectively.
Conclusion
This study does not find any association between pre-diagnostic phytosterols intake and risk of all-cause mortality among ESCC patients. Further research is required to determine the effect of post-diagnostic phytosterols intake on ESCC survival.
Acknowledgments
The authors would like to thank epidemiologists, nurses, and doctors in the Yanting Tumor Hospital for their cooperation in data collection, and thank all study subjects for their participation.
Author’s Contributions
XDL conceived and designed the study; SYW, WJZ, and JL drafted the manuscript; SYW analyzed the data; JL, PH, and YZ collected the data; ZFR, JHL, XBX, LAT, and XDL reviewed and edited the manuscript. All coauthors provided comments and approved the final version. The authors state that they have no conflicts of interest.
Consent for Publication
All authors have read and agreed to the published version of the manuscript.
Ethics Approval
The study was approved Ethical Review Committee for Biomedical Research, School of Public Health, Sun Yat-sen University (No. 2019-096). It met the requirements of the Declaration of Helsinki and Informed consent was obtained from all subjects involved in the study.
Disclosure Statement
No potential conflict of interest was reported by the authors.
Data Availability Statement
The data used to support the findings of this study are available from the corresponding author upon request. A proposal with a description of study objectives and a statistical analysis plan will be needed for evaluation of the reasonability of requests if someone requests data sharing.