Research Papers:

Association between dietary nitrate and nitrite intake and site-specific cancer risk: evidence from observational studies

Li Xie, Miao Mo, Hui-Xun Jia, Fei Liang, Jing Yuan and Ji Zhu _

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Oncotarget. 2016; 7:56915-56932. https://doi.org/10.18632/oncotarget.10917

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Li Xie1,3,*, Miao Mo1,3,*, Hui-Xun Jia1,3, Fei Liang1,3, Jing Yuan1,3, Ji Zhu1,2,3

1Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Radiation Oncology, Fudan University Shanghai Cancer Center, China

3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

*These authors have contributed equally to this work

Correspondence to:

Ji Zhu, email: leo.zhu@126.com

Keywords: nitrate, nitrite, cancer, risk, meta-analysis

Received: January 06, 2016    Accepted: July 18, 2016    Published: July 29, 2016


Epidemiological studies have reported inconsistent findings on the association between dietary nitrate and nitrite intake and cancer risk. We performed a meta-analysis of epidemiological studies to summarize available evidence on the association between dietary nitrate and nitrite intake and cancer risk from published prospective and case-control studies. PubMed database was searched to identify eligible publications through April 30th, 2016. Study-specific relative risks (RRs) with corresponding 95% confidence interval (CI) from individual studies were pooled by using random- or fixed- model, and heterogeneity and publication bias analyses were conducted.

Data from 62 observational studies, 49 studies for nitrates and 51 studies for nitrites, including a total of 60,627 cancer cases were analyzed. Comparing the highest vs. lowest levels, dietary nitrate intake was inversely associated with gastric cancer risk (RR = 0.78; 95%CI = 0.67-0.91) with moderate heterogeneity (I2 = 42.3%). In contrast, dietary nitrite intake was positively associated with adult glioma and thyroid cancer risk with pooled RR of 1.21 (95%CI = 1.03-1.42) and 1.52 (95%CI = 1.12-2.05), respectively. No significant associations were found between dietary nitrate/nitrite and cancers of the breast, bladder, colorectal, esophagus, renal cell, non-Hodgkin lymphoma, ovarian, and pancreas. The present meta-analysis provided modest evidence that positive associations of dietary nitrate and negative associations of dietary nitrite with certain cancers.

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