Research Papers:

Dietary inflammatory index and risk of upper aerodigestive tract cancer in Japanese adults

Makiko Abe, Nitin Shivappa, Hidemi Ito, Isao Oze, Tetsuya Abe, Yasuhiro Shimizu, Yasuhisa Hasegawa, Chikako Kiyohara, Masatoshi Nomura, Yoshihiro Ogawa, James R. Hebert and Keitaro Matsuo _

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Oncotarget. 2018; 9:24028-24040. https://doi.org/10.18632/oncotarget.25288

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Makiko Abe1,2,3, Nitin Shivappa4,5,6, Hidemi Ito3,7, Isao Oze3, Tetsuya Abe8, Yasuhiro Shimizu8, Yasuhisa Hasegawa9, Chikako Kiyohara1, Masatoshi Nomura10, Yoshihiro Ogawa2,11, James R. Hebert4,5,6 and Keitaro Matsuo3,7

1Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, 812-8582, Japan

2Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan

3Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan

4Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA

5Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

6Connecting Health Innovations LLC, Columbia, SC, 29201, USA

7Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan

8Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan

9Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan

10Department of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, 830-0011, Japan

11Department of Molecular and Cellular Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan

Correspondence to:

Keitaro Matsuo, email: [email protected]

Keywords: upper aerodigestive tract cancer; dietary inflammatory index; Japanese adults; persistent infection; case-control study

Received: November 26, 2017     Accepted: April 13, 2018     Published: May 08, 2018


Background: The inflammatory potential of diet that has been shown to be associated with cancer risk. We examined the association between dietary inflammatory potential as measured by the dietary inflammatory index (DII®) and risk of upper aerodigestive tract cancers in a Japanese case-control study.

Results: A positive association was observed between increasing DII scores and overall upper aerodigestive tract cancers, and across anatomic subsites. For upper aerodigestive tract cancers, the ORQ4vsQ1 = 1.73 (95% CI: 1.37–2.20); head and neck cancer, the ORQ4vsQ1 was 1.92 (95% CI: 1.42–2.59); and for esophageal cancer, the ORQ4vsQ1 was1.71 (95% CI: 1.54–1.90). Risks for hypopharyngeal and nasopharyngeal cancers were greatly elevated: (ORQ4vsQ1 = 4.05 (95% CI: 1.24–13.25) for hypopharyngeal cancer and ORQ4vsQ1 = 4.99 (95% CI: 1.14–21.79) for nasopharyngeal cancer.

Conclusion: A more pro-inflammatory diet was associated with an elevated risk of upper aerodigestive tract cancers after accounting for important confounders. All anatomic subsites, except larynx, showed the consistently elevated risk with increasing DII score. Those subsites with known etiological associations with persistent infection showed the largest elevation in risk. These results warrant further evaluation in future studies.

Materials and Methods: This is a case-control study of 1,028 cases and 3,081 age- and sex-matched non-cancer controls recruited at Aichi Cancer Center. DII scores were computed based on estimates of macro- and micro-nutrients from a self-administered food frequency questionnaire. Scores were further categorized into quartiles (based on the distribution in controls). Conditional logistic regression models were fit to estimate odds ratio (OR) and 95% confidence intervals (CIs) adjusted for smoking, ethanol consumption, alcohol flushing, number of teeth, and occupation group.

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