Impact of a pro-inflammatory diet on upper gastrointestinal cancer risk: evidence from a population-based cohort in high-risk areas of China.

Abstract

Purpose: Chronic inflammation plays a pivotal role in carcinogenesis, particularly in upper gastrointestinal (UGI) cancers. However, the contribution of dietary inflammation to UGI cancer risk in the Chinese population remains insufficiently explored. This study investigated the association between energy-adjusted dietary inflammatory index (E-DII) and UGI cancer incidence in high-risk regions of China.

Methods: This prospective cohort study included 43,153 participants enrolled between 2017 and 2019 in the National Cohort of Esophageal Cancer. The E-DII score, based on 22 dietary parameters, quantified dietary inflammation. Cox proportional hazards regression models were used to assess the relationship between E-DII scores and incident UGI cancer, with adjustments for age, sex, residence, lifestyle factors, medical history, and pathological diagnoses. Subgroup and sensitivity analyses were conducted to address potential confounding effects.

Results: Over a median follow-up of 55 months, 527 participants developed UGI cancer. Higher E-DII scores were associated with increased UGI cancer risk (hazard ratio [HR] for highest vs. lowest quartile: 1.75; 95% confidence interval [CI]: 1.28-2.40; P for trend = 0.001). Significant associations were observed for esophageal cancer (HR = 1.81; 95% CI 1.03-3.18; P for trend = 0.050) and gastric cancer (HR = 1.69; 95% CI 1.16-2.47; P for trend = 0.009). Subgroup analyses and sensitivity tests confirmed the robustness of these findings.

Conclusion: This study highlights the role of dietary inflammation in increasing UGI cancer risk and suggests that promoting anti-inflammatory dietary patterns may serve as an effective preventive measure in high-risk populations.