title: Diet and esophageal cancer risk in the Eastern Cape Province of South Africa.
abstract: A multicenter hospital-based case-control study comprising 670 incident cases of esophageal cancer (EC) and 1188 controls, frequency-matched for age and sex, was conducted to evaluate the role of diet on EC development in the Eastern Cape Province, South Africa. A locally relevant lifestyle and dietary questionnaire was used. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional multivariable logistic regression. Individually, maize or sorghum consumption vs. never or rare consumption were not associated with EC (P > 0.1). Males and females consuming green leafy vegetables 5-7 days/wk had 38% (P = 0.04) and 50% (P = 0.007) reduced odds of developing EC, respectively, compared with consumption ≤1 day/wk. A similar reduction in odds was observed with fruit consumption. Principal component factor analysis revealed 3 distinct dietary patterns. In females, high vs. low consumption of Pattern 1 (sorghum, green leafy vegetables, green legumes, fruits, meat) was inversely associated with EC development (OR = 0.54; 95% CI: 0.34-0.89), whereas for Pattern 2 (maize, wild greens-imifino, dry beans) the odds were elevated (OR = 1.67; 95% CI: 1.04-2.67). Compared with low adherence, high adherence to Pattern 3 (wheat-based products) reduced the odds by 35% for both sexes. This study provides further evidence on the role of diet in minimizing EC risk in this population.
authors.affiliation: a Oncology Research Unit , Medical Research Council , Overport , South Africa.
authors.forename: Vikash
authors.initials: V
authors.lastname: Sewram
authors.forename: Freddy
authors.initials: F
authors.lastname: Sitas
authors.forename: Dianne
authors.initials: D
authors.lastname: O'Connell
authors.forename: Jonny
authors.initials: J
authors.lastname: Myers
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004032:Diet; D002523:Edible Grain; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008460:Meat; D008875:Middle Aged; D016017:Odds Ratio; D025341:Principal Component Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014675:Vegetables