title: Dietary intake of minerals and risk of esophageal squamous cell carcinoma: results from the Golestan Cohort Study.
abstract: BACKGROUND
  Dietary factors have been hypothesized to affect the risk of esophageal cancer via different mechanisms, but the intake of minerals is understudied and the evidence is conflicting.
  
  
  OBJECTIVE
  The objective was to evaluate the associations of dietary intake of minerals with risk of esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  We used data from the Golestan Cohort Study, which was launched in a high-risk region for esophageal cancer in Iran. Participants were enrolled in 2004-2008 and were followed to 2014. Intakes of minerals were assessed with a validated food-frequency questionnaire. A Cox proportional hazards model was used to estimate HRs and 95% CIs of ESCC for dietary intakes of selected minerals.
  
  
  RESULTS
  We identified 201 ESCC cases among 47,405 subjects. Calcium intake was significantly inversely associated with the risk of ESCC (HR per 100-mg/d increase: 0.88; 95% CI: 0.81, 0.96; P = 0.005; quartile 4 vs. quartile 1 HR: 0.49; 95% CI: 0.29, 0.82; P-trend = 0.013). Zinc intake was also inversely associated with ESCC, but the quartile association did not reach significance (HR per 1-mg/d increase: 0.87; 95% CI: 0.77, 0.98; P = 0.027; quartile 4 vs. quartile 1 HR: 0.56; 95% CI: 0.28, 1.12; P-trend = 0.097). The relations between dietary intakes of selenium, magnesium, and copper and risk of ESCC were nonlinear (P-nonlinear trend = 0.001, 0.016, and 0.029, respectively). There was no relation between dietary intake of manganese and the risk of ESCC.
  
  
  CONCLUSIONS
  The results suggest that higher intakes of calcium and zinc are associated with a lower risk of ESCC in a high-risk region of Iran.
authors.affiliation: International Branch and.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hashemian
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center and.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY;
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.affiliation: International Agency for Research on Cancer, Lyon, France; and.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Brennan
authors.affiliation: Cancer Research UK, Department of Oncology, Cambridge University, Cambridge, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Pharoah
authors.affiliation: Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;
authors.forename: Arash
authors.initials: A
authors.lastname: Etemadi
authors.affiliation: Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center and.
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharafkhah
authors.affiliation: Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; malek@ams.ac.ir a_hekmat2000@yahoo.com.
authors.forename: Azita
authors.initials: A
authors.lastname: Hekmatdoost
authors.affiliation: Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; malek@ams.ac.ir a_hekmat2000@yahoo.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D003300:Copper / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008274:Magnesium / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012643:Selenium / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014131:Trace Elements / Q000008:administration & dosage*
chemical_list: D014131:Trace Elements; D003300:Copper; D012643:Selenium; D008274:Magnesium
keywords: calcium; copper; esophageal cancer; magnesium; manganese; minerals; selenium; zinc