title: Dietary inflammatory index and risk of esophageal squamous cell cancer in a case-control study from Italy.
abstract: OBJECTIVE
  Diet and inflammation have been suggested to be important risk factors for esophageal squamous cell cancer (ESCC). In this study, we examined the association between the dietary inflammatory index (DII) and ESCC in a case-control study conducted between 1992 and 1997 in Italy.
  
  
  METHODS
  This study included 304 ESCC cases and 743 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a reproducible and valid 78-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) conditioned on age, sex, year of interview, and area of residence and adjusted for education, smoking, alcohol drinking, BMI, physical activity, and aspirin use. Energy adjustment was performed using the residual method.
  
  
  RESULTS
  Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of ESCC, with the DII being used as both a continuous variable (ORcontinuous 1.39, 95 % confidence interval, CI, 1.25-1.54; one-unit increase corresponding to ≈12 % of its range in the current study) and a categorical variable (ORquintile5vs1 2.46, 95 % CI 1.40-4.36; p trend < 0.001).
  
  
  CONCLUSIONS
  These results indicate that a pro-inflammatory diet is associated with a higher risk of ESCC, even after controlling for alcohol and tobacco exposure.
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA. shivappa@email.sc.edu.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. shivappa@email.sc.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, PN, Italy.|Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Zucchetto
authors.affiliation: SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, PN, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Dietary inflammatory index; Esophageal cancer; Italy