Dietary Inflammatory Index and Risk of Bladder Cancer in a Large Italian Case-control Study.
OBJECTIVE
To evaluate the association between diet in relation to its inflammatory property and bladder cancer (BC) risk.


METHODS
In this study we explored the association between the dietary inflammatory index (DII) and BC risk in an Italian case-control study conducted between 2003 and 2014. Cases were 690 patients with incident and histologically confirmed BC from 4 areas in Italy. Controls were 665 cancer-free subjects admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The DII was computed based on dietary intake assessed using a reproducible and valid 80-item food frequency questionnaire. Odds ratios (OR) were estimated through logistic regression models adjusting for age, sex, total energy intake, and other recognized confounding factors.


RESULTS
Subjects in the highest quartile of DII scores (ie, with a more pro-inflammatory diet) had a higher risk of BC compared to subjects in the lowest quartile (ie, with an anti-inflammatory diet) (ORQuartile4vs1= 1.97; 95% [confidence interval], 1.28, 3.03; P trend = .003). Stratified analyses produced stronger associations between DII and BC risk among females (ORQuartile4vs1= 5.73; 95% CI = 1.46, 22.44), older ≥65 years (ORQuartile4vs1= 2.45; 95% CI = 1.38, 4.34), subjects with higher education ≥7 years (ORQuartile4vs1= 2.22; 95% CI = 1.27, 3.88), and never smokers (ORQuartile4vs1= 4.04; 95% CI = 1.51, 10.80).


CONCLUSIONS
A pro-inflammatory diet as indicated by higher DII scores is associated with increased BC risk.
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC. Electronic address: shivappa@mailbox.sc.edu.
Nitin
N
Shivappa
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC.
James R
JR
Hébert
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Valentina
V
Rosato
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Marta
M
Rossi
Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, Università di Catania, Catania, Italy.
Massimo
M
Libra
Unit of Epidemiology, "Fondazione G. Pascale", Istituto Nazionale Tumori, Naples, Italy.
Maurizio
M
Montella
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
Diego
D
Serraino
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Carlo
C
La Vecchia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D003556:Cystitis / Q000453:epidemiology* / Q000473:pathology; D004032:Diet / Q000009:adverse effects*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*
Ann Intern Med. 2006 Jul 4;145(1):1-11
16818923
Urology. 2015 Dec;86(6):1179-84
26416008
Ann Epidemiol. 1996 Mar;6(2):110-8
8775590
Public Health Nutr. 2014 Aug;17(8):1825-33
24107546
Eur Urol. 2016 Sep;70(3):458-66
26149669
Ann Epidemiol. 1995 Jan;5(1):69-75
7728288
Ann Epidemiol. 2015 Jun;25(6):398-405
25900255
Eur Urol. 2013 Feb;63(2):234-41
22877502
Int J Cancer. 2016 Sep 15;139(6):1251-60
27149545
Oxid Med Cell Longev. 2013;2013:387014
24382987
Sci Rep. 2015 Mar 12;5:9051
25761588
J Nutr. 2009 Dec;139(12):2365-72
19864399
Am J Clin Nutr. 2012 Oct;96(4):902-10
22952186
Nutr Cancer. 2015;67(6):941-8
26226289
Cancer Causes Control. 2015 Oct;26(10):1439-47
26208592
Virchows Arch. 2015 Dec;467(6):623-633
26263854
Adv Exp Med Biol. 2014;816:197-234
24818725
J Leukoc Biol. 2006 Oct;80(4):685-90
16864602
Br J Nutr. 2015 Jan 28;113(2):278-83
25400225
Cancer Cell. 2005 Mar;7(3):211-7
15766659
Asian Pac J Cancer Prev. 2007 Apr-Jun;8(2):167-77
17696726
Eur J Nutr. 2014 Feb;53(1):39-48
23389112
Cancer Causes Control. 2014 Sep;25(9):1151-8
24964779
J Crohns Colitis. 2014 Aug;8(8):717-25
24636140
Public Health Nutr. 2014 Aug;17(8):1689-96
23941862
Cancer Causes Control. 2014 Dec;25(12):1645-58
25248495
Cancer Causes Control. 2015 Mar;26(3):399-408
25549833
Br J Cancer. 2015 Sep 29;113(7):1099-103
26335605