Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.
Semin Cancer Biol. 2022 Aug;83:605-616. doi: 10.1016/j.semcancer.2021.03.004. Epub 2021 Mar 10.
Upper gastrointestinal (UGI) cancers are among the most common cancers in the world, four of them being among the top eight causes of cancer related mortality. Included among UGI cancers are oesophageal, gastric, liver, biliary, pancreatic and small intestinal cancers. Despite more than half a century of well designed epidemiological (large cohort and case-control studies) and a limited number of experimental studies into the role of nutrition on UGI cancer, there is much inconsistency in the findings. Studies have reported significant associations of various food types and UGI cancers, but there are issues with reproducibility. Over the years, numerous meta-analyses have been conducted in an attempt to harmonize available data. On the whole, it is well accepted that fruit and vegetables reduce UGI cancer risk, while processed foods increase the risk. The role of antioxidants in protecting against UGI carcinogenesis is of great interest, but controversial. There is evidence that specific diets, such the Mediterranean or Okinawa, are associated with reduced cancer risk at a population level, but it is less clear if adopting them reduces risk in otherwise high-risk locations. In this review, I will discuss some of the available literature from selected original publications, systematic reviews and meta-analyses on the influence of diet on UGI cancers. I will also provide a brief overview of future directions that have the potential to provide specific evidence on how diet could be modified to reduce the growing global burden of UGI cancers.
上消化道（UGI）癌症是世界上最常见的癌症之一，其中四种癌症是癌症相关死亡的前八大原因之一。UGI 癌症包括食管癌、胃癌、肝癌、胆管癌、胰腺癌和小肠癌。尽管经过半个多世纪精心设计的流行病学（大型队列和病例对照研究）和为数不多的实验研究，探讨了营养在 UGI 癌症中的作用，但研究结果存在很大的不一致性。研究报告了各种食物类型与 UGI 癌症之间存在显著关联，但存在可重复性问题。多年来，已经进行了多次荟萃分析，试图协调现有数据。总的来说，人们普遍认为水果和蔬菜可以降低 UGI 癌症的风险，而加工食品会增加风险。抗氧化剂在预防 UGI 致癌中的作用引起了极大的关注，但存在争议。有证据表明，特定的饮食模式，如地中海饮食或冲绳饮食，与人群水平的癌症风险降低有关，但在其他高风险地区采用这些饮食是否能降低风险尚不清楚。在这篇综述中，我将讨论一些来自选定原始出版物、系统评价和荟萃分析的现有文献，这些文献探讨了饮食对 UGI 癌症的影响。我还将简要概述未来的方向，这些方向有可能提供具体的证据，说明如何改变饮食以减轻日益增长的全球 UGI 癌症负担。
