West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Br J Cancer. 2022 Jun;126(12):1735-1743. doi: 10.1038/s41416-022-01731-8. Epub 2022 Feb 8.
Acknowledging the role of inflammation in colorectal carcinogenesis, this study aimed to evaluate the associations between diet-associated inflammation, as measured by the energy-adjusted dietary inflammatory index (E-DII), and distinct stages of colorectal carcinogenesis.
The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial enrolled participants without a colorectal cancer history, who were asked to complete baseline questionnaires and food frequency questionnaires. To estimate the associations between the E-DII and risks of newly incident colorectal adenoma, recurrent adenoma, and colorectal cancer, multivariable-adjusted Cox proportional hazards regression models were employed.
Among 101,680 participants, with an average age of 65 years, a total of 1177 incident colorectal adenoma cases, 895 recurrent adenoma cases and 1100 colorectal cancer cases were identified. Higher E-DII scores from food and supplement (HR: 0.86 [0.69-1.06], P: 0.27) or from food only (HR: 0.82 [0.64-1.05], P: 0.06) were not associated with higher risks of incident adenoma. However, the elevated risk of recurrent adenoma was found in the highest category of E-DII from food plus supplement (HR: 1.63 [1.28-2.03], P: < 0.001) when compared with the lowest category. A significant association between colorectal cancer risk and E-DII from food plus supplement (HR: 1.34 [1.09-1.65], P: 0.009) was found, where this association was only pronounced in distal colorectal cancer.
Higher E-DII scores from diet plus supplement but not from diet only were associated with a higher risk of recurrent adenoma and distal colorectal cancer. The role of nutrient supplements on cancer risk, especially when combined with diet, needs to be elucidated in future studies.
鉴于炎症在结直肠癌发生中的作用，本研究旨在评估饮食相关炎症（通过能量调整后的饮食炎症指数[E-DII]来衡量）与结直肠癌不同阶段之间的关联。
前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验纳入了无结直肠癌病史的参与者，要求他们完成基线问卷和食物频率问卷。为了估计 E-DII 与新发结直肠腺瘤、复发性腺瘤和结直肠癌风险之间的关联，采用多变量调整的 Cox 比例风险回归模型。
在 101680 名参与者中，平均年龄为 65 岁，共发现 1177 例新发结直肠腺瘤病例、895 例复发性腺瘤病例和 1100 例结直肠癌病例。来自食物和补充剂（HR：0.86 [0.69-1.06]，P：0.27）或仅来自食物（HR：0.82 [0.64-1.05]，P：0.06）的更高 E-DII 评分与新发腺瘤的更高风险无关。然而，与最低类别相比，来自食物加补充剂的 E-DII 最高类别与复发性腺瘤的风险增加相关（HR：1.63 [1.28-2.03]，P：< 0.001）。还发现结直肠癌风险与来自食物加补充剂的 E-DII 之间存在显著关联（HR：1.34 [1.09-1.65]，P：0.009），这种关联仅在远端结直肠癌中明显。
来自饮食加补充剂而不是仅来自饮食的更高 E-DII 评分与复发性腺瘤和远端结直肠癌的风险增加相关。需要在未来的研究中阐明营养补充剂对癌症风险的作用，尤其是当与饮食结合使用时。
