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Int J Cancer. 2019 Mar 15;144(6):1292-1301. doi: 10.1002/ijc.31919. Epub 2018 Dec 3.

Association between the dietary inflammatory index and all-cause mortality in colorectal cancer long-term survivors.

Author information

1
Institute of Epidemiology, University Hospital Schleswig-Holstein, University of Kiel, Kiel, Germany.
2
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.
3
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
4
Connecting Health Innovations LLC, Columbia, SC.
5
Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
6
Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
7
Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany.
8
Institute for Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany.

Abstract

Pro-inflammatory dietary factors have been shown to be associated with the incidence of a range of cancers. However, there are many fewer studies on the association between the inflammatory potential of diet and survival after cancer diagnosis. We examined the association between post-diagnosis dietary inflammatory index (DII®) scores and all-cause mortality in long-term survivors of colorectal cancer (CRC). DII scores were calculated from dietary data of 1,404 CRC survivors collected at a median of 6 years after CRC diagnosis. Using multivariable-adjusted Cox proportional hazards regression models, hazard ratios (HR) and 95% confidence intervals (CI) were estimated for the association of DII scores, modeled continuous and in quartiles, with all-cause mortality. After a median follow-up time of 7 years (after dietary assessment), 204 study participants had died. Overall, in the fully adjusted model there was a suggestion of a positive association between DII score and all-cause mortality (HRDIIquartile4vs1 : 1.36; 95% CI: 0.88-2.09 and HRDIIcontinuous : 1.08; 95% CI: 0.97-1.20). However, in subgroup analyses, we found significant differences in individuals with metastatic disease (HRDIIcontinuous : 1.34; 95% CI: 1.07-1.67) and the absence of stoma (HRDIIcontinuous : 1.15; 95% CI: 1.02-1.29). Overall, the post-diagnosis DII was not statistically significantly associated with all-cause mortality in CRC long-term survivors; however, there was suggestive evidence of an association in select subgroups.

KEYWORDS:

colorectal cancer; dietary inflammatory index; inflammation; mortality; survivors

PMID:
30303515
DOI:
10.1002/ijc.31919
[Indexed for MEDLINE]
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