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Population Attributable Fraction of Dietary Risk Factors for Cancer Mortality With a Focus on Gastrointestinal Cancers in a Population Based Cohort Study Publisher Pubmed



Moallemian Isfahani M1 ; Dalvand S1 ; Raei Dehaghi N2 ; Sharafkhah M1 ; Sepanlou SG1 ; Hashemian M3 ; Poustchi H4 ; Sadjadi A4 ; Roshandel G5 ; Khoshnia M5 ; Delavari A4 ; Rezaei N6
Authors
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Authors Affiliations
  1. 1. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
  4. 4. Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  6. 6. Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, MD, MPH, Tehran, Iran

Source: Scientific Reports Published:2025


Abstract

Diet and nutrition are critical factors influencing cancer, the second leading cause of death worldwide. This study evaluated dietary risk factors and cancer mortality. 49,773 participants aged 40–75 years from the Golestan Cohort Study (GCS) were followed for a median of 15 years. Dietary intake was assessed using a validated food frequency questionnaire. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), while population attributable fractions (PAFs) quantified the impact of reducing dietary risk factors. Low fruit intake accounted for 4.7% (95% CI: 0.5-8.7%) of all cancer deaths and 4.91% (95% CI: 0-9.85%) of male cancer deaths. It contributed to 23.5% (95% CI: 4.7-38.59%) of pancreatic cancer mortality in both sexes and 29.36% (95% CI: 5.15-47.38%) of male pancreatic cancer deaths. Low omega-3 intake increased esophageal and gastric cancer mortality risks, with PAFs of 21.65% (95% CI: 1.14-37.9%) and 21.46% (95% CI: 2.81-36.53%), respectively. In females, low omega-3 intake accounted for 38.68% (95% CI: 4.05-60.81%) of gastric cancer deaths. Low fruit and omega-3 consumption elevated cancer mortality risk. Community- and individual-level interventions are essential to enhance nutrient intake and reduce cancer mortality. © The Author(s) 2025.
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