Dietary Inflammatory Index and the Risk of Esophageal Cancer: A Systematic Review and Meta-Analysis Publisher Pubmed



Hb Yarahmadi Hossein BAHRAAMI ; K Shahryari KIANOUSH ; M Bozorgi MAHDI ; A Shirdel AHMADREZA ; Z Mohamadi ZHINA ; N Rooshenas NEGAR ; H Karim Nezhad HELIA ; H Mobaraki HESAM ; M Aryannejad MAJID ; A Emdadi ANAHITA
Source: BMC Cancer Published:2025

Abstract

Background and aim: It is well-recognized that inflammation is an adaptive pathophysiological response in many types of cancer. Research on nutrition's critical role in inflammation, a risk factor for all forms of cancer, is growing. The dietary inflammatory index (DII) was created lately to assess if a diet is pro- or anti-inflammatory in terms of inflammation. Indeed, several studies have demonstrated the correlation between DII and the risk of several cancer types. This meta-analysis set out to look into the relationship between DII and the different forms of esophageal cancer. Method: PubMed, Cochrane library, Embase, Scopus, and Web of Science databases were searched up to May 2024 to retrieve relevant articles. RAYYAN intelligent tool for systematic reviews was incorporated for the screening of studies. Original articles written in English Studies that investigated the inflammatory index of diet in individuals who developed esophageal cancer were included in this study.STATA v18 software was used to conduct the meta-analysis. Egger's test for publication bias assessment was implemented. Newcastle Ottawa scale was used to evaluate the qualities of the included studies. A plot digitizer was used to extract digital data. Result: A total of 13 studies were included in the systematic review, with 6 studies contributing to the meta-analysis, comprising 10,150 participants. The participants were categorized into high and low DII groups, with the low DII group (n = 3,403) serving as the reference. The meta-analysis demonstrated a significant association between high DII and increased risk of esophageal cancer. Specifically, individuals in the high DII group were 29% more likely to develop esophageal cancer, with a pooled odds ratio (OR) of 1.29 (95% Confidence Interval [CI]: 1.16–1.43), as calculated using a random-effects model. Moderate heterogeneity was observed (I2 > 50%). Egger’s test indicated evidence of publication bias (p < 0.05). Subgroup and sensitivity analyses confirmed the robustness of this association across populations and study designs. Conclusion: our study concludes that a higher level of DII is associated with a higher risk of esophageal cancer development. This study suggests that modifying inflammatory properties of dietary patterns can reduce the risk of incidence of esophageal cancer. © 2025 Elsevier B.V., All rights reserved.