Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett’s esophagus onset and evolution to esophageal adenocarcinoma: results from a pilot study in a high-risk population

Stefano Realdon, Alessandro Antonello, Diletta Arcidiacono, Elisa Dassie, Francesco Cavallin, Matteo Fassan, Maria Teresa Nardi, Alfredo Alberti, Massimo Rugge, Giorgio Battaglia

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett’s esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. Methods: Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression. Results: Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 % CI 0.37–0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 %, p = 0.001), sedentary habits (from 33.3 to 0 %, p = 0.03), fruit consumption (from 37.0 to 5.6 %, p = 0.02) and processed meat consumption (from 51.9 to 10.5 %, p = 0.002). Conclusion: Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.

Original languageEnglish
JournalEuropean Journal of Nutrition
DOIs
Publication statusAccepted/In press - Jul 10 2015

Fingerprint

Barrett Esophagus
Life Style
Adenocarcinoma
Disease Progression
Research
Population
Gastroesophageal Reflux
Neoplasms
Guidelines
Guideline Adherence
Gastrointestinal Endoscopy
Metaplasia
Esophageal Neoplasms
Meat
Habits
Fruit
Histology
Logistic Models
Exercise
Diet

Keywords

  • Barrett’s esophagus
  • Diet
  • Esophageal adenocarcinoma
  • Lifestyle

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett’s esophagus onset and evolution to esophageal adenocarcinoma : results from a pilot study in a high-risk population. / Realdon, Stefano; Antonello, Alessandro; Arcidiacono, Diletta; Dassie, Elisa; Cavallin, Francesco; Fassan, Matteo; Nardi, Maria Teresa; Alberti, Alfredo; Rugge, Massimo; Battaglia, Giorgio.

In: European Journal of Nutrition, 10.07.2015.

Research output: Contribution to journalArticle

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title = "Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett’s esophagus onset and evolution to esophageal adenocarcinoma: results from a pilot study in a high-risk population",
abstract = "Purpose: While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett’s esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. Methods: Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression. Results: Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 {\%} CI 0.37–0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 {\%}, p = 0.001), sedentary habits (from 33.3 to 0 {\%}, p = 0.03), fruit consumption (from 37.0 to 5.6 {\%}, p = 0.02) and processed meat consumption (from 51.9 to 10.5 {\%}, p = 0.002). Conclusion: Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.",
keywords = "Barrett’s esophagus, Diet, Esophageal adenocarcinoma, Lifestyle",
author = "Stefano Realdon and Alessandro Antonello and Diletta Arcidiacono and Elisa Dassie and Francesco Cavallin and Matteo Fassan and Nardi, {Maria Teresa} and Alfredo Alberti and Massimo Rugge and Giorgio Battaglia",
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T2 - results from a pilot study in a high-risk population

AU - Realdon, Stefano

AU - Antonello, Alessandro

AU - Arcidiacono, Diletta

AU - Dassie, Elisa

AU - Cavallin, Francesco

AU - Fassan, Matteo

AU - Nardi, Maria Teresa

AU - Alberti, Alfredo

AU - Rugge, Massimo

AU - Battaglia, Giorgio

PY - 2015/7/10

Y1 - 2015/7/10

N2 - Purpose: While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett’s esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. Methods: Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression. Results: Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 % CI 0.37–0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 %, p = 0.001), sedentary habits (from 33.3 to 0 %, p = 0.03), fruit consumption (from 37.0 to 5.6 %, p = 0.02) and processed meat consumption (from 51.9 to 10.5 %, p = 0.002). Conclusion: Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.

AB - Purpose: While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett’s esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. Methods: Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression. Results: Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 % CI 0.37–0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 %, p = 0.001), sedentary habits (from 33.3 to 0 %, p = 0.03), fruit consumption (from 37.0 to 5.6 %, p = 0.02) and processed meat consumption (from 51.9 to 10.5 %, p = 0.002). Conclusion: Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.

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