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Nutrition in the prevention of gastrointestinal cancer

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Diet has been hypothesized to play a role in the etiology of gastrointestinal cancer for a long time. Initially, strong evidence of such effects was found in retrospective epidemiological studies. Dietary habits, in particular those from the distant past, are difficult to measure, however. Results from recent, prospective and larger studies of better quality did not always confirm these associations. Consumption of fruits and vegetables appear to have a modest role in the prevention of gastrointestinal cancers. In contrast, the roles of alcohol consumption and overweight on risk of gastrointestinal cancer have become much clearer. Overweight and obesity are important risk factors for adenocarcinoma (but not squamous carcinoma) of the esophagus, gastric cardia carcinoma (but not noncardia carcinoma), and colorectal cancer, the latter in particular among men. Alcohol consumption is a risk factor for squamous carcinoma (but not adenocarcinoma) of the esophagus, gastric cancer and colorectal cancer. Selenium may be inversely related to esophageal and gastric cancer.

Section snippets

Esophageal cancer

Esophageal cancer can be divided in esophageal squamous cell carcinoma (ESCC)—mostly occurring in upper parts of the esophagus—which used to represent 90% of all cases, and adenocarcinoma-mostly located in the lower third of the esophagus—which used to represent 10% in the past. While the incidence of esophageal adenocarcinoma (EAC) has increased rapidly over the past 3 decades in many western countries,2, 3 in the US, the incidence of EAC rose six fold from 1975–2001, more than any other major

Gastric cancer

It is important to discern between adenocarcinoma of the proximal stomach (cardia, GCC) and adenocarcinoma arising in other parts of the stomach (body, GNCC). The prognosis of proximal cancers may be even worse than those of distal cancers.30 While the incidence of gastric noncardia cancer has sharply declined in the past decades, the incidence of gastric cardia cancer (GCC) has increased quite rapidly over the past three decades in many western countries, together with EAC.2 The commonly

Pancreatic cancer

Pancreatic cancer is a relatively rare but highly fatal cancer, with 5-year survival rates of less than 5%. Regarding its etiology, still very few risk factors are known, also in the area of nutrition.

Colorectal cancer

Colorectal cancer is usually divided in colon and rectal cancer. The incidence of colon cancer has been increasing in developed countries including Japan, whereas rectal cancer has decreased in Europe56 and remained constant in Japan.57 The differing time trends provide evidence that the etiology of both cancer sites is not the same.

Besides colorectal cancer, colorectal adenoma are sometimes studied as a early endpoint or predictor of colorectal cancer, as adenoma are likely to be in the

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