Association between dietary vitamin C intake and risk of esophageal cancer: A dose-response meta-analysis

作者:Bo Yacong; Lu Yan; Zhao Yan; Zhao Erjiang; Yuan Ling; Lu Weiquan; Cui Lingling; Lu Quanjun*
来源:International Journal of Cancer, 2016, 138(8): 1843-1850.
DOI:10.1002/ijc.29838

摘要

While several epidemiological studies have investigated the association between vitamin C and risk of esophageal cancer, the results remain inconsistent. In the present study, a meta-analysis was conducted to assess the impact of dietary vitamin C intake on esophageal cancer risk. Online databases were searched up to March 29, 2015, for studies on the association between dietary vitamin C intake and esophageal cancer risk. Pooled risk ratios (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Dose-response analyses were performed using the method of restricted cubic splines with four knots at percentiles of 5, 35, 65 and 95% of the distribution. Publication bias was estimated using Egger's tests and funnel plots. In all, 15 articles were included in this meta-analysis, including 20 studies, containing 7063 controls and 3955 cases of esophageal cancer. By comparing the highest vs. the lowest categories of vitamin C intake, we found that vitamin C was inversely associated with the risk of esophageal cancer [overall OR=0.58, 95% CI=0.49-0.68, I-2=56%]. A linear dose-response relationship was found. With an increase in dietary vitamin C intake of 50 mg/day, the risk of esophageal cancer statistically decreased by 13% (OR=0.87, 95% CI=0.80-0.93, p(linearity)=0.0002). In conclusion, our analysis suggested that the higher intake of dietary vitamin C might have a protective effect against esophageal cancer.