Table 3.
Fully adjusted associations of aMED and mMED (including and excluding alcohol) with the risk of esophageal and gastric cancer subtypes in female NLCS participants
| PYsubcohort | ESCC | EAC | GCA | GNCA | |||||
|---|---|---|---|---|---|---|---|---|---|
| Cases | HR (95% CI)a | Cases | HR (95% CI)a | Cases | HR (95% CI)a | Cases | HR (95% CI)a | ||
| aMEDr | |||||||||
| 0–3 | 12254 | 21 | 1.00 | 19 | 1.00 | 15 | 1.00 | 92 | 1.00 |
| 4–5 | 15123 | 27 | 1.18 (0.62–2.25) | 18 | 0.80 (0.42–1.54) | 12 | 0.65 (0.30–1.42) | 71 | 0.70 (0.50–0.98) |
| 6–8 | 6278 | 9 | 1.13 (0.48–2.66) | 6 | 0.71 (0.27–1.88) | 6 | 0.85 (0.33–2.18) | 33 | 0.85 (0.56–1.31) |
| Ptrend | 0.756 | 0.480 | 0.726 | 0.410 | |||||
| Continuous, per 2 pts | 33655 | 57 | 1.09 (0.76–1.57) | 43 | 0.98 (0.67–1.44) | 33 | 0.82 (0.51–1.33) | 196 | 0.83 (0.67–1.01) |
| aMEDb | |||||||||
| 0–3 | 10734 | 18 | 1.00 | 15 | 1.00 | 14 | 1.00 | 84 | 1.00 |
| 4–5 | 14697 | 24 | 1.10 (0.56–2.15) | 19 | 1.00 (0.50–1.99) | 11 | 0.54 (0.24–1.24) | 73 | 0.69 (0.49–0.97) |
| 6–9 | 8224 | 15 | 1.41 (0.65–3.03) | 9 | 0.92 (0.38–2.21) | 8 | 0.75 (0.30–1.91) | 39 | 0.73 (0.49–1.10) |
| Ptrend | 0.373 | 0.851 | 0.653 | 0.153 | |||||
| Continuous, per 2 pts | 33655 | 57 | 1.09 (0.77–1.53) | 43 | 1.05 (0.73–1.51) | 33 | 0.80 (0.51–1.27) | 196 | 0.83 (0.69–1.01) |
| mMEDr | |||||||||
| 0–3 | 11675 | 17 | 1.00 | 17 | 1.00 | 9 | 1.00 | 75 | 1.00 |
| 4–5 | 16510 | 31 | 1.58 (0.83–3.03) | 19 | 0.75 (0.37–1.54) | 18 | 1.43 (0.63–3.27) | 91 | 0.92 (0.66–1.28) |
| 6–8 | 5470 | 9 | 1.62 (0.68–3.87) | 7 | 0.89 (0.35–2.26) | 6 | 1.39 (0.49–3.94) | 30 | 0.95 (0.60–1.50) |
| Ptrend | 0.231 | 0.793 | 0.538 | 0.797 | |||||
| Continuous, per 2 pts | 33655 | 57 | 1.33 (0.89–2.00) | 43 | 0.89 (0.58–1.36) | 33 | 1.03 (0.66–1.61) | 196 | 0.98 (0.80–1.21) |
| mMEDb | |||||||||
| 0–3 | 9693 | 15 | 1.00 | 16 | 1.00 | 9 | 1.00 | 63 | 1.00 |
| 4–5 | 16579 | 30 | 1.34 (0.68–2.66) | 17 | 0.59 (0.29–1.22) | 14 | 0.86 (0.36–2.05) | 98 | 0.95 (0.67–1.33) |
| 6–9 | 7383 | 12 | 1.35 (0.58–3.10) | 10 | 0.83 (0.36–1.92) | 10 | 1.37 (0.53–3.51) | 35 | 0.80 (0.51–1.26) |
| Ptrend | 0.511 | 0.793 | 0.429 | 0.327 | |||||
| Continuous, per 2 pts | 33655 | 57 | 1.28 (0.89–1.83) | 43 | 0.97 (0.65–1.45) | 33 | 0.99 (0.64–1.54) | 196 | 0.97 (0.79–1.18) |
aMED alternate Mediterranean diet score, mMED modified Mediterranean diet score, NLCS Netherlands Cohort Study, ESCC esophageal squamous cell carcinoma, EAC esophageal adenocarcinoma, GCA gastric cardia adenocarcinoma, GNCA gastric non-cardia adenocarcinoma, PYsubcohort person-years in the subcohort, HR hazard ratio, CI confidence interval, aMEDr alternate Mediterranean diet score without the alcohol component, pts points, mMEDr modified Mediterranean diet score without the alcohol component
aAdjusted for age at baseline (years), cigarette smoking status (never, former, current), cigarette smoking frequency (cigarettes smoked per day, centered), cigarette smoking duration (years, centered), body mass index (kilograms per meter2), daily energy intake (kilocalories), alcohol consumption (grams per day), highest level of education (primary school or lower vocational, secondary school or medium vocational, higher vocational or university), non-occupational physical activity (≤ 30, > 30-≤60, > 60-≤90, > 90 min per day), family history of esophageal cancer (for esophageal cancer subtypes; no, yes) and family history of gastric cancer (for gastric cancer subtypes; no, yes)
bNot adjusted for alcohol consumption