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. 2020 Dec 29;13(1):81. doi: 10.3390/nu13010081

Table 4.

Some epidemiological studies on whole grains/whole grain fiber on esophageal cancer.

Study Type and Design Main Findings * Refs
Whole grains Swiss 7-year retrospective hospital-based case-control study (349 controls and 101 EC patients).
Whole (whole wheat bread and cereals) and refined (white bread and biscuits, pizza, pasta and rice) grain foods
Tertiles for WG intake (times/week):

  • T1: <4

  • T2: 4–10

  • T3: >10

Tertiles for RG intake (times/week):

  • T1: <9

  • T2: 9–17

  • T3: 17

 EC risk inversely correlated to WG intakes (ORT3 vs. T1 = 0.30, CI 95% 0.1–0.6) and directly correlated to RG intakes (ORT2 vs. T1 = 2.6, CI 95% 1.1–6.2; ORT3 vs. T1 = 3.7, CI 95% 1.8–7.9) [91]
Italian 14-year hospital-based case-control studies (1983–1997)
10058 controls and 11.990 cancer patients (410 EC cases).
Tertiles for WG food intake (day/week):

  • T1: no or rare consumption

  • T2: 1–3

  • T3: >3

 WG consumption associated with reduced risk (OR T3 vs. T1 = 0.4, 95% CI 0.2–0.7 and ORT2 vs. T1 = 0.4, 95% CI 0.3–0.7) [108]
Meta-analysis of 34 studies of WG intake and risk of digestive tract cancer (EC: 4 case-control studies and 2 cohort studies (151,742 participants and 1223 EC cases)) WG consumption associated with reduced risk (RR = 0.54, 95% CI 0.44–0.67, p < 0.001)
No statistically significant heterogeneity (I2 = 27.7%, p = 0.217)		 [113]
Scandinavian 11-year prospective population-based case-control study (113,993 members from HELGA cohort including 56 EAC patients and 54 ESCC patients; 73.2% male and 33.8% women)
Sex-specific tertiles of total WG intake (g/day):

  • T1: F: 0–37.6; M: 0–37.8

  • T2: F: 37.7–60.5; M: 37.9–62.1

  • T3: F: 60.6–160.0; M: 62.2–160.0

Sex-specific tertiles of WG wheat intake (g/day):

  • T1 F: 0–6.1, M: 0–2.5 71

  • T2 F: 6.2–32.1, M: 2.6–8.0

  • T3 F: 32.2–94.0, M: 8.1–65.7

Sex-specific tertiles of WG bread intake (g/day):

  • T1: 0–59.6 for men; 0–65.8 for women

  • T2: 62.0–125.0 for men; 68.2–113.2 for women

  • T3: 129.6–520.0 for men; 113.8–520.0 for women

 Inverse correlation between EC risk and total WGs (HR T3 vs. T1 = 0.55, 95% CI 0.31–0.97) and WG products (HR T3 vs. T1 = 0.51, 95% CI 0.30–0.88 per 25 g)
Only wheat showed significant associations in adjusted models (adjusted HRT3 vs. T1 = 0.32, 95% CI 0.16–0.63)
Only WG bread showed significant associations in adjusted model (adjusted HR T3 vs. T1 = 0.88, 95% CI 0.80–0.96 per 25 g WG bread)
EAC: adjusted HR = 0.81, 95% CI 0.65–1.02 per 50 g WG products and HR = 0.85, 95% CI 0.66–1.09 per 20 g WGs
ECCS: adjusted HR = 0.66, 95% CI 0.51–0.86 per 50 g WG products and adjusted HR = 0.75, 95% CI 0.56–1.00 per 20 g WGs		 [181]
Whole grains/whole grain fiber Prospective 14-year cohort Iowa Women’s Health Study (34,651 initially free-cancer women; 21 EC and 56 GC)
Tertiles of WG intake (servings/week):

  • T1: 0–6.5

  • T2: 6.9–12.5

  • T3: 13.0–108.5

Tertiles of WG fiber intake (g/day):

  • T1: 0–1.49

  • T2: 1.50–3.98

  • T3: 3.99–35.75

 Inverse correlation between EC risk and WG (HRR T3 vs. T1 = 0.47) or WG fiber (HRR T3 vs. T1 = 0.35) intake [95]

* Findings on WG intake per se, after adjusting for confounding factors (e.g., age, sex, education, smoking, dietary habits, alcohol, physical activity, etc.) through multivariate models. CI: Confidence Interval; EAC: esophageal adenocarcinoma; EC: esophageal cancer; ESCC: esophageal squamous cell carcinoma; HR: Hazard Rate; HRR: Hazard Rate Ratio; OR: Odds Ratio; RG: refined grain; RR: Relative Risk; WG: whole grain.