Document Type


Publication Date

Summer 7-2011

Journal / Book Title

Annals of Epidemiology



To carry out pattern analyses of dietary and lifestyle factors in relation to risk of esophageal and gastric cancers.


We evaluated risk factors for esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and other gastric cancers (OGA) using data from a population-based case-control study conducted in Connecticut, New Jersey, and western Washington state. Dietary/lifestyle patterns were created using principal component analysis (PCA). The impact of the resultant scores on cancer risk was estimated through logistic regression.


PCA identified six patterns: meat/nitrite, fruit/vegetable, smoking/alcohol, legume/meat alternate, GERD/BMI, and fish/vitamin C. Risk of each cancer under study increased with rising meat/nitrite score. The risk of EA increased with increasing GERD/BMI score, and the risk of ESCC rose with increasing smoking/alcohol score and decreasing gastroesophageal reflux disease (GERD)/body mass index (BMI) score. Fruit/vegetable scores were inversely associated with EA, ESCC, and GCA.


PCA may provide a useful approach for summarizing extensive dietary/lifestyle data into fewer interpretable combinations that discriminate between cancer cases and controls. The analyses suggest that meat/nitrite intake is associated with an elevated risk of each cancer under study, whereas fruit/vegetable intake reduces the risk of EA, ESCC, and GCA. GERD/obesity was confirmed as risk factors for EA and smoking/alcohol as risk factors for ESCC.


Published Citation

Silvera, Stephanie A. Navarro, Susan T. Mayne, Harvey A. Risch, Marilie D. Gammon, Thomas Vaughan, Wong-Ho Chow, Joel A. Dubin et al. "Principal component analysis of dietary and lifestyle patterns in relation to risk of subtypes of esophageal and gastric cancer." Annals of epidemiology 21, no. 7 (2011): 543-550. Harvard