Principal Component Analysis of Dietary and Lifestyle Patterns in Relation to Risk of Subtypes of Esophageal and Gastric Cancer

Stephanie A. Navarro Silvera, Susan T. Mayne, Harvey A. Risch, Marilie D. Gammon, Thomas Vaughan, Wong Ho Chow, Joel A. Dubin, Robert Dubrow, Janet Schoenberg, Janet L. Stanford, A. Brian West, Heidrun Rotterdam, William J. Blot

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72 Scopus citations


Purpose: To carry out pattern analyses of dietary and lifestyle factors in relation to risk of esophageal and gastric cancers. Methods: 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). Impact of the resultant scores on cancer risk was estimated through logistic regression. Results: 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. Risk of EA increased with increasing GERD/BMI score, and 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. Conclusions: 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 elevated risk of each cancer under study, whereas fruit/vegetable intake reduces risk of EA, ESCC, and GCA. GERD/obesity were confirmed as risk factors for EA and smoking/alcohol as risk factors for ESCC.

Original languageEnglish
Pages (from-to)543-550
Number of pages8
JournalAnnals of Epidemiology
Issue number7
StatePublished - Jul 2011


  • Diet
  • Esophageal Adenocarcinoma
  • Esophageal Squamous Cell Carcinoma
  • Gastric Cardia Adenocarcinoma
  • Principal Components


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