Prospective Study of Glycemic Load, Glycemic Index, and Carbohydrate Intake in Relation to Risk of Biliary Tract Cancer

Abstract

Although these data do not prove a causal relationship, they are consistent with the hypothesis that high-GL and high-GI diets are associated with an increased risk of BTC.

Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis

“…Eleven reports provided results from case-control studies (including one report of a pooled analysis of two case-control studies [24]) and nine from cohort studies (including a combined analysis of two cohorts in Shanghai [25], a combined analysis of two Swedish cohorts [19], and a prospective analysis based on data from the PREvención con DIeta MEDiterránea (PREDIMED trial) [14]). Two reports gave results on a number of cancer sites [26,29]; the remaining reports were focused on a single cancer type.…”

“…One publication on breast cancer providing only the RRs for the increment of one unit of GI/GL [32], and four publications on cancers sites for which less than four studies were available (i.e., esophagus and gastric cardia [24], biliary tract [19], melanoma [23], thyroid [18]), were not considered in the quantitative meta-analyses. In the meta-analyses on breast cancer, the 2015 paper by Farvid et al [16] with updated results of the NHSII cohort replaced the 2003 paper by Cho et al [48], which was based on a shorter follow-up and a quarter of the cases.…”

“…Dietary GI and GL were positively related to the risk of biliary tract cancer in the combined analysis of the Swedish Mammography Cohort and cohort of Swedish Men, which included 140 extrahepatic and 23 intrahepatic cancer cases developed from a population of over 76,000 individuals during a mean follow-up of 13.3 years [19]. The HRs for the fourth versus first quartile of dietary GI was 2.12 (95% CI, 1.25–3.58) for extrahepatic and 1.47 (95% CI, 0.54–3.97) for intrahepatic biliary tract cancer; the corresponding values for GL were, respectively, 1.63 (95% CI, 1.01–2.63) and 3.46 (95% CI, 1.22–9.84) [19].…”

“…The HRs for the fourth versus first quartile of dietary GI was 2.12 (95% CI, 1.25–3.58) for extrahepatic and 1.47 (95% CI, 0.54–3.97) for intrahepatic biliary tract cancer; the corresponding values for GL were, respectively, 1.63 (95% CI, 1.01–2.63) and 3.46 (95% CI, 1.22–9.84) [19]. …”

“…After that review, 20 reports [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] have been published, accounting for 23 distinct original studies and almost 22,000 additional cancer cases. These included the EPIC-Italy cohort investigating multiple cancer sites [26], the Framingham Offspring cohort on adiposity-related cancers [29], a pooled analysis of two studies on esophageal and gastric cardia adenocarcinoma [24], three studies on colorectal cancer [17,30,31], one combined analysis of two North European cohorts on cancer of the biliary tract [19], two studies on lung cancer [22,25] (including a combined analysis of two Asian cohorts [25]), one on melanoma [23], four on breast cancer [14,15,16,32] (including the update to 2011 of the Nurses’ Health Study II (NHSII) [16]), two on endometrial cancer [20,33], one on ovarian cancer [21], one on bladder cancer [28], one on kidney cancer [27], and one on thyroid cancer [18].…”