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Original Article Association of the inflammatory balance of diet and lifestyle with colorectal cancer among Korean adults: a case-control study
Shinyoung Jun1orcid , Jeonghee Lee1orcid , Jae Hwan Oh2orcid , Hee Jin Chang2orcid , Dae Kyung Sohn2orcid , Aesun Shin3,4orcid , Jeongseon Kim1orcid
Epidemiol Health 2022;44e2022084-0
DOI: https://doi.org/10.4178/epih.e2022084
Published online: September 30, 2022
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1Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
2Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
4Cancer Research Institute, Seoul National University, Seoul, Korea
Corresponding author:  Jeongseon Kim,
Email: jskim@ncc.re.kr
Received: 21 July 2022   • Accepted: 30 September 2022

Dietary and lifestyle exposures may affect the risk of colorectal cancer (CRC) by promoting chronic inflammation. Therefore, we assessed the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with CRC.
Data from 919 pathologically confirmed CRC cases and 1,846 age- and sex-matched controls recruited at the National Cancer Center Korea were analyzed. We calculated the DIS and LIS, which characterize the collective contributions of 19 dietary and 4 lifestyle factors, respectively, to systemic inflammation by applying weights based on high-sensitivity C-reactive protein. A higher score represented a higher balance of pro- to anti-inflammatory exposures. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for CRC risk compared across the DIS and LIS tertile categories, with the lowest tertile as the reference group.
The highest DIS tertile had significantly increased odds of having CRC (OR, 2.65; 95% CI, 2.10 to 3.36), and the odds increased with increasing DIS. The highest LIS tertile group had 1.28-fold higher odds of having CRC (95% CI, 1.03 to 1.58). In the cross-classification analysis, the odds of having CRC increased as the DIS and LIS jointly increased until the DIS reached the highest tertile, where the risk was very high (3-fold or more) regardless of the LIS.
In conclusion, a higher balance of pro-inflammatory relative to anti-inflammatory dietary and lifestyle factors, especially dietary factors, was associated with higher CRC risk among Korean adults.

Epidemiol Health : Epidemiology and Health