Sex-specific effects of fruit, vegetable, and red meat intake on the risk of gastric and esophageal cancer in a large cohort

Background Dietary effects on gastric and esophageal cancer by sex and smoking has rarely been investigated. Methods Individuals who had undergone national gastric cancer screening during 2008 and had no any cancer at baseline were enrolled and followed up to 2017. The gastric and esophageal cancer risk was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results Among 3.645 million (44.1% men), 45,741 gastric cancers (67.7% men) and 3,550 esophageal cancers (89.5% men) developed during 9 years follow-up. In adjusted analysis, a frequent intake of fruit (≥ 7 servings per week) reduced the gastric cancer risk (aHR=0.91; 95% CI, 0.83–0.99) comparing to nearly no intake in women but slightly increased male gastric cancer risk (aHR=1.06; 95% CI, 1.00–1.13). A frequent intake of dietary fruit reduced the esophageal cancer risk only in men (aHR=0.75; 95% CI, 0.62–0.92). Frequent intake of red meat (3–4/week) slightly increased the gastric cancer risk only in men (aHR=1.04; 95% CI, 1.01–1.09). The favorable effect of fruit on the gastric and esophageal cancer risk was observed only in never smoker. Conclusions The effect of fruit and red meat intake on the gastric and esophageal cancer risk differed according to sex and smoking status.