[Dietary habits and cancer: the experience of EPIC-Italy]

Abstract

Objectives: to investigate hypothesised relationships between diet and cancer by assessing diet as a whole, in the Italian cohort EPIC.

Design: multicentric prospective study.

Setting and participants: 47,749 volunteers were recruited between 1993 and 1998 in the centres of Varese and Turin (Northern Italy), Florence (Central Italy), Naples and Ragusa (Southern Italy). Information on diet and lifestyle were collected through validated questionnaires. Anthropometric measurements were taken and biological samples collected using standardised protocols.

Main outcome measures: follow-up was carried out by accessing regional cancer and mortality registries, hospital discharge records, and by telephone inquiries (only for Naples). After a median follow-up of 11 years, 879 incident cases of breast cancer, 421 cases of colorectal cancer, and 152 deaths were identified. Multivariate Cox regression models were used to estimate risks in relation to dietary characteristics.

Results: the "Olive oil & Salad" dietary pattern, characterised by high consumption of raw vegetables and olive oil, was associated with a lower risk of overall mortality in the elderly. Adherence to a Mediterranean diet rich in vegetables and fruit was associated with reduced risk of colon cancer. Consumption of high-glycemic carbohydrates was associated with higher incidence of breast cancer and colorectal cancer. Reduced risk of colon cancer was also found in regular consumers of yoghurt.

Conclusions: the accuracy and comprehensiveness of EPIC-Italy data made it possible to investigate both individual dietary components and dietary habits as a whole, to thereby provide Italians with dietary and lifestyle advice that will help them to remain healthy.