Effect of dietary cholesterol intake on the risk of esophageal cancer: a meta-analysis

OBJECTIVE: This systematic review aimed to explore the potential association between dietary cholesterol intake and esophageal cancer risk. METHODS: A literature search was conducted using PubMed, Embase, and Web of Science databases from inception to March 2019 according to specific inclusion and exclusion criteria. Pooled estimates with odds ratio (ORs) and 95% confidence intervals (CIs) were obtained using random effects models. RESULTS: Nine articles of 12 independent studies were included in the final meta-analysis. Pooled analysis suggested that dietary cholesterol intake may increase the risk of esophageal cancer (summarized OR = 1.424, 95% CI = 1.191–1.704). Consistent results were found in American (summarized OR = 1.410, 95% CI = 1.130–1.758) and European populations (summarized OR = 1.556, 95% CI = 1.021–2.373). Subgroup analysis by disease type showed that dietary cholesterol intake had a significant association with the development of esophageal adenocarcinoma and esophageal squamous cell carcinoma. CONCLUSION: Our findings indicated that dietary cholesterol intake could significantly increase the risk of developing esophageal cancer in both European and American populations. Further high-quality studies are necessary to confirm the effects of cholesterol intake.