High spicy food intake may increase the risk of esophageal cancer: a meta-analysis and systematic review

Spicy food is popular with people around the world. However, reports on the association between spicy food intake and esophageal cancer (EC) risk have been controversial. Therefore, we conducted a meta-analysis of 25 studies to provide the latest evidence for this uncertainty. We hypothesized that high spicy food intake is associated with an increased risk of EC. The database was searched to identify case-control or cohort studies of spicy food intake associated with EC through March 2022. Combined odds ratios (ORs) and their 95% confidence intervals (CIs) were used to estimate the effect of spicy food intake on EC. Subgroup analyses and sensitivity analyses were also performed. All data were analyzed using STATA 15.1 software.25 studies from 22 articles met the inclusion criteria for the meta-analysis (7,810 patients with EC and 515,397 controls). Despite significant heterogeneity (p<0.001), the comparison of highest versus lowest spicy food intake in each study showed a significant OR of 1.70 (95% CI 1.30–2.22). In subgroup analyses, this positive association was found among the Chinese population, different sample sizes of EC, different sources of the control group, and different quality of articles. However, for India, as well as for other countries, esophageal squamous cell carcinoma (ESCC) and Esophageal adenocarcinoma (EAC), no statistically significant association was observed. This meta-analysis suggests that high levels of spicy food intake may be associated with an increased risk of EC, although one prospective study found an inverse association. Additional studies are necessary to confirm the relationship between spicy food and EC risk.