我们研究了多种饮食模式与全消化系统癌症（DSC）发病率和死亡率的关系。在分析中，纳入了共213,038名健康专业人员，他们分别来自保健专业人员追踪研究（1986-2016年）和护士健康研究（NHS）（1986-2018年）以及NHS II（1991-2017年），基线时没有癌症诊断报告。使用时间可变的Cox比例风险回归模型评估了DSC的发病率和死亡率。在长达32年的随访中，我们记录了5724例DSC病例。遵循八种健康饮食模式与DSC的风险具有7-13%的下降，尤其适用于消化道癌症。除了替代地中海饮食（AMED）和健康植物膳食指数之外，所有模式评分均表现出与胃肠道癌症相反的关联，危险比（HR）在0.84和0.89之间。对于胃癌，炎症减轻的经验性膳食指数（rEDIP）（0.53，95% CI 0.39至0.72）以及胃肠炎系统癌症的rEDIH（HR for 90th versus 10th percentile 0.64，95% CI 0.47至0.87）均显示出与之相反的关联，对于小肠癌而言，rEDIP（0.58，95% CI 0.37至0.92）也如此。在附加癌症中，健康饮食指数-2010（AHEI-2010），AMED和降低糖尿病风险饮食与肝癌的风险降低了43-51%。rEDIH，rEDIP以及AHEI-2010与消化系统致命性癌症的风险也呈负相关。坚持健康饮食与发生和致命DSC的风险降低有关，尽管与不同的模式之间的关联程度略有不同。 版权所有 © 2023 美国胃肠学会。

We examined multiple dietary patterns in relation to total digestive system cancer (DSC) incidence and death.A total of 213,038 health professionals from the Health Professionals Follow-up Study (1986-2016) and the Nurses' Health Study (NHS) (1986-2018) and the NHS II (1991-2017) with no cancer diagnosis at baseline were analyzed. DSC incidence and death were estimated using time varying Cox proportional hazards regression models.During up to 32 years of follow-up, 5724 DSC cases accrued. Adherence to eight healthy diet patterns were associated with a 7-13% lower risk of DSC, particularly for digestive tract cancers. An inverse association with gastrointestinal tract cancer was also shown for all pattern scores except alternative Mediterranean diet (AMED) and healthy Plant Dietary Index, with hazard ratios (HRs) between 0.84 and 0.89. Inverse associations were shown for the rEDIH (HR for 90th versus 10th percentile 0.64, 95% confidence interval (CI) 0.47 to 0.87) and the empirical dietary index associated with lower inflammation (rEDIP) (0.53, 95% CI 0.39 to 0.72) for stomach cancer, and for the rEDIP (0.58, 95% CI 0.37 to 0.92) for small intestine cancer. Among accessory cancers, the Alternate Healthy Eating Index-2010 (AHEI-2010), AMED, and diabetes risk reduction diet were associated with a 43-51% lower risk of liver cancer. The rEDIH, rEDIP, and the AHEI-2010 were inversely associated with risk of digestive system fatal cancer.Adherence to healthy diets was associated with a lower risk of incident and fatal DSC, although the magnitude of the association varied slightly among the patterns.Copyright © 2023 by The American College of Gastroenterology.