Association of Circulating Nutritional Markers, Diets, Lifestyles, Workplace and Environmental Exposures With Nasopharyngeal Carcinoma In Malaysia

Abstract

Abstract Objectives This case-control study was conducted to determine the association between circulating nutritional markers, diet, lifestyle factors, workplace and environmental exposure with risk and survival of NPC in the search for markers to predict risk and prognosticate survival for this disease. Methods A total of 300 histologically confirmed NPC cases and 300 matched (age, gender, ethnicity) cancer-free controls were recruited from two local hospitals. An interviewer-administrated questionnaire was used to collect data. Anthropometry measurements were taken directly after interview. The fasting blood sample was collected by a trained and qualified paramedic from respective hospitals and analysed using relevant analysis in the laboratory. Clinical characteristics were obtained from patients’ medical records. Results Vigorous physical activity (AOR = 1.58, 95% CI = 1.09, 2.31), ex-smoking habit (AOR (quitted ≤ 2 years) = 4.69, 95% CI = 1.63, 13.5) and alcohol consumption (AOR (once a week) = 3.10, 95% CI = 1.22, 7.91) significantly increased the risk of NPC. A medium consumption of high-protein dietary pattern was protective against NPC risk (AOR (Q2 vs Q1) = 0.44, 95% CI = 0.25, 0.76), while a high consumption of high-salted and processed food dietary pattern increased the risk of NPC (AOR (Q4 vs. Q1) = 9.75, 95% CI = 4.66, 20.38). Workplace exposures to leather, cloth, textiles or carpet and dust, smoke, fumes or gases significantly increased the risk of NPC. Environmental exposure to disinfectants or biocides significantly increased the risk of NPC. The overall survival of NPC was 63.7% with 79.3% complete remission. Advanced NPC stage (AOR (Stage 4C) = 5.64, 95% CI = 1.13, 28.2), treatment with chemotherapy alone (AOR = 5.58, 95% CI = 2.30, 13.50) and low serum leptin level (AOR (Q1 vs. Q4) = 9.61, 95% CI = 3.36, 27.47) significantly increased risk of NPC mortality. Conclusions In conclusion, the generation of risk models in this study based on these factors would not only increase understanding of NPC aetiology, but could potentially contribute to planning and implementation of clinical and public health interventions. Funding Sources This study was funded by Science Fund, Ministry of Science, Technology, and Innovation, Malaysia.