Abstract

No study has investigated the relationship between dietary patterns and the risk of oral, pharyngeal and laryngeal cancer in the Middle East and North Africa region. Thus, the present study aimed to investigate the association between dietary patterns and the risk of oral, pharyngeal and laryngeal cancer in Syria. A hospital-based unmatched case–control study was conducted on 108 cases with histologically confirmed oral, pharyngeal or laryngeal squamous cell carcinoma and 105 healthy controls, who did not suffer from any diet-related diseases. Dietary intake data were collected by a face-to-face interview, using a food frequency questionnaire. Socio-demographic and health risk behavioural information was collected using a self-completed questionnaire. Factor analysis and logistic and linear regression analyses were performed. The level of significance was set at 5 %. The factor analysis revealed three dietary patterns labeled “Western”, “Traditional Syrian” and “High Protein”. The results of logistic regression analyses showed that consumption of Western food in the middle and high tertiles posed a significant increased oral, pharyngeal and laryngeal cancer risk of four and three-fold, respectively (adjusted OR = 4.05, 2.80; 95 % CI = 1.57–10.44, 1.05–7.51; P = 0.004, 0.041; respectively). In contrast, consumption of Traditional Syrian in the high tertile and High Protein in the middle and high tertiles displayed significant protective effects in relation to oral, pharyngeal and laryngeal cancer risk (adjusted OR = 0.28, 0.24, 0.10; 95 % CI = 0.10–0.80, 0.10–0.62, 0.03–0.25; P = 0.018, 0.003, <0.001; respectively). Compared to males, females were more likely to adhere to the High Protein dietary pattern. Traditional Syrian pattern’s scores decreased with increasing level of education and smoking. High Protein pattern’s scores decreased with age and smoking and increased with working status. Traditional Syrian and High Protein dietary patterns were associated with a decreased oral, pharyngeal and laryngeal cancer risk, whereas Western pattern was associated with an increased oral, pharyngeal and laryngeal cancer risk.

Highlights

  • No study has investigated the relationship between dietary patterns and the risk of oral, pharyngeal and laryngeal cancer in the Middle East and North Africa region

  • The main objective of this study is to investigate the association between dietary patterns and the risk of OPLC in Syria

  • Females were more likely to adhere to the High Protein dietary pattern (β = 0.48, 95 % CI: 0.04, 0.93)

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Summary

Introduction

No study has investigated the relationship between dietary patterns and the risk of oral, pharyngeal and laryngeal cancer in the Middle East and North Africa region. The present study aimed to investigate the association between dietary patterns and the risk of oral, pharyngeal and laryngeal cancer in Syria. OPLC incidence in developing countries, shows a large geographic variation, with such differences reaching up to 20 fold across different countries [2] Underlying factors explaining these geographical variations are ethnic and racial differences which are postulated to play an important role in the etiology of OPLC [3]. These variations in incidence rates of the cancer have been attributed mainly to environmental factors [4] including tobacco use, alcohol consumption, and dietary intakes [5, 6]. While alcohol and tobacco have been extensively researched in association with OPLC risk [5,6,7], dietary factors remain to be fully explored [7]

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