Investigating the association between diet and risk of head and neck cancer in Taiwan.

Wei Ting Lee ,Wei Hsueh ,Jow-Lay Huang ,Jenn Ren Hsiao ,Shang Yin Wu ,Yu Hsuan Lin ,Yuan Wu ,Sen Tien Tsai ,Han Yang ,Ya Ling Weng ,Yu Lü ,Yi-Chun Lai ,Tung Yiu Wong ,Chan-Chi Chang,Yao Chou Lee ,Chen Lin Lin ,Chia Jui Yen ,Jeffrey S. Chang,Jiunn-Lin Wu ,Chien-Hui Ou ,Ken Chung Chen ,Cheng Huang ,Jang Yang Chang ,Sheen Yie Fang ,Yu Shan Chen

doi:10.18632/oncotarget.22010

Abstract

Most studies reporting an inverse association between the consumption of vegetables and fruits and head and neck cancer (HNC) risk were conducted in Western populations and only a few included East Asians. The current case-control study investigated the association between diet and HNC risk using data of 838 HNC cases and 998 controls from a case-control study of HNC conducted in Taiwan. Each participant was asked about their consumption of fresh vegetables, pickled vegetables, fresh fruits, citrus fruits, meat, processed meat, fish, egg, and dairy products. Unconditional logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of HNC risk associated with each food category, adjusted for sex, age, education, and use of alcohol, betel quid and cigarette. An inverse association was observed between HNC risk and daily intake of fresh vegetables (OR = 0.44, 95% CI: 0.20-0.95, p-trend = 0.002) or fruits (OR = 0.55, 95% CI: 0.43-0.72, p-trend = 0.00001). Individuals who did not consume fresh fruits and vegetables daily had more than double the risk of HNC compared to those with daily intake of vegetables and fruits (OR= 2.24, 95% CI: 1.54-3.25). The results of the current study supported an inverse association between the consumption of fresh vegetables and fruits and HNC risk. In addition to cessation of cigarette smoking and betel quid chewing and reduction of alcohol drinking, a public health campaign for preventing the occurrence of HNC should promote a healthy diet that contains plenty of fresh vegetables and fruits.

Highlights

Head and neck cancer (HNC) consists of cancers of the oral cavity, oropharynx, hypopharynx, and larynx and together these cancers make up the fifth leading cancer in the world, with approximately 600,000 incident cases diagnosed worldwide annually [1]
An inverse association was observed between head and neck cancer (HNC) risk and daily intake of fresh vegetables (OR = 0.44, 95% confidence interval (CI): 0.20-0.95, p-trend = 0.002) or fruits (OR = 0.55, 95% CI: 0.43-0.72, p-trend = 0.00001)
More HNC cases were users of alcohol, betel quid, or cigarette compared to the controls (p < 0.0001)

Summary

Introduction

Head and neck cancer (HNC) consists of cancers of the oral cavity, oropharynx, hypopharynx, and larynx and together these cancers make up the fifth leading cancer in the world, with approximately 600,000 incident cases diagnosed worldwide annually [1]. HNC is one of the leading cancers in Taiwan, among men. In 2014, oral, oropharyngeal, and hypopharyngeal cancers together ranked as the sixth most common cancer in Taiwan and as the fourth most common cancer among Taiwanese men [2]. The risk factors of HNC are well-established and the occurrence of most HNCs can be attributed to the consumption of alcohol, betel quid, and cigarette [3]. The incidence of human papillomavirus-associated oropharyngeal cancer has been increasing [4]. The only factor that has been consistently associated with a reduced HNC risk is the consumption of fruits and vegetables [5].

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