Abstract
BackgroundNasopharyngeal carcinoma (NPC) is rare in most parts of the world but is a common malignancy in southern China, especially in Guangdong. Dietary habit is regarded as an important modifier of NPC risk in several endemic areas and may partially explain the geographic distribution of NPC incidence. In China, rapid economic development during the past few decades has changed the predominant lifestyle and dietary habits of the Chinese considerably, requiring a reassessment of diet and its potential influence on NPC risk in this NPC-endemic area.MethodsTo evaluate the association between dietary factors and NPC risk in Guangdong, China, a large-scale, hospital-based case-control study was conducted. 1387 eligible cases and 1459 frequency matched controls were recruited. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated using a logistic regression model, adjusting for age, sex, education, dialect, and habitation household type.ResultsObservations made include the following: 1) consumption of canton-style salted fish, preserved vegetables and preserved/cured meat were significantly associated with increased risk of NPC, with enhanced odds ratios (OR) of 2.45 (95% CI: 2.03-2.94), 3.17(95% CI: 2.68-3.77) and 2.09 (95% CI: 1.22-3.60) respectively in the highest intake frequency stratum during childhood; 2) consumption of fresh fruit was associated with reduced risk with a dose-dependent relationship (p = 0.001); and 3) consumption of Canton-style herbal tea and herbal slow-cooked soup was associated with decreased risk, with ORs of 0.84 (95% CI: 0.68-1.03) and 0.58 (95% CI: 0.47-0.72) respectively in the highest intake frequency stratum. In multivariate analyses, these associations remained significant.ConclusionsIt can be inferred that previously established dietary risk factors in the Cantonese population are still stable and have contributed to the incidence of NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is rare in most parts of the world but is a common malignancy in southern China, especially in Guangdong
Reports indicate that southern Chinese who migrate to intermediate-risk areas, such as Southeast Asia, or to low-risk areas, such as the United Kingdom, Australia and the United States, continue to have a high incidence of NPC [1,5,6,7,8,9,10]. Those who reside for a longer period of time in low-risk areas and their succeeding generations born in the West, have a decreased risk for NPC [8,9,10]. These results suggest that environmental factors inherent in the traditional southern Chinese culture are responsible for the unusually high incidence of NPC in southern China
Subsequent studies have consistently reported that consumption of salt-preserved fish in NPC-endemic areas of Guangdong and Guangxi in Southern China [12,13,14] is strongly associated with risk of NPC
Summary
Nasopharyngeal carcinoma (NPC) is rare in most parts of the world but is a common malignancy in southern China, especially in Guangdong. Rare in most parts of the world, nasopharyngeal carcinoma (NPC) is a common malignancy in southern China, especially in the Guangdong province [1,2]. Subsequent studies have consistently reported that consumption of salt-preserved fish in NPC-endemic areas of Guangdong and Guangxi in Southern China [12,13,14] is strongly associated with risk of NPC. In a current study in Guangxi, a second risk area of Southern China, salted fish consumption was still observed to be related to NPC risk [14]
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