Research Papers:
Investigating the association between diet and risk of head and neck cancer in Taiwan
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Abstract
Chan-Chi Chang1,2,*, Wei-Ting Lee1,2,*, Yao-Chou Lee2,3, Cheng-Chih Huang1, Chun-Yen Ou1, Yu-Hsuan Lin1, Jehn-Shyun Huang4, Tung-Yiu Wong4, Ken-Chung Chen4, Jenn-Ren Hsiao1,2, Yu-Cheng Lu1, Sen-Tien Tsai1, Yu-Hsuan Lai2,5, Yuan-Hua Wu5, Wei-Ting Hsueh5, Chia-Jui Yen6, Shang-Yin Wu2,6, Jang-Yang Chang6,7, Sheen-Yie Fang1, Jiunn-Liang Wu1, Chen-Lin Lin8, Ya-Ling Weng7, Han-Chien Yang7, Yu-Shan Chen1 and Jeffrey S. Chang7
1Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
2Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
3Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
4Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
5Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
6Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
7National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan
8Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
*These authors have contributed equally to this work
Correspondence to:
Jeffrey S. Chang, email: [email protected]
Keywords: head and neck cancer, diet, vegetables and fruits, risk factor, Taiwan
Abbreviations: confidence interval (CI); head and neck cancer (HNC); Nutrition and Heath Surveys in Taiwan (NAHSIT); OR (odds ratio); upper aerodigestive tract (UADT)
Received: July 23, 2017 Accepted: September 30, 2017 Published: October 24, 2017
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.
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