Journal
EUROPEAN JOURNAL OF EPIDEMIOLOGY
Volume 31, Issue 4, Pages 369-383Publisher
SPRINGER
DOI: 10.1007/s10654-015-0036-3
Keywords
Carotenoids; Head and neck cancer; Nutrients; Diet
Categories
Funding
- NIH (NCI) [R03CA113157]
- NIH (NIDCR) [R03DE016611]
- Italian Foundation for Research on Cancer (Italian Ministry of Health, General Directorate of European and International Relations)
- Italian Ministry of Education [PRIN 2009 X8YCBN]
- Italian Association for Research on Cancer (AIRC)
- Italian League Against Cancer
- Italian Ministry of Research
- Swiss League against Cancer
- Swiss Research against Cancer/Oncosuisse [KFS-700, OCS-1633]
- National Institutes of Health (NIH) US [R01CA078609, R01CA100679, R01CA061188]
- National Institute of Health (NIH) US [P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, R21ES011667]
- Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center
- National Institute of Environmental Health Sciences [P30ES010126]
- NCI, NIH, United States
- Ministry of Education, Science, Sports, Culture and Technology of Japan [17015052]
- Ministry of Health, Labor and Welfare of Japan [H20-002]
- Fondazione Veronesi
- Italian Association for Research on Cancer (AIRC) [10491 - 2010/2013]
- NIH [R01CA051845]
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Food and nutrition play an important role in head and neck cancer (HNC) etiology; however, the role of carotenoids remains largely undefined. We explored the relation of HNC risk with the intake of carotenoids within the International Head and Neck Cancer Epidemiology Consortium. We pooled individual-level data from 10 case-control studies conducted in Europe, North America, and Japan. The analysis included 18,207 subjects (4414 with oral and pharyngeal cancer, 1545 with laryngeal cancer, and 12,248 controls), categorized by quintiles of carotenoid intake from natural sources. Comparing the highest with the lowest quintile, the risk reduction associated with total carotenoid intake was 39 % (95 % CI 29-47 %) for oral/pharyngeal cancer and 39 % (95 % CI 24-50 %) for laryngeal cancer. Intakes of beta-carotene equivalents, beta-cryptoxanthin, lycopene, and lutein plus zeaxanthin were associated with at least 18 % reduction in the rate of oral and pharyngeal cancer (95 % CI 6-29 %) and 17 % reduction in the rate of laryngeal cancer (95 % CI 0-32 %). The overall protective effect of carotenoids on HNC was stronger for subjects reporting greater alcohol consumption (p < 0.05). The odds ratio for the combined effect of low carotenoid intake and high alcohol or tobacco consumption versus high carotenoid intake and low alcohol or tobacco consumption ranged from 7 (95 % CI 5-9) to 33 (95 % CI 23-49). A diet rich in carotenoids may protect against HNC. Persons with both low carotenoid intake and high tobacco or alcohol are at substantially higher risk of HNC.
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