title: Refined and whole grain cereals and the risk of oral, oesophageal and laryngeal cancer.
abstract: OBJECTIVE
  To investigate the possible differential role of refined and whole grain cereals on the risk of upper digestive and respiratory tract neoplasms.
  
  
  METHODS
  Hospital-based case-control study.
  
  
  METHODS
  University Hospital of Lausanne, Switzerland.
  
  
  METHODS
  A total of 156 incident cases of cancers of the oral cavity and pharynx, 101 of the oesophagus, 40 of the larynx, and 349 control subjects admitted for a wide spectrum of acute non-neoplastic conditions.
  
  
  METHODS
  Trained interviewers collected information using a structured and validated questionnaire. Odds ratios (OR) of various cancers for a tertile increment of intake of refined and whole grains were estimated using unconditional multiple logistic regression.
  
  
  RESULTS
  Refined grains were directly related to the risk of cancer of the oral cavity and pharynx (OR=1.9 for the highest tertile), oesophagus (OR=3.7) and larynx (OR=4.0). In contrast, whole grain cereals were protective, with OR of 0.6 for oral cavity and pharynx, 0.3 for oesophagus, and 0.7 for larynx. For the three sites combined, the OR for the highest tertile was 5.7 for refined grains and 0.5 for wholegrains. The trends in risk for refined grains were significant for all sites and their combination, and for wholegrain for oesophageal cancer and all sites.
  
  
  CONCLUSIONS
  Even if inference on causality and the biological interpretation remain open to discussion, the present data indicate and further quantify that refined cereals are an unfavourable, but whole grain ones a favourable indicator of the risk of upper aerodigestive and respiratory tract neoplasms.
authors.affiliation: Unité d'épidémiologie du cancer and Registre vaudois des tumeurs, Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Levi
authors.forename: C
authors.initials: C
authors.lastname: Pasche
authors.forename: F
authors.initials: F
authors.lastname: Lucchini
authors.forename: L
authors.initials: L
authors.lastname: Chatenoud
authors.forename: D R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000328:Adult; D000368:Aged; D002523:Edible Grain; D004938:Esophageal Neoplasms / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005511:Food Handling; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology / Q000517:prevention & control; D016017:Odds Ratio; D012307:Risk Factors