Folate intake and risk of oral and pharyngeal cancer.
BACKGROUND
Diet has been recognised as having a role in the aetiology of oral and pharyngeal cancer, and dietary factors may account for 10-15% of cases in Europe. Folate deficiency has been linked to risk of several cancers, but has not been studied adequately with respect to oral cancer.


METHODS
This case-control study, conducted in Italy and French-speaking Switzerland, included 749 patients with incident cancer of the oral cavity and pharynx, and 1772 hospital controls with acute, non-neoplastic conditions. The interviews used a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multiple logistic regression.


RESULTS
The ORs were 0.68 (95% CI 0.52-0.88) for the intermediate tertile and 0.53 (95% CI 0.40-0.69) for the highest tertile of dietary folate intake, compared with the lowest tertile. No heterogeneity was found in strata of gender, age, methionine intake or alcohol consumption. The combined OR for low-folate and high-alcohol intake versus high-folate and low-alcohol intake was 22.3 (95% CI 13.1-38).


CONCLUSIONS
Our study supports a protective role of folate against oral and pharyngeal carcinogenesis. Compared with low folate intake, a consistent reduction in risk was already observed from intermediate levels of intake, suggesting that cancer risk may be related to relative folate deficiency.
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. pelucchi@marionegri.it
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Pelucchi
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Talamini
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Negri
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Levi
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Conti
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Franceschi
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La Vecchia
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D016022:Case-Control Studies; D005060:Europe; D005247:Feeding Behavior; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005494:Folic Acid Deficiency / Q000150:complications*; D005638:Fruit; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology*; D016017:Odds Ratio; D010610:Pharyngeal Neoplasms / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D014675:Vegetables
D005492:Folic Acid