title: Do tobacco and alcohol modify protective effects of diet on oral carcinogenesis?
abstract: Recent systematic reviews concluded that the frequent consumption of fruits and vegetables is inversely associated with the risk of oral cancer. We assessed this association, specifically comparing results obtained to nonsmokers and smokers, as well to nondrinkers and drinkers. We conducted a case-control study involving 296 patients with oral squamous cell carcinoma (cases) attended in 3 major hospitals of São Paulo, Brazil, paired with 296 controls, recruited from outpatient units of the same hospitals. Multivariate models assessed the effect of fruits and salads according to smoking and drinking. The intake of fruit was associated with the prevention of the disease in the specific assessment among light [odds ratio (OR) = 0.46; 95% confidence interval (CI) = 0.27-0.78) and heavy (OR = 0.30; 95% CI = 0.14-0.65) smokers. The same was observed for vegetables consumption. For nonsmokers, no fruit (OR = 50; 95% CI = 0.22-1.12) or vegetable (for tomato, OR = 0.53; 95% CI = 0.31-0.93) was associated with reduced risk of oral and oropharyngeal cancer. Similar results were found in the stratified analysis according to drinking status with OR = 0.51 (95% CI = 0.30-0.87) and 0.18 for fruits (95% CI = 0.07-0.45), respectively, for light and heavy drinkers. This observation suggests that the protective effect of fruit and salad intake may modulate the deleterious effects from tobacco and alcohol.
authors.affiliation: Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. toporcov@usp.br
authors.forename: Tatiana Natasha
authors.initials: TN
authors.lastname: Toporcov
authors.forename: Giovanna Emann
authors.initials: GE
authors.lastname: Tavares
authors.forename: Ligia Drovandi Braga
authors.initials: LD
authors.lastname: Rotundo
authors.forename: Gabriela Fürst
authors.initials: GF
authors.lastname: Vaccarezza
authors.forename: Maria Gabriela Haye
authors.initials: MG
authors.lastname: Biazevic
authors.forename: Rosana Sarmento
authors.initials: RS
authors.lastname: Brasileiro
authors.forename: Marcos Brasilino
authors.initials: MB
authors.lastname: de Carvalho
authors.forename: Pedro
authors.initials: P
authors.lastname: JMichaluart unior
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: José Leopoldo Ferreira
authors.initials: JL
authors.lastname: Antunes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D004032:Diet; D005260:Female; D005638:Fruit; D006258:Head and Neck Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology / Q000517:prevention & control; D009959:Oropharyngeal Neoplasms / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects*; D014675:Vegetables