title: The role of a Mediterranean diet on the risk of oral and pharyngeal cancer.
abstract: BACKGROUND
  The Mediterranean diet has a beneficial role on various neoplasms, but data are scanty on oral cavity and pharyngeal (OCP) cancer.
  
  
  METHODS
  We analysed data from a case-control study carried out between 1997 and 2009 in Italy and Switzerland, including 768 incident, histologically confirmed OCP cancer cases and 2078 hospital controls. Adherence to the Mediterranean diet was measured using the Mediterranean Diet Score (MDS) based on the major characteristics of the Mediterranean diet, and two other scores, the Mediterranean Dietary Pattern Adherence Index (MDP) and the Mediterranean Adequacy Index (MAI).
  
  
  RESULTS
  We estimated the odds ratios (ORs), and the corresponding 95% confidence intervals (CI), for increasing levels of the scores (i.e., increasing adherence) using multiple logistic regression models. We found a reduced risk of OCP cancer for increasing levels of the MDS, the ORs for subjects with six or more MDS components compared with two or less being 0.20 (95% CI 0.14-0.28, P-value for trend <0.0001). The ORs for the highest vs the lowest quintile were 0.20 (95% CI 0.14-0.28) for the MDP score (score 66.2 or more vs less than 57.9), and 0.48 (95% CI 0.33-0.69) for the MAI score (score value 2.1 or more vs value less 0.92), with significant trends of decreasing risk for both scores. The favourable effect of the Mediterranean diet was apparently stronger in younger subjects, in those with a higher level of education, and in ex-smokers, although it was observed in other strata as well.
  
  
  CONCLUSIONS
  Our study provides strong evidence of a beneficial role of the Mediterranean diet on OCP cancer.
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Filomeno
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bosetti
authors.affiliation: Department of Surgery and Translational Medicine, Clinica Otorinolaringoiatrica, Università degli Studi di Milano Bicocca, Milan, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Garavello
authors.affiliation: Cancer Epidemiology Unit, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Levi
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Galeone
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Negri
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D038441:Diet, Mediterranean; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D016017:Odds Ratio; D010610:Pharyngeal Neoplasms / Q000453:epidemiology*; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult