title: Consumption of vegetables and fruits and risk of subtypes of head-neck cancer in the Netherlands Cohort Study.
abstract: There is limited prospective data on the relationship between consumption of vegetables and fruits and the risk of head-neck cancer (HNC) subtypes [i.e., oral cavity cancer (OCC), oro-/hypopharyngeal cancer (OHPC) and laryngeal cancer (LC)]. Therefore, we investigated these associations within the Netherlands Cohort Study, in which 120,852 participants completed a 150-item food frequency questionnaire at baseline in 1986. After 20.3 years of follow-up, 415 cases of HNC (131 OCC, 88 OHPC, three oral cavity/pharynx unspecified or overlapping and 193 LC) and 3,898 subcohort members were available for case-cohort analysis using Cox proportional hazards models. Total vegetable and fruit consumption was inversely associated with risk of HNC overall [multivariable-adjusted rate ratios for highest vs. lowest quartile: 0.61, 95% confidence interval (CI) 0.44-0.85, p trend 0.002] and all HNC subtypes, with the strongest associations for OCC. Total vegetable intake and total fruit intake were also associated with a decreased risk of HNC overall and HNC subtypes. No significant interaction was found between vegetable and fruit intake and alcohol consumption or cigarette smoking. In conclusion, in this large-scale cohort study, consumption of vegetables and fruits was associated with a decreased risk of HNC overall and all subtypes. Consumption of vegetables and fruits (or of specific groups of them) may protect against HNC and its subtypes.
authors.affiliation: Department of Epidemiology, GROW - School for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Denise H E
authors.initials: DH
authors.lastname: Maasland
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006258:Head and Neck Neoplasms / Q000145:classification / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables
keywords: cohort studies; etiology; fruits; head-neck cancer; vegetables