Carotenoid intake and head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.
Food and nutrition play an important role in head and neck cancer (HNC) etiology; however, the role of carotenoids remains largely undefined. We explored the relation of HNC risk with the intake of carotenoids within the International Head and Neck Cancer Epidemiology Consortium. We pooled individual-level data from 10 case-control studies conducted in Europe, North America, and Japan. The analysis included 18,207 subjects (4414 with oral and pharyngeal cancer, 1545 with laryngeal cancer, and 12,248 controls), categorized by quintiles of carotenoid intake from natural sources. Comparing the highest with the lowest quintile, the risk reduction associated with total carotenoid intake was 39 % (95 % CI 29-47 %) for oral/pharyngeal cancer and 39 % (95 % CI 24-50 %) for laryngeal cancer. Intakes of β-carotene equivalents, β-cryptoxanthin, lycopene, and lutein plus zeaxanthin were associated with at least 18 % reduction in the rate of oral and pharyngeal cancer (95 % CI 6-29 %) and 17 % reduction in the rate of laryngeal cancer (95 % CI 0-32 %). The overall protective effect of carotenoids on HNC was stronger for subjects reporting greater alcohol consumption (p < 0.05). The odds ratio for the combined effect of low carotenoid intake and high alcohol or tobacco consumption versus high carotenoid intake and low alcohol or tobacco consumption ranged from 7 (95 % CI 5-9) to 33 (95 % CI 23-49). A diet rich in carotenoids may protect against HNC. Persons with both low carotenoid intake and high tobacco or alcohol are at substantially higher risk of HNC.
Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, 00168, Rome, Italy.
Emanuele
E
Leoncini
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Valeria
V
Edefonti
Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
Mia
M
Hashibe
Department of Medical and Biological Sciences, Institute of Hygiene and Epidemiology, University of Udine, Udine, Italy.
Maria
M
Parpinel
Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
Gabriella
G
Cadoni
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Monica
M
Ferraroni
Aviano Cancer Centre, Aviano, Italy.
Diego
D
Serraino
Faculty of Medical Sciences, Kyushu University, Kyushu, Japan.
Keitaro
K
Matsuo
School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
Andrew F
AF
Olshan
School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
Jose P
JP
Zevallos
National Cancer Institute, Bethesda, MD, USA.
Deborah M
DM
Winn
Roswell Park Cancer Institute, Buffalo, NY, USA.
Kirsten
K
Moysich
UCLA School of Public Health, Los Angeles, CA, USA.
Zuo-Feng
ZF
Zhang
Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
Hal
H
Morgenstern
Institut Universitaire de Medecine Sociale et Preventive (IUMSP), Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Fabio
F
Levi
Brown University, Providence, RI, USA.
Karl
K
Kelsey
Boston University School of Public Health, Boston, MA, USA.
Michael
M
McClean
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Itlay.
Cristina
C
Bosetti
New York Eye and Ear Infirmary, New York, NY, USA.
Stimson
S
Schantz
Medical Informatics Center, Peking University, Beijing, China.
Guo-Pei
GP
Yu
The Tisch Cancer Institute and Institute of Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Paolo
P
Boffetta
Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
Yuan-Chin Amy
YC
Lee
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Shu-Chun
SC
Chuang
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Adriano
A
Decarli
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Carlo
C
La Vecchia
Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, 00168, Rome, Italy. sboccia@rm.unicatt.it.
Stefania
S
Boccia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000517:prevention & control*; D002338:Carotenoids / Q000627:therapeutic use*; D016022:Case-Control Studies; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology
D000975:Antioxidants; D002338:Carotenoids
Carotenoids; Diet; Head and neck cancer; Nutrients