title: Allergy symptoms, serum total immunoglobulin E, and risk of head and neck cancer.
abstract: Allergy symptoms have been associated with a reduced head and neck cancer (HNC) risk, while elevated blood immunoglobulin E (IgE) levels have been associated with an increased HNC risk. According to the "prophylaxis hypothesis," allergic reaction is the body's way of expelling carcinogens. IgE level may be increased by exposure to environmental carcinogens, including alcohol and cigarette smoke. We hypothesized that individuals with elevated serum IgE without allergy symptoms (i.e., asymptomatic atopic) would have the highest HNC risk.
  
  
  
  A case-control study of HNC (576 cases and 740 controls) was conducted to evaluate the association between allergy symptoms or serum total IgE and HNC risk and the effect modification of allergy symptoms on the association between serum total IgE and HNC risk.
  
  
  
  Elevated serum total IgE was associated with a significantly increased HNC risk [odds ratio (OR) 1.71, 95 % confidence interval (CI) 1.21-2.42]. Having allergy symptoms was associated with a significantly reduced HNC risk (OR 0.56, 95 % CI 0.43-0.73). Compared to subjects with normal serum total IgE and no allergy symptoms, asymptomatic atopic individuals had a significantly increased HNC risk (OR 2.12, 95 % CI 1.33-3.35).
  
  
  
  Our results provided further evidence to support the "prophylaxis hypothesis." Further investigations regarding the immune profiles of asymptomatic atopic individuals may provide additional clues for the biological mechanisms underlying the association between allergy symptoms, IgE, and HNC risk.
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Hsiao-Chen
authors.initials: HC
authors.lastname: Liao
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Shang-Yin
authors.initials: SY
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Ou
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Jenn-Ren
authors.initials: JR
authors.lastname: Hsiao
authors.affiliation: Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Jehn-Shyun
authors.initials: JS
authors.lastname: Huang
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Sen-Tien
authors.initials: ST
authors.lastname: Tsai
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Cheng-Chih
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Tung-Yiu
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lee
authors.affiliation: Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Ken-Chung
authors.initials: KC
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Sheen-Yie
authors.initials: SY
authors.lastname: Fang
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Jiunn-Liang
authors.initials: JL
authors.lastname: Wu
authors.affiliation: Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Tze-Ta
authors.initials: TT
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Yuan-Hua
authors.initials: YH
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hsueh
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Chia-Jui
authors.initials: CJ
authors.lastname: Yen
authors.affiliation: Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Forn-Chia
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Yu-Hsuan
authors.initials: YH
authors.lastname: Lai
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Jang-Yang
authors.initials: JY
authors.lastname: Chang
authors.affiliation: Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Chen-Lin
authors.initials: CL
authors.lastname: Lin
authors.affiliation: National Institute of Cancer Research, National Health Research Institutes, 1F No. 367, Sheng-Li Road, Tainan, 70456, Taiwan.
authors.forename: Yi-Hui
authors.initials: YH
authors.lastname: Wang
authors.affiliation: National Institute of Cancer Research, National Health Research Institutes, 1F No. 367, Sheng-Li Road, Tainan, 70456, Taiwan.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Weng
authors.affiliation: National Institute of Cancer Research, National Health Research Institutes, 1F No. 367, Sheng-Li Road, Tainan, 70456, Taiwan.
authors.forename: Han-Chien
authors.initials: HC
authors.lastname: Yang
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan.
authors.forename: Yu-Shan
authors.initials: YS
authors.lastname: Chen
authors.affiliation: National Institute of Cancer Research, National Health Research Institutes, 1F No. 367, Sheng-Li Road, Tainan, 70456, Taiwan. jeffreychang@nhri.org.tw.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Chang
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012306:Risk
chemical_list: D007073:Immunoglobulin E
keywords: Allergy; Case–control; Head and neck cancer; Immunoglobulin E