Adherence to the Mediterranean diet and nasopharyngeal cancer risk in Italy.
Few studies investigated the role of diet on nasopharyngeal cancer (NPC) risk in non-endemic areas. The aim of this study was to assess the association between adherence to the traditional Mediterranean diet and NPC risk in a southern European low-risk population.



We conducted a hospital-based case-control study in Italy, including 198 histologically confirmed NPC cases and 594 matched controls. Dietary habits were collected by means of a validated food-frequency questionnaire, including 83 foods, food groups, or beverages. Adherence to the traditional Mediterranean diet was assessed through a Mediterranean Diet Score (MDS), based on nine dietary components characterizing this dietary profile, i.e., high intake of vegetables, fruits and nuts, cereals, legumes, and fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated odds ratios (ORs) of NPC, and the corresponding 95% confidence intervals (CIs), for increasing MDS (i.e., increasing adherence) using multiple logistic regression models, adjusted for major confounding factors.



As compared to MDS ≤ 4, the ORs of NPC were 0.83 (95% CI: 0.54-1.25) for MDS of 5 and 0.66 (95% CI: 0.44-0.99) for MDS ≥ 6, with a significant trend of decreasing risk (p 0.043). The corresponding population attributable fraction was 22%, indicating that 22% of NPC cases in this population would be avoided by shifting all subjects to a score ≥6.



Our study supports a favorable role of the Mediterranean diet on NPC risk.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy. federica.turati@unimi.it.
Federica
0000-0002-5841-5773
F
Turati
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy.|Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", via G. La Masa 19, 20156, Milan, Italy.
Francesca
F
Bravi
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, Italy.
Jerry
J
Polesel
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", via G. La Masa 19, 20156, Milan, Italy.
Cristina
C
Bosetti
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", via G. La Masa 19, 20156, Milan, Italy.
Eva
E
Negri
Department of Otorhinolaryngology, School of Medicine and Surgery, Università di Milano-Bicocca, via Cadore 48, 20900, Monza, Italy.
Werner
W
Garavello
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, Italy.
Martina
M
Taborelli
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, Italy.
Diego
D
Serraino
Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, Università di Catania, Via Androne 83, 95124, Catania, Italy.
Massimo
M
Libra
Unit of Epidemiology, Istituto Tumori "Fondazione Pascale IRCCS", Via M. Semmola 1, 80131, Naples, Italy.
Maurizio
M
Montella
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy.|Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCSS Istituto Nazionale Tumori di Milano, via G. Venezian 1, 20133, Milan, Italy.
Adriano
A
Decarli
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy.
Monica
M
Ferraroni
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy.
Carlo
C
La Vecchia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology*; D016022:Case-Control Studies; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology*; D012306:Risk
Case–control study; Mediterranean diet; Nasopharyngeal cancer; Prevention; Risk factor