Inflammatory potential of diet and risk of oral and pharyngeal cancer in a large case-control study from Italy.
Diet and inflammation have been suggested to be important risk factors for oral and pharyngeal cancer. We examined the association between dietary inflammatory index (DII™) and oral and pharyngeal cancer in a large case-control study conducted between 1992 and 2009 in Italy. This study included 946 cases with incident, histologically confirmed oral and pharyngeal cancer, and 2,492 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a valid 78-item food frequency questionnaire and was adjusted for nonalcohol energy intake using the residual approach (E-DII™). Logistic regression models were used to estimate odds ratios (ORs), and 95% confidence intervals (CIs), adjusted for age, sex, non-alcohol energy intake, study center, year of interview, education, body mass index, tobacco smoking, and alcohol drinking. Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of oral and pharyngeal cancer, the OR being 1.80 (95% CI 1.36-2.38) for the highest versus the lowest DII quartile and 1.17 (95% CI 1.10-1.25) for a one-unit increase (8% of the DII range). When stratified by selected covariates, a stronger association was observed among women (ORquartile4 v.13.30, 95% CI 1.95-5.57). We also observed a stronger association for oral cancers and a strong combined effect of higher DII score and tobacco smoking or alcohol consumption on oral and pharyngeal cancer. These results indicate that the pro-inflammatory potential of the diet, as shown by higher DII scores, is associated with higher odds of oral and pharyngeal cancer.
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.|Connecting Health Innovations LLC, Columbia, SC.
Nitin
0000-0003-0441-8896
N
Shivappa
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.|Connecting Health Innovations LLC, Columbia, SC.|Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC.
James R
JR
Hébert
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.|Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy.
Valentina
V
Rosato
Department of Surgery and Translational Medicine, University of Milano-Bicocca, Milan, Italy.
Werner
W
Garavello
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, (PN), Italy.
Diego
D
Serraino
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Carlo
0000-0003-1441-897X
C
La Vecchia
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007558:Italy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology*; D010610:Pharyngeal Neoplasms / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
Italy; case-control; dietary inflammatory index; oral and pharyngeal cancer