title: Intake of meat and fish and risk of head-neck cancer subtypes in the Netherlands Cohort Study.
abstract: OBJECTIVE
  To date, the role of meat and fish intake in head-neck cancer (HNC) etiology is not well understood and prospective evidence is limited. This prompted us to study the association between meat, fish, and HNC subtypes, i.e., oral cavity cancer (OCC), oro- and hypopharyngeal cancer (OHPC), and laryngeal cancer (LC), within the Netherlands Cohort Study (NLCS).
  
  
  METHODS
  In 1986, 120,852 participants (aged 55-69 years) completed a baseline 150-item food frequency questionnaire (FFQ), from which daily meat and fish intake were calculated. After 20.3 years of follow-up, 430 HNC overall (134 OCC, 90 OHPC and 203 LC) cases and 4,111 subcohort members were found to be eligible for case-cohort analysis. Multivariate hazard ratios were calculated using Cox's proportional hazards model within quartiles of energy-adjusted meat and fish intake.
  
  
  RESULTS
  Processed meat intake, but not red meat intake, was positively associated with HNC overall [HR(Q4 vs. Q1) = 1.46, 95% CI 1.06-2.00; ptrend = 0.03]. Among HNC subtypes, processed meat was positively associated with OCC, while no associations were found with OHPC and LC. Fish intake was not associated with HNC risk. Tests for interaction did not reveal statistically significant interaction between meat, fish, and alcohol or smoking on HNC overall risk.
  
  
  CONCLUSIONS
  In this large cohort study, processed meat intake was positively associated with HNC overall and HNC subtype OCC, but not with OHPC and LC.
authors.affiliation: Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Peter Debijeplein 1, 6229 HA, Maastricht, The Netherlands.
authors.forename: Andy
authors.initials: A
authors.lastname: Perloy
authors.affiliation: Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Peter Debijeplein 1, 6229 HA, Maastricht, The Netherlands.
authors.forename: Denise H E
authors.initials: DHE
authors.lastname: Maasland
authors.affiliation: Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Peter Debijeplein 1, 6229 HA, Maastricht, The Netherlands.
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.affiliation: Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Peter Debijeplein 1, 6229 HA, Maastricht, The Netherlands. lj.schouten@maastrichtuniversity.nl.
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
mesh_terms: D000368:Aged; D000818:Animals; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood / Q000009:adverse effects*; D012907:Smoking
keywords: Fish; Head–neck cancer; Meat; Prospective cohort studies; Risk factors