Inflammatory potential of diet and risk of laryngeal cancer in a case–control study from Italy (original) (raw)

Abstract

Background

Besides tobacco and alcohol, diet and inflammation have been suggested to be important risk factors for laryngeal cancer. In this study, we examined the role of diet-associated inflammation, as estimated by dietary inflammatory index (DII) scores, in laryngeal cancer in a multicentre case–control study conducted between 1992 and 2000 in Italy.

Methods

This study included 460 cases with incident, histologically confirmed laryngeal cancer, and 1,088 controls hospitalized for acute non-neoplastic diseases unrelated to tobacco and alcohol consumption. DII scores were computed from a reproducible and valid 78-item food-frequency questionnaire. Logistic regression models controlling for age, sex, study center, education, body mass index, tobacco smoking, alcohol drinking, and non-alcohol energy intake were used to estimate odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs).

Results

Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of laryngeal cancer. The OR was 3.30 (95 % CI 2.06, 5.28; p for trend <0.0001) for the highest versus the lowest DII quartile. When DII was considered as a continuous variable, the OR was 1.27 (95 % CI 1.15, 1.40) for a one-unit (9 % of the DII range) increase. Stratified analyses produced slightly stronger associations between DII and laryngeal cancer risk among Subjects <60 years old (ORquartile4vs1 = 4.68), overweight subjects (ORQuartile4vs1 = 3.62), and among those with higher education (ORQuartile4vs1 = 3.92). We also observed a strong combined effect of higher DII and tobacco smoking or alcohol consumption on risk of laryngeal cancer. Compared with non-smokers having low DII scores, the OR was 6.64 for smokers with high DII scores. Likewise, compared with non/moderate drinkers with low DII, the OR was 5.82 for heavy drinkers with high DII.

Conclusion

These results indicate that a pro-inflammatory diet is associated with increased risk of laryngeal cancer.

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Funding

This study was supported by the Italian Foundation for Research on Cancer (FIRC) and by the Italian Ministry of Health, General Directorate of European and International Relations. Drs. Shivappa and Hébert were supported by Grant No. R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Valentina Rosato was supported by a fellowship from the Italian Foundation for Cancer Research (FIRC #18107).

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Authors and Affiliations

  1. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA
    Nitin Shivappa & James R. Hébert
  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
    Nitin Shivappa & James R. Hébert
  3. Connecting Health Innovations LLC, Columbia, SC, 29201, USA
    Nitin Shivappa & James R. Hébert
  4. Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC, 29208, USA
    James R. Hébert
  5. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
    Valentina Rosato & Carlo La Vecchia
  6. Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
    Valentina Rosato
  7. Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano, Italy
    Diego Serraino

Authors

  1. Nitin Shivappa
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  2. James R. Hébert
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  3. Valentina Rosato
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  4. Diego Serraino
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  5. Carlo La Vecchia
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Corresponding author

Correspondence toNitin Shivappa.

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Conflict of interest

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI.

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Shivappa, N., Hébert, J.R., Rosato, V. et al. Inflammatory potential of diet and risk of laryngeal cancer in a case–control study from Italy.Cancer Causes Control 27, 1027–1034 (2016). https://doi.org/10.1007/s10552-016-0781-y

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