Natural vitamin C intake and the risk of head and neck cancer: A pooled analysis in the International Head and Neck Cancer Epidemiology Consortium - PubMed (original) (raw)

Multicenter Study

. 2015 Jul 15;137(2):448-62.

doi: 10.1002/ijc.29388. Epub 2015 Jan 28.

Mia Hashibe 2, Maria Parpinel 3, Federica Turati [ 4](#full-view-affiliation-4 "Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri,", Milan, Italy.") 5, Diego Serraino 6, Keitaro Matsuo 7, Andrew F Olshan 8, Jose P Zevallos 9, Deborah M Winn 10, Kirsten Moysich 11, Zuo-Feng Zhang 12, Hal Morgenstern 13, Fabio Levi 14, Karl Kelsey 15, Michael McClean 16, Cristina Bosetti [ 4](#full-view-affiliation-4 "Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri,", Milan, Italy."), Carlotta Galeone [ 4](#full-view-affiliation-4 "Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri,", Milan, Italy."), Stimson Schantz 17, Guo-Pei Yu 18, Paolo Boffetta 19, Yuan-Chin Amy Lee 20, Shu-Chun Chuang 21, Carlo La Vecchia [ 1](#full-view-affiliation-1 "Dipartimento di Scienze Cliche e di Comunità Sezione Di Statistica Medica E Biometria "Giulio A. Maccacaro,", Università degli Studi di Milano, Milan, Italy."), Adriano Decarli [ 1](#full-view-affiliation-1 "Dipartimento di Scienze Cliche e di Comunità Sezione Di Statistica Medica E Biometria "Giulio A. Maccacaro,", Università degli Studi di Milano, Milan, Italy.") 5

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Multicenter Study

Natural vitamin C intake and the risk of head and neck cancer: A pooled analysis in the International Head and Neck Cancer Epidemiology Consortium

Valeria Edefonti et al. Int J Cancer. 2015.

Abstract

Evidence of associations between single nutrients and head and neck cancer (HNC) is still more limited and less consistent than that for fruit and vegetables. However, clarification of the protective mechanisms of fruit and vegetables is important to our understanding of HNC etiology. We investigated the association between vitamin C intake from natural sources and cancer of the oral cavity/pharynx and larynx using individual-level pooled data from ten case-control studies (5,959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. After harmonization of study-specific exposure information via the residual method, adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional multiple logistic regression models on quintile categories of 'non-alcohol energy-adjusted' vitamin C intake. In the presence of heterogeneity of the estimated ORs among studies, we derived those estimates from generalized linear mixed models. Higher intakes of vitamin C were inversely related to oral and pharyngeal (OR = 0.54, 95% CI: 0.45-0.65, for the fifth quintile category versus the first one, p for trend<0.001) and laryngeal cancers (OR = 0.52, 95% CI: 0.40-0.68, p for trend = 0.006), although in the presence of heterogeneity among studies for both sites. Inverse associations were consistently observed for the anatomical subsites of oral and pharyngeal cancer, and across strata of age, sex, education, body mass index, tobacco, and alcohol, for both cancer sites. The inverse association of vitamin C intake from foods with HNC may reflect a protective effect on these cancers; however, we cannot rule out other explanations.

Keywords: INHANCE; head and neck cancer; laryngeal cancer; oral and pharyngeal cancer; vitamin C.

© 2014 UICC.

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Conflict of interest statement

Conflict of interest: There is no conflict of interest to declare.

Figures

Figure 1

Figure 1

Forest plots of pooled and study-specific odds ratios (ORs) for the associations between the highest versus the lowest quintile categories of non-alcohol energy-adjusted vitamin C intake and oral and pharyngeal, and laryngeal cancers, respectively. International Head and Neck Cancer Epidemiology (INHANCE) consortium.

Figure 2

Figure 2

Odds ratios (ORs)a,b,c of oral and pharyngeal, and laryngeal cancers, and corresponding confidence intervals (95% CIs), according to alcohol or tobacco consumption and ‘non-alcohol energy-adjusted’ vitamin C intake. International Head and Neck Cancer Epidemiology (INHANCE) consortium. a The odds ratios were derived from mixed-effects logistic regression models adjusted for age, sex, education, race/ethnicity, study center, combined smoking habits of cigarettes, cigars, and pipes, and alcohol drinking, when appropriate. b The number of cases and controls within each category was indicated below the corresponding odds ratio as: “number of cases : number of controls”. c The never/light drinker category included never drinkers and subjects who drinks less than 1 drink per day; the moderate drinker category included subjects drinking between 1 (included) and 5 drinks per day; the heavy drinker category included subjects drinking 5 drinks per day or more.

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