Abstract
Background
Dietary fiber and grain consumption may reduce the risk of head and neck cancer; however, the epidemiological evidence is limited. We investigated this relationship in the National Institutes of Health (NIH)-AARP Diet and Health Study.
Methods
Cox proportional hazards models were used to calculate multivariable hazard ratios (HR) and 95% confidence intervals (CI) to investigate dietary fiber and grain intake in relation to head and neck cancer.
Results
During approximately 11 years of follow-up, 1,867 (401 women/1,466 men) cases of head and neck cancer were diagnosed. Our data indicated that the relationship between fiber and grain intake and head and neck cancer is modified by sex (p-interactions < 0.001 and 0.001, respectively). Women with higher intake of total fiber and total grains had a lower risk of head and neck cancer (HR10g/day = 0.77, 95% CI = 0.64–0.93; HRserving/1,000kcal = 0.89, 95% CI = 0.80–0.99, respectively); this inverse relation was consistent across subtypes of fiber and grains. Conversely in men, the inverse associations were weaker and nonsignificant.
Conclusions
In the largest prospective cohort study to investigate this relation to date, intake of total fiber and grain foods was inversely associated with head and neck cancer incidence among women, but not among men.
Similar content being viewed by others
References
Rhys Evans P, Montgomery P, Gullane P (2003) Principles and practice of head and neck oncology. Martin Dunitz, London
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108
Jemal A, Siegel R, Ward E (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249
Sturgis EM, Wei Q, Spitz MR (2004) Descriptive epidemiology and risk factors for head and neck cancer. Semin Oncol 31:726–733
Chyou PH, Nomura AM, Stemmermann GN (1995) Diet, alcohol, smoking and cancer of the upper aerodigestive tract: a prospective study among Hawaii Japanese men. Int J Cancer 60:616–621
Kjaerheim K, Gaard M, Andersen A (1998) The role of alcohol, tobacco, and dietary factors in upper aerogastric tract cancers: a prospective study of 10,900 Norwegian men. Cancer Causes Control 9:99–108
Kasum CM, Jacobs DR Jr, Nicodemus K, Folsom AR (2002) Dietary risk factors for upper aerodigestive tract cancers. Int J Cancer 99:267–272
Boeing H, Dietrich T, Hoffmann K (2006) Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study. Cancer Causes Control 17:957–969
Freedman ND, Park Y, Subar AF (2007) Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer 121:2753–2760
World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington
La Vecchia C, Tavani A (1998) Fruit and vegetables, and human cancer. Eur J Cancer Prev 7:3–8
Riboli E, Kaaks R, Esteve J (1996) Nutrition and laryngeal cancer. Cancer Causes Control 7:147–156
Garavello W, Lucenteforte E, Bosetti C, La Vecchia C (2009) The role of foods and nutrients on oral and pharyngeal cancer risk. Minerva Stomatol 58:25–34
Levi F, Pasche C, Lucchini F (2000) Refined and whole grain cereals and the risk of oral, oesophageal and laryngeal cancer. Eur J Clin Nutr 54:487–489
Chatenoud L, Tavani A, La Vecchia C (1998) Whole grain food intake and cancer risk. Int J Cancer 77:24–28
McLaughlin JK, Gridley G, Block G (1988) Dietary factors in oral and pharyngeal cancer. J Natl Cancer Inst 80:1237–1243
De Stefani E, Ronco A, Mendilaharsu M, Deneo-Pellegrini H (1999) Diet and risk of cancer of the upper aerodigestive tract–II. Nutrients. Oral Oncol 35:22–26
Pelucchi C, Talamini R, Levi F (2003) Fibre intake and laryngeal cancer risk. Ann Oncol 14:162–167
Soler M, Bosetti C, Franceschi S (2001) Fiber intake and the risk of oral, pharyngeal and esophageal cancer. Int J Cancer 91:283–287
Lucenteforte E, Garavello W, Bosetti C, La Vecchia C (2009) Dietary factors and oral and pharyngeal cancer risk. Oral Oncol 45:461–467
La Vecchia C, Chatenoud L, Negri E, Franceschi S (2003) Session: whole cereal grains, fibre and human cancer wholegrain cereals and cancer in Italy. Proc Nutr Soc 62:45–49
Chatenoud L, La Vecchia C, Franceschi S (1999) Refined-cereal intake and risk of selected cancers in Italy. Am J Clin Nutr 70:1107–1110
Franceschi S, Barra S, La Vecchia C (1992) Risk factors for cancer of the tongue and the mouth. A case–control study from northern Italy. Cancer 70:2227–2233
Schatzkin A, Subar AF, Thompson FE (2001) Design and serendipity in establishing a large cohort with wide dietary intake distributions : the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol 154:1119–1125
Fritz A (2000) International classification of diseases for oncology: ICD-O. World Health Organization, Geneva
Freedman ND, Schatzkin A, Leitzmann MF, Hollenbeck AR, Abnet CC (2007) Alcohol and head and neck cancer risk in a prospective study. Br J Cancer 96:1469–1474
Subar AF, Midthune D, Kulldorff M (2000) Evaluation of alternative approaches to assign nutrient values to food groups in food frequency questionnaires. Am J Epidemiol 152:279–286
Tippett K (1997) Design and operation: the continuing survey of food intakes by individuals and diet and health knowledge survey, 1994–1996. Continuing survey of food intakes by individuals, nationwide food surveys. US Department of Agriculture, Agricultural Research Service, Washington
Prosky L, Asp NG, Furda I (1985) Determination of total dietary fiber in foods and food products: collaborative study. J Assoc Off Anal Chem 68:677–679
Friday JE, Bowman SA (2006) MyPyramid equivalents database for USDA survey food codes, 1994–2002. USDA, ARS, Community Nutrition Research Group, Beltsville, MD
Thompson FE, Kipnis V, Midthune D (2008) Performance of a food-frequency questionnaire in the US NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health Study. Public Health Nutr 11:183–195
Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27
Uzcudun AE, Retolaza IR, Fernandez PB (2002) Nutrition and pharyngeal cancer: results from a case-control study in Spain. Head Neck 24:830–840
Franceschi S, Bidoli E, Baron AE (1991) Nutrition and cancer of the oral cavity and pharynx in north-east Italy. Int J Cancer 47:20–25
De Stefani E, Deneo-Pellegrini H, Mendilaharsu M, Ronco A (1999) Diet and risk of cancer of the upper aerodigestive tract–I. Foods. Oral Oncol 35:17–21
Moller ME, Dahl R, Bockman OC (1988) A possible role of the dietary fibre product, wheat bran, as a nitrite scavenger. Food Chem Toxicol 26:841–845
Fardet A New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutr Res Rev 23:65–134
Maras JE, Newby PK, Bakun PJ, Ferrucci L, Tucker KL (2009) Whole grain intake: the Baltimore longitudinal study of aging. J Food Compost Anal 22:53–58
Slavin JL (2000) Mechanisms for the impact of whole grain foods on cancer risk. J Am Coll Nutr 19:300S–307S
Fernandez E, Gallus S, La Vecchia C (2006) Nutrition and cancer risk: an overview. J Br Menopause Soc 12:139–142
Edefonti V, Bravi F, La Vecchia C Nutrient-based dietary patterns and the risk of oral and pharyngeal cancer. Oral Oncol 46:343–348
Slavin JL (2000) Whole grains, refined grains and fortified refined grains: what’s the difference? Asia Pacific J Clin Nutr 9:S23–S27
Freedman ND, Abnet CC, Leitzmann MF, Hollenbeck AR, Schatzkin A (2007) Prospective investigation of the cigarette smoking-head and neck cancer association by sex. Cancer 110:1593–1601
Yoo HJ, Sepkovic DW, Bradlow HL (2001) Estrogen metabolism as a risk factor for head and neck cancer. Otolaryngol Head Neck Surg 124:241–247
Lukits J, Remenar E, Raso E (2007) Molecular identification, expression and prognostic role of estrogen- and progesterone receptors in head and neck cancer. Int J Oncol 30:155–160
Ferguson BJ, Hudson WR, McCarty KS Jr (1987) Sex steroid receptor distribution in the human larynx and laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 113:1311–1315
Freedman ND, Lacey JV Jr, Hollenbeck AR (2007) The association of menstrual and reproductive factors with upper gastrointestinal tract cancers in the NIH-AARP cohort. Cancer 116:1572–1581
Kuiper GG, Lemmen JG, Carlsson B (1998) Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor beta. Endocrinology 139:4252–4263
Adlercreutz H (2007) Lignans and human health. Crit Rev Clin Lab Sci 44:483–525
Hennessey PT, Westra WH, Califano JA (2009) Human papillomavirus and head and neck squamous cell carcinoma: recent evidence and clinical implications. J Dent Res 88:300–306
Acknowledgments
This research was supported [in part] by the Intramural Research Program of the NIH, National Cancer Institute. Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University. Cancer incidence data from California were collected by the California Department of Health Services, Cancer Surveillance Section. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, State of Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System (FCDC) under contract with the Florida Department of Health (FDOH). The views expressed herein are solely those of the authors and do not necessarily reflect those of the FCDC or FDOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Medical Center in New Orleans. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey State Department of Health and Senior Services. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions. Cancer incidence data from Arizona were collected by the Arizona Cancer Registry, Division of Public Health Services, Arizona Department of Health Services. Cancer incidence data from Texas were collected by the Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services. We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. We also thank Sigurd Hermansen and Kerry Grace Morrissey from Westat for study outcomes ascertainment and management and Leslie Carroll at Information Management Services for data support and analysis.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lam, T.K., Cross, A.J., Freedman, N. et al. Dietary fiber and grain consumption in relation to head and neck cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control 22, 1405–1414 (2011). https://doi.org/10.1007/s10552-011-9813-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-011-9813-9