Food groups, nutrients and the risk of head and neck cancer.

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While tobacco use and alcohol are the primary risk factors for head and neck squamous cell cancer (HNSCC), dietary factors may also contribute substantially to the etiology of this cancer. Many reports on fruit and vegetable intake and risk of oral cancer suggest a decreased risk for higher fruit and/or vegetable consumption, although epidemiologic studies investigating the protective effect of fruits and vegetables on the risk of head and neck cancer are far from being conclusive. As part of a population-based case-control study in the greater Boston area, we investigated the relationship between the several food groups, nutrients and HNSCC risk. All subjects were asked to complete food frequency and risk factors questionnaires and to provide blood samples. Incident HNSCC cases were accrued through Boston area hospitals from 1999 to 2004. Controls were selected from the cases' neighborhoods, matched by age and gender. There were 496 cases and 712 controls enrolled who had completed the food frequency questionnaire. Cases and controls were divided into quintiles according to the distribution of food groups among the entire study population. The association between intake of food groups and the risk of HNSCC was examined using unconditional logistic regression. We observed no association between fruits, vegetables and the combined consumption of fruits and vegetables and the risk of HNSCC. All models were adjusted for age, race, gender, BMI, education, tobacco, alcohol and non-alcohol caloric intake. There was a positive association between the consumption of dairy products and HNSCC. The odds of cancer by successively higher quintiles of dairy consumption were 1.74 (1.15-2.63), 1.13 (0.73-1.76), 1.54 (1.02-2.32) and 1.67 (1.1-2.6) compared to subjects in the lowest quintile (p-trend = 0.06). We also observed a significant inverse association with HNSCC for the consumption of cereals and starch roots. The odds of cancer by successively higher quintiles of cereal consumption were 0.58 (0.38-0.89), 0.46 (0.29-0.72), 0.49 (0.31-0.79 and 0.47 (0.27-0.8) compared to subjects in the lowest quintile (p-trend = 0.03). Finally, animal fat was also associated with an elevation in HNSSC risk. The odds of cancer in successively higher quintiles of fat consumption were 1.13 (0.76-1.69), 1.15 (0.76-1.72), 1.61 (1.07-2.43 and 1.63 (1.08-2.46) compared to subjects in the lowest quintile (p-trend < 0.01). Our data suggest that while fruits and vegetables are not universally protective for HNSCC, other food groups and nutrients may influence risk of this disease. Supported by NIH grants CA78609, ES00002 and CA100679 and The Flight Attendants Medical Research Institute.