Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium

Int J Cancer. 2017 Nov 1;141(9):1811-1821. doi: 10.1002/ijc.30886. Epub 2017 Jul 27.

Abstract

The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40-0.59; p for trend <0.001) and with laryngeal cancer (OR = 0.66, 95% CI: 0.54-0.82, p for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk.

Keywords: INHANCE; dietary fiber intake; head and neck cancer; laryngeal cancer; oral cavity and pharyngeal cancer.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects
  • Carcinoma, Squamous Cell / diet therapy*
  • Carcinoma, Squamous Cell / pathology
  • Case-Control Studies
  • Dietary Fiber / therapeutic use*
  • Female
  • Head and Neck Neoplasms / diet therapy*
  • Head and Neck Neoplasms / epidemiology
  • Head and Neck Neoplasms / pathology
  • Humans
  • Laryngeal Neoplasms / diet therapy
  • Laryngeal Neoplasms / pathology
  • Male
  • Middle Aged
  • Nicotiana / adverse effects
  • Pharyngeal Neoplasms / diet therapy
  • Pharyngeal Neoplasms / pathology
  • Risk Factors
  • Squamous Cell Carcinoma of Head and Neck

Substances

  • Dietary Fiber