American Journal of Epidemiology Original Contribution Associations between Dietary Patterns and Head and Neck Cancer the Carolina Head and Neck Cancer Epidemiology Study-猫眼课题宝

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P. Bradshaw;Anna Maria Siega-Riz;M. Campbell;M. Weissler;W. Funkhouser;A. Olshan

很少有研究调查饮食模式与头颈部鳞状细胞癌（SCC）之间的关系，或者它们是否因种族而异。这是利用一项基于人群的病例对照研究（2002-2006）的数据进行评估的，该研究包括1176例头颈部鳞状细胞癌和1317例年龄、种族和性别匹配的对照，这些对照来自北卡罗来纳州中部和东部，他们的饮食通过食物频率问卷进行评估。因子分析确定了两种摄入模式：1)大量食用水果、蔬菜和瘦肉蛋白；2)大量食用油炸食品、高脂肪和加工肉类以及甜食。使用逻辑回归估计关联，调整匹配因素和混杂因素。肿瘤部位（口腔/咽部vs.喉部）的异质性和效果测量修改也进行了评估。发现水果、蔬菜和瘦肉蛋白模式降低了头颈部鳞状细胞癌的几率（最高四分位数vs最低，优势比为0.53,95%可信区间：0.39,0.71）。油炸食品、高脂肪和加工肉类以及甜食的饮食模式仅与喉癌呈正相关（优势比为2.12,95%可信区间为1.21,3.72）。这些发现强调了多吃水果和蔬菜、少吃高脂肪、加工肉类和糖果的饮食模式对预防头颈癌的重要性。头颈部癌症，通常包括口腔、咽部和喉部的鳞状细胞癌（SCCs），在美国和全世界都是一个重要的癌症负担（1,2）。仅在美国，2012年预计有40,250例口腔癌和咽喉癌诊断，12,360例喉癌诊断(3)。这些癌症的发病率在男性中通常高于女性；尤其是黑人男性在这两个部位的癌症发病率最高(4)。烟草和酒精使用仍然是头颈部鳞状细胞癌最强烈的行为危险因素（1,2）；然而，饮食暴露的额外重要性正在显现(5)。尽管许多研究人员已经注意到食用水果和蔬菜及其相关微量营养素的风险降低（6-8），但只有少数研究探索了饮食模式与头颈部鳞状细胞癌之间的关系（9-14）。此外，根据种族、性别或体型来检查饮食改变效果的研究一直缺乏，这些结果可能对公共卫生干预具有重要意义。为了研究饮食模式与头颈部鳞状细胞癌风险之间的关系，我们检查了来自一项研究的数据。

Few studies have examined the associations between dietary patterns and head and neck squamous cell carcinoma (SCC) or whether they differ by race. This was evaluated using data from a population-based case-control study (2002–2006) including 1,176 cases of head and neck SCC and 1,317 age-, race-, and gender-matched controls from central and eastern North Carolina whose diets had been assessed by food frequency questionnaire. Factor analysis identified 2 patterns of intake: 1) high consumption of fruits, vegetables, and lean protein and 2) high consumption of fried foods, high-fat and processed meats, and sweets. Associations were estimated using logistic regression, adjusting for matching factors and confounders. Heterogeneity by tumor site (oral/pharyngeal vs. laryngeal) and effect-measure modification were also evaluated. Reduced odds of head and neck SCC were found for the fruit, vegetable, and lean protein pattern (for highest quartile vs. lowest, odds ratio ¼ 0.53, 95% confidence interval: 0.39, 0.71). The fried foods, high-fat and processed meats, and sweets pattern was positively associated only with laryngeal cancer (odds ratio ¼ 2.12, 95% confidence interval: 1.21, 3.72). These findings underline the importance of a dietary pattern rich in fruits and vegetables and low in high-fat and processed meats and sweets for prevention of head and neck cancer. Cancers of the head and neck, which generally include squamous cell carcinomas (SCCs) of the oral cavity, phar-ynx, and larynx, represent a significant cancer burden in the United States and worldwide (1, 2). In the United States alone, 40,250 diagnoses of oral and pharyngeal cancer and 12,360 diagnoses of laryngeal cancer are expected in the year 2012 (3). Incidence rates for these cancers are typically higher for men than for women; black men in particular have the greatest incidence of cancer at both sites (4). Tobacco and alcohol use remain the strongest behavioral risk factors for head and neck SCC (1, 2); however, the additional importance of dietary exposures is emerging (5). Although many investigators have noted reduced risks for consumption of fruits and vegetables, as well as their related micronutrients (6–8), only a few studies have explored the association between dietary patterns and head and neck SCC (9–14). Additionally, studies examining effect modification of diet by race, gender, or body size have been lacking, and these results may have significant implications for public health interventions. To investigate the association between dietary patterns and risk of head and neck SCC, we examined data from a …

American Journal of Epidemiology Original Contribution Associations between Dietary Patterns and Head and Neck Cancer the Carolina Head and Neck Cancer Epidemiology Study

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