Annals of Oncology Advance Access published online on June 1, 2009
Annals of Oncology, doi:10.1093/annonc/mdp036
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Dietary vitamin D and cancers of the oral cavity and esophagus
1 International Epidemiology Institute, Rockville, MD
2 Department of Preventive Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
3 Department of Epidemiology, Institute of Pharmacologic Research "Mario Negri", Milan
4 Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
5 Epidemiology and Biostatistics Unit, Oncology Referral Center, Aviano (PN), Italy
6 Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchatel, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
7 Epidemiology and Biology Cluster, International Agency for Research on Cancer, Lyon, France
8 Institute of Medical Statistics and Biometrics "G. A. Maccacaro", University of Milan, Milan, Italy
* Correspondence to: Dr L. Lipworth, International Epidemiology Institute, 1455 Research Boulevard, Suite 550, Rockville, MD 20850, USA. Tel: +1-301-424-1054 ext. 4291; Fax: +1-301-424-1053; E-mail: loren{at}iei.us
Background: Data on the association between vitamin D and upper digestive tract neoplasms are limited.
Methods: In two case–control studies in Italy, we examined the relation between dietary vitamin D intake and squamous cell carcinoma of the esophagus (SCCE; 304 cases) and oral/pharyngeal cancer (804 cases). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multiple logistic regression.
Results: Adjusted ORs for SCCE and oral/pharyngeal cancer were 0.58 (95% CI 0.39–0.86) and 0.76 (95% CI 0.60–0.94), respectively, for the highest tertile of vitamin D intake. Using a reference group of those in the highest tertile of vitamin D who were never/former smokers, ORs were 8.7 (95% CI 4.1–18.7) for SCCE and 10.4 (95% CI 6.9–15.5) for oral/pharyngeal cancer among heavy smokers in the lowest vitamin D tertile; similarly, compared with those in the highest tertile of vitamin D who drank <3 alcoholic drinks/day, corresponding ORs were 41.9 (95% CI 13.7–128.6) for SCCE and 8.5 (95% CI 5.7–12.5) for oral/pharyngeal cancer, among heavy alcohol drinkers in the lowest vitamin D tertile.
Conclusion: We observed inverse associations between dietary vitamin D intake and risk of SCCE and, perhaps, oral/pharyngeal cancer, which were most pronounced among heavy current smokers and heavy consumers of alcohol.
cancer, epidemiology, esophageal, oral, pharyngeal, vitamin D
Received for publication November 14, 2008. Revision received January 26, 2009. Accepted for publication January 27, 2009.