Annals of Oncology 14:1677-1681, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Folate intake and risk of oral and pharyngeal cancer
1 Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan; 2 Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano (PN), Italy; 3 Registre Vaudois des Tumeurs, Institut Universitaire de Médicine Sociale et Préventive, Lausanne, Switzerland; 4 Servizio Integrato di Epidemiologia e Sistemi Informativi (SINTESI), Rome, Italy; 5 International Agency for Research on Cancer, Lyon Cedex, France; 6 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy
Received 20 November 2002; revised 3 March 2003; accepted 25 July 2003
Background:
Diet has been recognised as having a role in the aetiology of oral and pharyngeal cancer, and dietary factors may account for 10–15% of cases in Europe. Folate deficiency has been linked to risk of several cancers, but has not been studied adequately with respect to oral cancer.
Patients and methods:
This case–control study, conducted in Italy and French-speaking Switzerland, included 749 patients with incident cancer of the oral cavity and pharynx, and 1772 hospital controls with acute, non-neoplastic conditions. The interviews used a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multiple logistic regression.
Results:
The ORs were 0.68 (95% CI 0.52–0.88) for the intermediate tertile and 0.53 (95% CI 0.40–0.69) for the highest tertile of dietary folate intake, compared with the lowest tertile. No heterogeneity was found in strata of gender, age, methionine intake or alcohol consumption. The combined OR for low-folate and high-alcohol intake versus high-folate and low-alcohol intake was 22.3 (95% CI 13.1–38).
Conclusions:
Our study supports a protective role of folate against oral and pharyngeal carcinogenesis. Compared with low folate intake, a consistent reduction in risk was already observed from intermediate levels of intake, suggesting that cancer risk may be related to relative folate deficiency.
Key words: alcohol, case–control study, diet, folate, oral and pharyngeal cancer
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