Diet and oral and pharyngeal cancer among blacks

Data from a population-based multicenter case-control study were examined to assess for the first time the relationship between diet and oral and pharyngeal cancer among blacks. An increased intake of fruits and vegetables was associated with a decreased risk for oral cancer among both men and women, although the protective effect was stronger among men. Risk also declined in both sexes with an increase in the consumption of vitamin C and fiber and in men only for carotene and vitamin E. In both sexes, no associations were found with an intake of smoked, pickled, or charcoal-grilled meats or of hot beverages. However, the consumption of nitrite-containing meats was linked to increased risk among men. The dietary patterns of risk for blacks were generally similar to those previously reported for whites; however, a lower consumption of fruits and vegetables among blacks in this study may contribute to their higher rates of oral and pharyngeal cancer.     

Diet and oral and pharyngeal cancer among blacks

Data from a population‐based multicenter case‐control study were examined to assess for the first time the relationship between diet and oral and pharyngeal cancer among blacks. An increased intake of fruits and vegetables was associated with a decreased risk for oral cancer among both men and women, although the protective effect was stronger among men. Risk also declined in both sexes with an increase in the consumption of vitamin C and fiber and in men only for carotene and vitamin E. In both sexes, no associations were found with an intake of smoked, pickled, or charcoal‐grilled meats or of hot beverages. However, the consumption of nitrite‐containing meats was linked to increased risk among men. The dietary patterns of risk for blacks were generally similar to those previously reported for whites; however, a lower consumption of fruits and vegetables among blacks in this study may contribute to their higher rates of oral and pharyngeal cancer.     

Diet diversity and the risk of oral and pharyngeal cancer

BACKGROUND: Diet diversity has been recommended to achieve a healthy diet and prevent cancer. AIM OF THE STUDY: The relation between diet diversity (i.e., variety in food intake computed as the total number of foods consumed at least once per week) and the risk of oral and pharyngeal cancer was investigated using data from a multicentric case-control study carried out between 1991 and 2005 in Italy. METHODS: Cases were 805 patients with histologically confirmed incident cancers of the oral cavity and pharynx, and controls were 2,081 patients admitted for acute, non-neoplastic diseases, unrelated to tobacco or alcohol consumption. RESULTS: A significant inverse association was observed with total diet diversity. The multivariate odds ratio (OR), adjusted for education, tobacco and alcohol, was 0.78 (95% confidence interval, CI 0.61-0.98) for subjects in the highest tertile of diversity. Inverse relations were found also for diversity within vegetables (OR = 0.62; 95% CI 0.49-0.78) and fruits (OR = 0.67; 95% CI 0.53-0.86). CONCLUSIONS: This study suggests that a more diversified, and particularly a diet varied in vegetables and fruit, is a favourable indicator of oral and pharyngeal cancer risk, independently from the major recognised risk factors, i.e. alcohol and tobacco consumption.     

Dietary indicators of oral and pharyngeal cancer

The relationship between frequency of consumption of a selected number of indicator foods and oral and oropharyngeal cancer risk was analysed in a case-control study conducted in Northern Italy on 105 cases of oral and pharyngeal cancer and 1169 controls in hospital for acute, non-neoplastic or digestive diseases. Besides significant and strong direct associations with tobacco (relative risk, RR = 11.0 for current versus never smokers) and alcohol (RR = 5.8 for upper versus lower consumption tertile), consumption of six food items (milk, meat, cheese, carrots, green vegetables and fruit) were inversely and significantly related to oral and pharyngeal cancer risk. The strongest protection was apparently related to frequent fruit consumption, with RRs of 0.8 and 0.2 in the two highest tertiles. Allowance for major potential confounding factors, including tobacco, alcohol and social class indicators explained only part of the dietary correlates observed. The two items remaining significant after multivariate analysis were fruit (RR = 0.3 for the upper tertile) and alcohol (RR = 3.8 for the upper tertile). The associations observed may simply reflect a generally poorer nutritional status in the cases, although the observation that fruit consumption appears to be a particularly important protective factor against oropharyngeal cancer is of potential interest, in terms of aetiological clues and preventive implications.     

Diet and esophageal cancer: A case-control study

A case control study of osophageal cancer was conducted among black male and female residents of Washington, D.C., to assess the influence of the intake of food groups, alcohol, and smoking to the esophageal cancer. Twenty-three pairs (23 cases and 23 controls) were interviewed. Cases ate more pork (p<0.005), bacon, hot dogs, sausages (p<0.025) and drank more beer, champale, malted liquor (p<0.01), and canned beer (p<0.01). They also smoked more frequently (p<0.05). Pork consumption is higher among blacks and this could be one of the reasons for high incidence of esophageal carcinoma in this population. The processing of pork and pork products may be associated with esophageal cancer rather than the pork itself. Although we have made some preliminary observations regarding the relationship of nutrition to esophageal cancer in the black population, further studies need to be conducted to identify specific nutrient deficiency, if any, in these cases.     

Diet and esophageal cancer in calvados (France)

The role of nutrients and food factors in relation to esophageal cancer was observed in a large case‐control study in a region having a high incidence of the disease. Several factors that increased or decreased the risk were identified. After adjusting for other covariates, we found that animal proteins and polyunsaturated fats had a significant protective effect. Separating the effects of specific nutrients was difficult because of the intercorrelation between individual intakes of most nutrients.

Foods were not so highly intercorrelated. Fresh meat, citrus fruits, and oil were found to be protective. A dietary index combining these foods was used; between the lowest and the highest levels of intake, a nine‐fold difference in risk was observed. This effect is added to that of alcohol, which remains the major risk factor.

The adequacy of the concepts of nutrients and foods in epidemiological studies is discussed in addition to the theoretical and practical implications of the findings.     

Diet and esophageal cancer in Calvados (France)

The role of nutrients and food factors in relation to esophageal cancer was observed in a large case-control study in a region having a high incidence of the disease. Several factors that increased or decreased the risk were identified. After adjusting for other covariates, we found that animal proteins and polyunsaturated fats had a significant protective effect. Separating the effects of specific nutrients was difficult because of the intercorrelation between individual intakes of most nutrients. Foods were not so highly intercorrelated. Fresh meat, citrus fruits, and oil were found to be protective. A dietary index combining these foods was used; between the lowest and the highest levels of intake, a nine-fold difference in risk was observed. This effect is added to that of alcohol, which remains the major risk factor. The adequacy of the concepts of nutrients and foods in epidemiological studies is discussed in addition to the theoretical and practical implications of the findings.     

The relation of socioeconomic status to oral and pharyngeal cancer

We assessed the relation between socioeconomic status and risk of oropharyngeal cancer in a population-based interview study of 762 male cases and 837 male controls in four areas of the United States. Three primary indicators of socioeconomic status were evaluated: education, occupational status, and percentage of potential working life spent in employment. With adjustment for the effects of established risk factors, such as use of tobacco products, alcohol consumption, and poor dentition, a relatively low percentage of years worked was also a risk factor. Educational attainment and occupational status were not independently related to risk of oropharyngeal cancer. These results are consistent with the hypothesis that behaviors that lead to social instability, and/or social instability itself, are linked to an increased risk of oral and pharyngeal cancers.     

Diet in the epidemiology of oral cancer

In this comparison of 425 oral cancer patients and 588 controls, it was found that risk increased in dose‐response fashion as vitamin A or vitamin C intake decreased. This elevation of relative risk persisted with control for smoking and alcohol ingestion.     

Coffee consumption and the risk of oral, pharyngeal, and esophageal cancers in Japan: the Miyagi Cohort Study

An inverse association between coffee consumption and the risk of oral, pharyngeal, and esophageal cancers has been suggested in case-control studies, but few results from prospective studies are available. Data from the Miyagi Cohort Study in Japan were used to clarify the association between coffee consumption and the risk of these cancers. Information about coffee consumption was obtained from self-administered food frequency questionnaires in 1990. Among 38,679 subjects aged 40-64 years with no previous history of cancer, 157 cases of oral, pharyngeal, and esophageal cancers were identified during 13.6 years of follow-up. Hazard ratios were estimated by the Cox proportional hazards regression model. The risk of oral, pharyngeal, and esophageal cancers was inversely associated with coffee consumption. The multivariate-adjusted hazard ratio of these cancers for > or =1 cups of coffee per day compared with no consumption was 0.51 (95% confidence interval: 0.33, 0.77). This inverse association was consistent regardless of sex and cancer site and was observed both for subjects who did not drink or smoke and for those who currently drank or smoked at baseline. In conclusion, coffee consumption was associated with a lower risk of oral, pharyngeal, and esophageal cancers, even in the group at high risk of these cancers.     

Vitamin supplement use and reduced risk of oral and pharyngeal cancer.

Use of vitamin and mineral supplements was assessed in a population-based case-control study of oral and pharyngeal cancer, conducted during 1984-1985 in four areas of the United States. There was no association with intake of multivitamin products, but users of supplements of individual vitamins, including vitamins A, B, C, and E, were at lower risk after controlling for the effects of tobacco, alcohol, and other risk factors for these cancers. After further adjustment for use of other supplements, vitamin E was the only supplement that remained associated with a significantly reduced cancer risk. The adjusted odds ratio of oral and pharyngeal cancer for "ever regularly used" vitamin E was 0.5 (95% confidence interval 0.4-0.6). To the authors' knowledge, this is the first epidemiologic study to show a reduced oral cancer risk with vitamin E use. Although it is not clear that the lower risk among consumers of vitamin E supplements is due to the vitamin per se, the findings are consistent with experimental evidence and should prompt further research on the role of vitamin E and other micronutrients as inhibitors of oral and pharyngeal cancer.     

An epidemiological study of oral and pharyngeal cancer in Central and South-East Asia

The author has investigated the epidemiology of oral and pharyngeal cancer in several different countries and localities in Central and South-East Asia. From comparisons of the various countries and areas and from detailed case studies among oral-cancer groups and control groups, the author has obtained strong supportive evidence for the association of the disease with the habit of chewing tobacco. He has also found a less marked association with smoking, the drinking of alcohol, and vegetarian dietary customs.     

Breast cancer, colorectal cancer, and esophageal cancer

This is the second of a six-part series on metastatic spread and natural history of 18 common tumors. Part one summarized symptom/problem anticipation, cancer metastasis, and the 18 tumors that each cause more than 6,000 deaths per year in the United States. Bladder and brain cancer were discussed, with information given on tumor types, metastatic spread and invasion, and common symptoms. Part two charts the natural histories of breast, colorectal, and esophageal cancers. Each of these cancers is presented separately, with information given on mortality rates, the most common tumor types, sites of metastases, common problems, and common oncologic emergencies. Sites of spread, resulting problems (including site-specific symptoms), and assessment parameters are presented as tables. Material is presented so that clinicians will be able to anticipate the spread of these cancers and thus identify problems early in their development so that the problems are more easily managed.     

Vitamin supplement use and risk for oral and esophageal cancer.

In a hospital-based case-control study, 290 oral cancer cases and 133 esophageal cancer cases were queried as to smoking status, alcohol consumption, and dietary exposures, including vitamin supplement history. Among oral cancer cases, vitamin E use appeared to exert a protective effect. Vitamins C and E had protective effects among esophageal cancer cases. When stratified by smoking status, the protective effect of vitamin C use in esophageal cancer was significant only among current smokers, as was vitamin B use. A reduced risk of oral cancer was correlated with multivitamin use and increasing vegetable consumption, as was vegetable/fruit consumption and vitamin C supplementation. Among esophageal cancer cases, increasing meat consumption and vitamin C use were associated with a significantly reduced cancer risk.     

Preoperative oral supplementation support in patients with esophageal cancer

Objective

Surgeries for cancer of the esophagus are still associated with a high rate of postoperative morbidity. There are few reports of perioperative nutritional support for patients undergoing esophageal cancer surgery, and there is insufficient evidence to recommend routine use of immunonutrition in these patients. The aim of this study was to determine whether preoperative immunonutrition positively influences key clinical outcomes such as postoperative infectious complications, mortality, length of hospital stay, and short-term survival in this population.

Design and Setting

We undertook a retrospective investigation of the effects of preoperative nutritional support on the postoperative course of esophageal cancer surgery at the Department of Gastroenterological Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan.

Participants

Fifty-five patients who underwent esophagectomy for esophageal cancer were included in this study. Of the 55 patients, 26 patients consumed a liquid dietary supplement (IMPACT group) before surgery and 29 patients did not (STANDARD group).

Intervention

Before surgery, the IMPACT group consumed 750 ml (3 packs)/day of Impact® for 5 consecutive days.

Measurements

The analysis was based on postoperative complications, hospital mortality, length of hospital stay, and short-term survival.

Results

Significantly fewer patients developed postoperative infections in the IMPACT group compared with the STANDARD group (p=.007): 4 of 21 patients in the IMPACT group and 10 of 29 patients in the STANDARD group. Either an infectious complication or another complication developed in 8 patients in the IMPACT group and 13 patients in the STANDARD group, with the result that 6 patients in the STANDARD group died of postoperative complications (p=.001). The duration of hospitalization was 34 days in the IMPACT group and 48 days in the STANDARD group; hence, hospitalization was significantly shorter in patients treated with Impact® (p=.008). The mean 6-month survival rates for the IMPACT group and the STANDARD group were 92% (24/26) and 72% (21/29), respectively (p=.028).

Conclusion

Simple preoperative supplementation significantly improved outcome. Administration of the supplemental diet before esophageal surgery appeared to be an effective strategy in reducing infectious complications, mortality, and hospitalization, and improving short-term survival.