Folate intake and the risk of oral cavity and pharyngeal cancer: A pooled analysis within the International Head and Neck Cancer Epidemiology Consortium |
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| Authors: | Maria Parpinel Emanuele Leoncini Keitaro Matsuo Renato Talamini Andrew F. Olshan Jose P. Zevallos Deborah M. Winn Vijayvel Jayaprakash Kirsten Moysich Zuo‐Feng Zhang Hal Morgenstern Fabio Levi Cristina Bosetti Karl Kelsey Michael McClean Stimson Schantz Guo‐Pei Yu Paolo Boffetta Yuan‐Chin Amy Lee Mia Hashibe Stefania Boccia |
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| Affiliation: | 1. Department of Medical and Biological Sciences, Unit of Hygiene and Epidemiology, University of Udine, Udine, Italy;2. Section of Hygiene, Institute of Public Health, Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy;3. Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Kyushu, Japan;4. Unit of Epidemiology and Biostatistics, Aviano Cancer Centre, Aviano, Italy;5. Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC;6. Bobby R. Alford Department of Otolaryngology Head and Neck Surgery, Baylor College of Medicine, University of Texas School of Dentistry at Houston, Houston, TX;7. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD;8. Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY;9. Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA;10. Department of Epidemiology, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI;11. Department of Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI;12. Cancer Epidemiology Unit, Institute for Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland;13. Department of Epidemiology, IRCCS—Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;14. Department of Epidemiology, Brown University, Providence, RI;15. Department of Environmental Health, Boston University School of Public Health, Boston, MA;16. Department of Otolaryngology, New York Eye and Ear Infirmary, New York, NY;17. Medical Informatics Center, Peking University, Beijing, China;18. The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahan School of Medicine at Mount Sinai, New York, NY;19. Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT;20. Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT |
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| Abstract: | There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPCs), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. Our study aims to investigate the association between folate intake and the risk of OPC within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual‐level data from ten case–control studies participating in the INHANCE consortium, including 5,127 cases and 13,249 controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated for the associations between total folate intake (natural, fortification and supplementation) and natural folate only, and OPC risk. We found an inverse association between total folate intake and overall OPC risk (the adjusted OR for the highest vs. the lowest quintile was 0.65, 95% CI: 0.43–0.99), with a stronger association for oral cavity (OR = 0.57, 95% CI: 0.43–0.75). A similar inverse association, though somewhat weaker, was observed for folate intake from natural sources only in oral cavity cancer (OR = 0.64, 95% CI: 0.45–0.91). The highest OPC risk was observed in heavy alcohol drinkers with low folate intake as compared to never/light drinkers with high folate (OR = 4.05, 95% CI: 3.43–4.79); the attributable proportion (AP) owing to interaction was 11.1% (95% CI: 1.4–20.8%). Lastly, we reported an OR of 2.73 (95% CI:2.34‐3.19) for those ever tobacco users with low folate intake, compared with nevere tobacco users and high folate intake (AP of interaction =10.6%, 95% CI: 0.41‐20.8%). Our project of a large pool of case–control studies supports a protective effect of total folate intake on OPC risk. |
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| Keywords: | oral cancer folate intake diet epidemiology risk factor |
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