Diet and Head and Neck Squamous Cell Carcinoma

While it is well-established that tobacco and alcohol account for the majority of head and neck squamous cell carcinomas (HNSCCs), important questions remain regarding the role of dietary intake on its development. Aim: To determine whether specific food groups are associated with HNSCCs in participants of the Head and Neck Cancer Life Study (HeNCe life study). Methods: The HeNCe Life study is an ongoing international case-control study investigating the etiology of HNSCCs in relation to social, psychosocial and lifestyle factors using a life course framework. Cases (N=121) comprise of newly diagnosed subjects with squamous cell carcinoma in the upper aero-digestive tract (mouth, pharynx, and larynx) at stages I-IV selected from the AC Camargo Hospital in São Paulo. Non-cancer control subjects (N=121) matched for gender and age (±5 years) were selected from a variety of clinics at nearby hospitals. Participants answered an extensive questionnaire including a self-reporting 7-day dietary recall. Logistic regression analyses assessed the odds ratio (OR) and 95% confidence interval (95%CI) for individual food groups in relation to HNSCCs. Results: After adjusting for potential confounders, high intakes (>20 servings per week) of dairy foods and vegetables significantly decreased the OR of HNSCC development compared to low intakes in smokers (OR= 0.23 [95% CI 0.1-0.6]) and (OR=0.31 [95%CI 0.1-0.8]), respectively), but not in non-smokers. Using this same model, an intake of 3-5 servings of red meat per week increased the risk of developing HNSCC in smokers (OR=9.01 95%CI [1.4-59]) and non-smokers (OR=3.36 95% CI [1.5-7.7]). Similar trends were seen for dairy, vegetable, and red meat intake when comparing drinkers to non-drinkers. Conclusions: These results suggest that high intakes of dairy foods and vegetables are protective to smokers and drinkers against HNSCC development, while even an average intake of red meat increases the likelihood of all groups to develop HNSCC.