Association between folate intake and risk of head and neck squamous cell carcinoma

Abstract

The results of published studies about the relationships between folate intake and risk of head and neck squamous cell carcinoma (HNSCC) remained inconsistent. Hence, a comprehensive and dose–response meta-analysis was performed to clarify the association between folate intake and HNSCC risk.The electric searches of Pubmed, Medline, and EMBASE databases were performed to identify the studies examining the relationship between folate intake and HNSCC risk on April 5, 2017. According to the inclusion criteria, finally 9 studies were included in this meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of associations. Dose–response analysis was conducted to quantitate the relationship between dietary folate intake and HNSCC risk.The pooled OR for assessing the risk of HNSCC and folate intake in the highest level versus lowest level was 0.505 (95% CI 0.387–0.623). The linearity model of dose–response analysis indicated that with increased 100 μg/d folate intake, the risk of HNSCC decreased 4.3% degree (OR 0.957, 95% CI 0.935–0.980).These results indicate that folate is a protective nutrient against HNSCC carcinogenesis.

Folate and Its Impact on Cancer Risk

“…Inadequate folate intake or deficiency, as measured by serum levels, may increase risk for cancer, including cancers of the head and neck [ 18 ], oral cavity and pharynx [ 19 ], esophagus [ 21 ], pancreatic [ 21 , 22 ], bladder [ 25 ], and cervix. Low intake combined with high alcohol intake may also increase the risk of breast cancer.…”

“… NS Tio [ 52 ] 36 studies. Breast Dietary folate NS: once adjusted 608,265 sample size, 34,602 cases Total folate intake NS Menopausal status NS once adjusted Hormone status NS Study design S: retrospective study design showed decreased risk of postmenopausal breast cancer Fan C [ 18 ] 4,090/10,902 9 case-control studies: 7 dietary folate with FFQ; 2 studies serum folate concentration; 4 studies dose-response analysis Head and neck Folate intake S: decreased risk comparing highest to lowest folate intake Dose-response S: every 100 mcg/day increase in folate intake associated with 4.3% decreased risk Galeone C [ 19 ] 5,127/13,249 Pooled analysis of individual-level data from 10 case-control studies Oral cavity and pharyngeal (OPC) Total folate intake S: Reduced risk for highest compared lowest quintile total folate intake and overall OPC risk S: decreased risk for oral cavity Alcohol S: increased risk for heavy drinkers with low folate intake compared to low alcohol intake with higher folate intake Smoking S: increased risk for smoking Zhao Y [ 20 ] 19 studies Esophageal Dietary folate intake S: decreased risk with highest folate intake compared to lowest intake 14 case-control 1 cohort dietary folate intake 6 case-control 1 cohort for dose-response Dose-response S: 100 mcg/day increment in dietary folate intake reduced risk by 12% Tio M [ 21 ] 9 case-control 2574/9254 for any histological type of esophageal cancer. Esophageal, gastric, pancreatic Dietary folate S: dietary folate associated with decreased risk of esophageal and pancreatic cancer NS: gastric cancer 8 studies (5 prospective, 3 retrospective) 2209/295,526 for pancreatic cancer.…”

“…Folate intake is associated with a protective effect for some cancers, little to no effect for others, and a potential for increased risk with higher intake. When comparing the highest to lowest intake of folate, higher intake was associated with a nearly 50% decreased risk for squamous cell carcinoma of the head and neck (HNSCC) [ 18 ]; 35% reduced risk for oral cavity and pharyngeal (OPC) [ 19 ]; 41% reduced risk for all histological types of esophageal [ 21 ]; 34% reduction in pancreatic [ 21 , 22 ]; and 16% reduction in bladder cancers [ 25 ]. The prospective analysis for pancreatic cancer was only significant when a study was removed that had lower levels of folate intake then the other studies.…”

“…Dose-response analyses have shown that every 100 mcg/day increase in folate intake was associated with a 4.3% decrease in risk of HNSCC [ 18 ]; 12% decrease in risk of esophageal cancer in studies other than Asian and American studies [ 20 ]; and a 7% lower risk of pancreatic cancer [ 22 ].…”

Mikronährstoffe in der Onkologie: Risiko und Nutzen – Update 2020

“…In aktuellen Studien inklusive Metaanalysen zeigte sich eine protektive Wirkung für die Entwicklung von Kopf-Hals-Tumoren [9,10].…”