Carotenoid intake and head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology Consortium

Abstract

Food and nutrition play an important role in head and neck cancer (HNC) etiology; however, the role of carotenoids remains largely undefined. We explored the relation of HNC risk with the intake of carotenoids within the International Head and Neck Cancer Epidemiology Consortium. We pooled individual-level data from 10 case–control studies conducted in Europe, North America, and Japan. The analysis included 18,207 subjects (4414 with oral and pharyngeal cancer, 1545 with laryngeal cancer, and 12,248 controls), categorized by quintiles of carotenoid intake from natural sources. Comparing the highest with the lowest quintile, the risk reduction associated with total carotenoid intake was 39 % (95 % CI 29–47 %) for oral/pharyngeal cancer and 39 % (95 % CI 24–50 %) for laryngeal cancer. Intakes of β-carotene equivalents, β-cryptoxanthin, lycopene, and lutein plus zeaxanthin were associated with at least 18 % reduction in the rate of oral and pharyngeal cancer (95 % CI 6–29 %) and 17 % reduction in the rate of laryngeal cancer (95 % CI 0–32 %). The overall protective effect of carotenoids on HNC was stronger for subjects reporting greater alcohol consumption (p < 0.05). The odds ratio for the combined effect of low carotenoid intake and high alcohol or tobacco consumption versus high carotenoid intake and low alcohol or tobacco consumption ranged from 7 (95 % CI 5–9) to 33 (95 % CI 23–49). A diet rich in carotenoids may protect against HNC. Persons with both low carotenoid intake and high tobacco or alcohol are at substantially higher risk of HNC.

Hen egg carotenoids (lutein and zeaxanthin) and nutritional impacts on human health: a review

“…Similar inverse associations are on record between serum concentrations of zeaxanthin and other carotenoids and colorectal neoplasm (Okuyama et al, 2014). Likewise, associated with lutein plus zeaxanthin intake, research studies recorded decline in the rate of oral and pharyngeal cancer (18%) and laryngeal cancer (17%) (Leoncini et al, 2015), whereas other researchers reported inconsistent results between lutein/zeaxanthin intake and colorectal cancer risk (Lu et al, 2015) and breast cancer risk (Sisti et al, 2015). Overall number of preclinical and observational research studies regarding the role of lutein and zeaxanthin in prevention or reducing the intensity of different cancers continues to evolve from basic research as well as from human studies.…”

Head and neck cancer: smoking, drinking, eating and…sexual practices

“…A low carotenoid intake was associated with a higher risk of oropharyngeal and laryngeal cancers in heavy drinkers (5 or more drinks per day) and with a higher risk of oropharyngeal cancer (but not laryngeal) in current smokers of more than 20 cigarettes per day. The protective association between carotenoid intake and the risk of head and neck cancer was higher for beta-carotene and lower for lycopene, and differed by geographic region, being stronger in Europe [8]. This may be partially explained by differences in HPV infection rates since fruit and vegetables consumption may reduce the progression of oropharyngeal carcinoma, as has been previously described for cervical cancer [16].…”

“…Other factors involved are food and nutrition [5] and infection with human papilloma virus (HPV) for oropharyngeal cancer only [6]. In this issue of the European Journal of Epidemiology, we are without a doubt dealing with two crucial studies [7,8] that provide powerful and decisive data on the epidemiology and prevention of head and neck cancers.In the first, Dal Maso et al[7] highlights in figures 1 and 2 mesh plots and contour plots showing the synergy between alcohol (from 0 to 180 g/day) and tobacco (from 0 to 40 cigarettes/day) consumption, estimated applying a bidimensional regression spline, which allow the measurement of continuous exposures. The representation of the risk gradient is truly amazing and extremely illustrative.…”

“…Other factors involved are food and nutrition [5] and infection with human papilloma virus (HPV) for oropharyngeal cancer only [6]. In this issue of the European Journal of Epidemiology, we are without a doubt dealing with two crucial studies [7,8] that provide powerful and decisive data on the epidemiology and prevention of head and neck cancers.…”

“…The other key study in this issue is the work done by Leoncini et al [8] as a result of the INHANCE-the International Head and Neck Cancer EpidemiologyConsortium with 16 centres participating from four different countries: Italy, Switzerland, the USA and Japan [14]. Leoncini et al delves deeper into the relationship between carotenoid intakes and head and neck cancer.…”