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Vitamin and carotenoid intake and risk of head-neck cancer subtypes in the Netherlands Cohort Study.
Am J Clin Nutr 2015; 102(2):420-32AJ

Abstract

BACKGROUND

Head and neck cancer (HNC) is the seventh most-common type of cancer worldwide. Evidence regarding the potential protective effect of vitamins and carotenoids on HNC is limited and mostly based on case-control studies.

OBJECTIVE

We evaluated the association of intake of dietary vitamins C and E (including supplementation) and the most-common carotenoids (α-carotene, β-carotene, lutein plus zeaxanthin, lycopene, and β-cryptoxanthin) and risk of HNC and HNC subtypes in a large prospective study.

DESIGN

The Netherlands Cohort Study included 120,852 participants. For efficiency reasons, a case-cohort design was used. At baseline in 1986, participants completed a food-frequency questionnaire. A subcohort was randomly selected from the total cohort. After 20.3 y of follow-up, 3898 subcohort members and 415 HNC cases [131 oral cavity cancer (OCCs), 88 oro-/hypopharyngeal cancer (OHPs), and 193 laryngeal cancer cases] were available for analysis. Rate ratios and 95% CIs for highest (quartile 4) compared with lowest (quartile 1) quartiles of vitamin and carotenoid intake were estimated by using the Cox proportional hazards model.

RESULTS

A strong inverse association was shown between vitamin C and HNC overall (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.39; 95% CI: 0.23, 0.66; P-trend < 0.001), OCC (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.35; 95% CI: 0.16, 0.77; P-trend < 0.05), and OHPC (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.29; 95% CI: 0.12, 0.67; P-trend < 0.01). No statistically significant results were shown for vitamin E, α-carotene, β-carotene, lycopene, and lutein plus zeaxanthin. The association of vitamin E and HNC was modified by alcohol status (P-interaction = 0.003) with lower risks in alcohol abstainers.

CONCLUSIONS

With this study, we show an inverse association between intake of vitamin C and the incidence of HNC and HNC-subtypes. Future research is recommended to investigate the underlying mechanisms and to confirm our results, which may be promising for the prevention of HNC.

Authors+Show Affiliations

Department of Epidemiology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, Netherlands; and.Department of Epidemiology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, Netherlands; and.Department of Epidemiology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, Netherlands; and.Department of Otorhinolaryngology, Head & Neck Surgery, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands.Department of Epidemiology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, Netherlands; and lj.schouten@maastrichtuniversity.nl.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26156734

Citation

de Munter, Leonie, et al. "Vitamin and Carotenoid Intake and Risk of Head-neck Cancer Subtypes in the Netherlands Cohort Study." The American Journal of Clinical Nutrition, vol. 102, no. 2, 2015, pp. 420-32.
de Munter L, Maasland DH, van den Brandt PA, et al. Vitamin and carotenoid intake and risk of head-neck cancer subtypes in the Netherlands Cohort Study. Am J Clin Nutr. 2015;102(2):420-32.
de Munter, L., Maasland, D. H., van den Brandt, P. A., Kremer, B., & Schouten, L. J. (2015). Vitamin and carotenoid intake and risk of head-neck cancer subtypes in the Netherlands Cohort Study. The American Journal of Clinical Nutrition, 102(2), pp. 420-32. doi:10.3945/ajcn.114.106096.
de Munter L, et al. Vitamin and Carotenoid Intake and Risk of Head-neck Cancer Subtypes in the Netherlands Cohort Study. Am J Clin Nutr. 2015;102(2):420-32. PubMed PMID: 26156734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin and carotenoid intake and risk of head-neck cancer subtypes in the Netherlands Cohort Study. AU - de Munter,Leonie, AU - Maasland,Denise H E, AU - van den Brandt,Piet A, AU - Kremer,Bernd, AU - Schouten,Leo J, Y1 - 2015/07/08/ PY - 2015/03/10/received PY - 2015/06/05/accepted PY - 2015/7/10/entrez PY - 2015/7/15/pubmed PY - 2015/10/20/medline KW - carotenoid intake KW - head-neck cancer KW - prospective cohort study KW - risk factors KW - vitamins SP - 420 EP - 32 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 102 IS - 2 N2 - BACKGROUND: Head and neck cancer (HNC) is the seventh most-common type of cancer worldwide. Evidence regarding the potential protective effect of vitamins and carotenoids on HNC is limited and mostly based on case-control studies. OBJECTIVE: We evaluated the association of intake of dietary vitamins C and E (including supplementation) and the most-common carotenoids (α-carotene, β-carotene, lutein plus zeaxanthin, lycopene, and β-cryptoxanthin) and risk of HNC and HNC subtypes in a large prospective study. DESIGN: The Netherlands Cohort Study included 120,852 participants. For efficiency reasons, a case-cohort design was used. At baseline in 1986, participants completed a food-frequency questionnaire. A subcohort was randomly selected from the total cohort. After 20.3 y of follow-up, 3898 subcohort members and 415 HNC cases [131 oral cavity cancer (OCCs), 88 oro-/hypopharyngeal cancer (OHPs), and 193 laryngeal cancer cases] were available for analysis. Rate ratios and 95% CIs for highest (quartile 4) compared with lowest (quartile 1) quartiles of vitamin and carotenoid intake were estimated by using the Cox proportional hazards model. RESULTS: A strong inverse association was shown between vitamin C and HNC overall (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.39; 95% CI: 0.23, 0.66; P-trend < 0.001), OCC (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.35; 95% CI: 0.16, 0.77; P-trend < 0.05), and OHPC (multivariable-adjusted rate ratio for quartile 4 compared with quartile 1: 0.29; 95% CI: 0.12, 0.67; P-trend < 0.01). No statistically significant results were shown for vitamin E, α-carotene, β-carotene, lycopene, and lutein plus zeaxanthin. The association of vitamin E and HNC was modified by alcohol status (P-interaction = 0.003) with lower risks in alcohol abstainers. CONCLUSIONS: With this study, we show an inverse association between intake of vitamin C and the incidence of HNC and HNC-subtypes. Future research is recommended to investigate the underlying mechanisms and to confirm our results, which may be promising for the prevention of HNC. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26156734/Vitamin_and_carotenoid_intake_and_risk_of_head_neck_cancer_subtypes_in_the_Netherlands_Cohort_Study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.114.106096 DB - PRIME DP - Unbound Medicine ER -