Folate intake and the risk of oral cavity and pharyngeal cancer: A pooled analysis within the International Head and Neck Cancer Epidemiology Consortium

Abstract

There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPC), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. This 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 10 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 versus 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 (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 due to interaction was 11.1%(95% CI: 1.4–20.8%). The present project of a large pool of case-control studies supports a protective effect total folate intake on OPC risk.

Inflammatory potential of diet and risk of oral and pharyngeal cancer in a large case-control study from Italy

“…In the pooled analyses within the International Head and Neck Cancer Epidemiology Consortium folate 47 , vitamin C 45 , coffee and tea intake 48 were found to be protective against oral and pharyngeal cancer. Moreover, a meta-analyses based on 15 case-control and one cohort studies revealed a protective role of fruit and vegetables consumption 49 .…”

Folate, vitamin B6, vitamin B12 and methionine intakes and risk for nasopharyngeal carcinoma in Chinese adults: a matched case–control study

“…However, only one case-control study of 198 NPC Italian cases focused on NPC risk and found a null association (16) . Although many other studies have found an inverse association between dietary (17)(18)(19)(20)(21)(22)(23) or blood (24)(25)(26)(27) folate and the risk for head and neck cancer, the numbers of NPC cases in these studies were generally <100. In addition, all of these studies were conducted among populations with dietary habits and NPC risks different from those of the Chinese in south China (1)(2)(3) .…”

Cáncer de colon y su relación con la fortificación de ácido fólico

“…También cabe destacar que si bien no fue el objetivo de esta revisión, en la literatura se describen asociaciones entre la ingesta de folatos con modificaciones del riesgo de otros tipos de cáncer como pancreático 24,25 , cáncer de próstata 26,27 , cáncer de cavidad oral y faringe 28 , cáncer mamario [29][30][31][32][33] , cáncer pulmonar 34,35 , cáncer de vejiga 36 , cáncer gastrointestinal 37 , por lo que se sugiere considerar en el análisis del programa de fortificación nacional con ácido fólico.…”