Chinese nonmedicinal herbal diet and risk of nasopharyngeal carcinoma: A population‐based case‐control study

Abstract

Background An association between a nonmedicinal herbal diet and nasopharyngeal carcinoma (NPC) has often been hypothesized but never thoroughly investigated. Methods This study enrolled a total of 2469 patients with incident NPC and 2559 population controls from parts of Guangdong and Guangxi Provinces in southern China between 2010 and 2014. Questionnaire information was collected on the intake of traditional herbal tea and herbal soup as well as the specific herbal plants used in soups and other potentially confounding lifestyle factors. Multivariate logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the NPC risk in association with herbal tea and soup intake. Results Ever consumption of herbal tea was not associated with NPC risk (OR, 1.03; 95% CI, 0.91‐1.17). An inverse association was observed for NPC among ever drinkers of herbal soup (OR, 0.78; 95% CI, 0.67‐0.90) but without any monotonic trend with an increasing frequency or duration of herbal soup consumption. Inverse associations with NPC risk were detected with 9 herbal plants used in herbal soup, including Ziziphus jujuba, Fructus lycii, Codonopsis pilosula, Astragalus membranaceus, Semen coicis, Smilax glabra, Phaseolus calcaratus, Morinda officinalis, and Atractylodes macrocephala (OR range, 0.31‐0.79). Conclusions Consuming herbal soups including specific plants, but not herbal tea, was inversely associated with NPC. If replicated, these results might provide potential for NPC prevention in endemic areas.

The Association between Tea Consumption and Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis

“…However, this current metaanalysis is limited by disparity in the parameters studied by our data source. This investigation found a contrary association between NPC risk and tea consumption from a previous report by Lin et al (2019), which revealed that the risk of NPC was increased among people who consume herbal tea for up to five years compared to those who cosumed less. Therefore, few studies have reported that, inconsistent habit of tea drinking could lead to NPC risk.…”

The Evolving Epidemiology of Nasopharyngeal Carcinoma

“…Use of Asian traditional herbal medicines was associated with a 2-to 4-fold excess risk of NPC in some case-control studies (61,65,70,102), but not others (72)(73)(74)88). Two studies, including ours, found inverse associations of NPC risk with consumption of Cantonese-style slowcooked herbal soup (83,103), including nine specific plant species commonly used in such soups (103); however, these studies found conflicting inverse and null results, respectively, for consumption of Cantonese-style herbal teas. Associations with use of traditional herbal medicines are susceptible to confounding by indication and, in casecontrol studies, reverse causation.…”

Association Between Traditional Herbal Diet and Nasopharyngeal Carcinoma Risk: A Prospective Cohort Study in Southern China

“…However, through our previous case-control study in Sihui, we found that plants frequently used in herbal soups include Semen coicis , Bulbus lilii , Polygonatum odoratum , Fructus lycii , etc, and the most prevalent herbs used in teas are Chrysanthemum morifolium , Prunella asiatica , Flos lonicerae , Glycyrrhiza uralensis , Helicteres angustifolia , etc. ( 19 ).…”

“…Distinguished with herbal tea for the main purpose of being anti-inflammatory, people consume herbal soup with discrepant herbal ingredients to maintain energy and improve immunity. According to our previous study, nine commonly used herbal plants species (Ziziphus jujuba, F. lycii, Codonopsis pilosula, Astragalus membranaceus, S. coicis, Smilax glabra, Pristimantis calcaratus, Morinda officinalis, and Atractylodes macrocephala) in herbal soups might have been involved in the anticancer effect through inducing apoptosis, inhibiting cancer cell migration and differentiation, or regulating signaling pathway (19,(38)(39)(40)(41)(42). As many studies in vitro have shown that bioactive components in herbal soup may inhibit EBV (25,43,44), the most important risk factor for NPC (2), an association between herbal diet and NPC through antiviral biological mechanisms have often been hypothesized but never thoroughly investigated.…”

“…An association between herbal diet and NPC has been hypothesized, but the results are inconsistent. Several studies reported that the use of herbal medicines was associated with an elevated risk of NPC ( 16 – 18 ), whereas some reported an inverse association ( 19 , 20 ). The reasons for the discrepancy might be that previous studies did not separate the herbs nature and function in diet.…”