Inflammatory potential of diet and risk of laryngeal cancer in a case–control study from Italy

Abstract

Background Besides tobacco and alcohol, diet and inflammation have been suggested to be important risk factors for laryngeal cancer. In this study, we examined the role of diet-associated inflammation, as estimated by dietary inflammatory index (DII) scores, in laryngeal cancer in a multicentre case-control study conducted between 1992 and 2000 in Italy. Methods This study included 460 cases with incident, histologically confirmed laryngeal cancer, and 1088 controls hospitalized for acute nonneoplastic diseases unrelated to tobacco and alcohol consumption. DII scores were computed from a reproducible and valid 78-item food frequency questionnaire. Results Logistic regression models controlling for age, sex, study center, education, body mass index, tobacco smoking, alcohol drinking, and nonalcohol energy intake, were used to estimate odds ratios (ORs), and the corresponding 95% confidence intervals (CIs). Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of laryngeal cancer. The OR was 3.30 (95% CI 2.06, 5.28; p for trend < 0.0001) for the highest versus the lowest DII quartile. When DII was considered as a continuous variable, the OR was 1.27 (95 % CI 1.15, 1.40) for a one unit (9% of the DII range) increase. Stratified analyses produced slightly stronger associations between DII and laryngeal cancer risk among current smokers (ORQuartile4vs1= 4.16), moderate drinkers (ORQuartile4vs1= 4.86), overweight subjects (ORQuartile4vs1= 3.62), and among those with higher education (ORQuartile4vs1= 3.92). We also observed a strong combined effect of higher DII and tobacco smoking or alcohol consumption on risk of laryngeal cancer. Compared with non-smokers having low DII scores, the OR was 6.64 for smokers with high DII scores. Likewise, compared with non/moderate drinkers with low DII, the OR was 5.82 for heavy drinkers with high DII. Conclusion These results indicate that a pro-inflammatory diet is associated with increased risk of laryngeal cancer.

Proinflammatory diet is associated with increased risk of squamous cell head and neck cancer

“…Our results replicate a previous Italian case-control study of 460 laryngeal cases and 1,088 hospital-based controls, which found that individuals in E-DII Q4 had 3.30 (95% CI: 2.06-5.28) times the risk of laryngeal cancer compared with those in Q1. 23 Similar to our findings, Shivappa et al noted a borderline significant additive interaction with smoking in that study. 23 In another study from Italy of 946 oral and pharyngeal cancer cases and 2492 controls, higher DII scores (i.e., with a more proinflammatory diet) had a higher risk of oral and pharyngeal cancer (Q4 vs. Q1 OR: 1.80; 95% CI 1.36-2.38 and one-unit increase OR: 1.17; 95% CI 1.10-1.25).…”

“…Previous studies conducted in Italy reported associations between a pro‐inflammatory diet and increased HNSCC risk. Our results replicate a previous Italian case–control study of 460 laryngeal cases and 1,088 hospital‐based controls, which found that individuals in E‐DII Q4 had 3.30 (95% CI: 2.06–5.28) times the risk of laryngeal cancer compared with those in Q1 . Similar to our findings, Shivappa et al .…”

“…Similar to our findings, Shivappa et al . noted a borderline significant additive interaction with smoking in that study . In another study from Italy of 946 oral and pharyngeal cancer cases and 2492 controls, higher DII scores (i.e., with a more proinflammatory diet) had a higher risk of oral and pharyngeal cancer (Q4 vs .…”

“…The index has been associated with inflammatory biomarkers including CRP, IL-6 and homocysteine. [19][20][21] The DII also has been shown to be associated with cancers of head and neck in Italy, [22][23][24] but has never been investigated in a populationbased case-control study in the United States.…”

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

“…The DII has been associated with colorectal 22 , pancreatic 23 and hepatocellular 24 cancers. DII has also been shown to be strongly associated with esophageal squamous cell 25 laryngeal 26 and nasopharyngeal cancers 27 in Italy.…”