Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD (W-QL, YP, JWW, AMG, PRT, NDF, and CCA), and AARP, Washington, DC (ARH).
Am J Clin Nutr. 2014 Mar;99(3):559-66. doi: 10.3945/ajcn.113.073163. Epub 2014 Jan 8.
Head and neck cancer (HNC) is the seventh most common cancer worldwide. Although diet has been proposed to play an important role in HNC, few associations with diet have been convincing other than alcohol intake. Studies of dietary patterns that examine overall diets may provide broader insight than studies of individual foods. Little is known about the association between dietary patterns and risk of HNC.
We prospectively evaluated the association between 2 index-based dietary patterns [ie, the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet Score (aMED)] and risk of head and neck squamous cell carcinoma.
We included 494,967 participants from the NIH-AARP Diet and Health study (1995-2006). HRs (95% CIs) were estimated by using Cox regression. Scores for the HEI-2005 and aMED were calculated on the basis of diet assessed by using a baseline food-frequency questionnaire. Higher scores reflected adherence to dietary recommendations for healthy eating. Our main outcome was the incidence of HNC, including cancer of the larynx, oral cavity, and orohypopharynx.
A total of 1868 HNC cases were identified during follow-up. Higher HEI-2005 scores were associated with reduced risk of HNC in men [HR: 0.74 (95% CI: 0.61, 0.89) for highest compared with lowest quintiles; P-trend = 0.0008] and women [HR: 0.48; 95% CI: 0.33, 0.70; P-trend < 0.0001]. High aMED scores were also associated with lower HNC risk in men (HR: 0.80; 95% CI: 0.64, 1.01; P-trend = 0.002) and women (HR: 0.42; 95% CI: 0.24, 0.74; P-trend < 0.0001). Associations were similar among subsites. We did not find significant interactions between smoking and alcohol intake and each index on HNC risk.
HEI-2005 and aMED scores were associated inversely with risk of HNC. Large interventional studies are required to assess the causality before conveying definite public health messages.
头颈部癌症（HNC）是全球第七大常见癌症。尽管饮食已被提出在 HNC 中发挥重要作用，但除了饮酒外，很少有令人信服的饮食与饮食相关的关联。研究整体饮食的饮食模式可能比研究个别食物提供更广泛的见解。关于饮食模式与 HNC 风险之间的关系知之甚少。
我们前瞻性评估了基于 2 个指数的饮食模式[即，健康饮食指数-2005（HEI-2005）和替代地中海饮食评分（aMED）]与头颈部鳞状细胞癌风险之间的关联。
我们纳入了来自 NIH-AARP 饮食与健康研究（1995-2006 年）的 494,967 名参与者。使用 Cox 回归估计 HR（95%CI）。基于基线食物频率问卷评估的饮食，计算 HEI-2005 和 aMED 的得分。较高的分数反映了对健康饮食建议的遵守。我们的主要结局是 HNC 的发病率，包括喉癌、口腔癌和口咽癌。
在随访期间共确定了 1868 例 HNC 病例。男性中，较高的 HEI-2005 评分与 HNC 风险降低相关[最高五分位数与最低五分位数相比 HR：0.74（95%CI：0.61，0.89）；P-trend = 0.0008]，女性也如此[HR：0.48；95%CI：0.33，0.70；P-trend <0.0001]。男性（HR：0.80；95%CI：0.64，1.01；P-trend = 0.002）和女性（HR：0.42；95%CI：0.24，0.74；P-trend <0.0001）中，高 aMED 评分也与 HNC 风险降低相关。亚部位的关联相似。我们没有发现吸烟和饮酒与每个指数与 HNC 风险之间的显著相互作用。
HEI-2005 和 aMED 评分与 HNC 风险呈负相关。需要进行大型干预性研究来评估因果关系，然后再传达明确的公共卫生信息。
