Turati Federica, Bravi Francesca, Polesel Jerry, Bosetti Cristina, Negri Eva, Garavello Werner, Taborelli Martina, Serraino Diego, Libra Massimo, Montella Maurizio, Decarli Adriano, Ferraroni Monica, La Vecchia Carlo
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via A. Vanzetti 5, 20133, Milan, Italy.
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", via G. La Masa 19, 20156, Milan, Italy.
Cancer Causes Control. 2017 Feb;28(2):89-95. doi: 10.1007/s10552-017-0850-x. Epub 2017 Feb 2.
Few studies investigated the role of diet on nasopharyngeal cancer (NPC) risk in non-endemic areas. The aim of this study was to assess the association between adherence to the traditional Mediterranean diet and NPC risk in a southern European low-risk population.
We conducted a hospital-based case-control study in Italy, including 198 histologically confirmed NPC cases and 594 matched controls. Dietary habits were collected by means of a validated food-frequency questionnaire, including 83 foods, food groups, or beverages. Adherence to the traditional Mediterranean diet was assessed through a Mediterranean Diet Score (MDS), based on nine dietary components characterizing this dietary profile, i.e., high intake of vegetables, fruits and nuts, cereals, legumes, and fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated odds ratios (ORs) of NPC, and the corresponding 95% confidence intervals (CIs), for increasing MDS (i.e., increasing adherence) using multiple logistic regression models, adjusted for major confounding factors.
As compared to MDS ≤ 4, the ORs of NPC were 0.83 (95% CI: 0.54-1.25) for MDS of 5 and 0.66 (95% CI: 0.44-0.99) for MDS ≥ 6, with a significant trend of decreasing risk (p 0.043). The corresponding population attributable fraction was 22%, indicating that 22% of NPC cases in this population would be avoided by shifting all subjects to a score ≥6.
Our study supports a favorable role of the Mediterranean diet on NPC risk.
很少有研究调查饮食在非流行地区鼻咽癌（NPC）风险中的作用。本研究的目的是评估在南欧低风险人群中，坚持传统地中海饮食与NPC风险之间的关联。
我们在意大利进行了一项基于医院的病例对照研究，包括198例经组织学确诊的NPC病例和594例匹配对照。通过一份经过验证的食物频率问卷收集饮食习惯，该问卷包括83种食物、食物类别或饮料。基于代表这种饮食模式的九个饮食成分，即蔬菜、水果和坚果、谷物、豆类和鱼类的高摄入量；乳制品和肉类的低摄入量；高单不饱和脂肪酸与饱和脂肪酸比例；以及适度饮酒，通过地中海饮食评分（MDS）评估对传统地中海饮食的坚持程度。我们使用多因素逻辑回归模型，在对主要混杂因素进行调整后，估计NPC的比值比（OR）以及相应的95%置信区间（CI），用于MDS增加（即坚持程度增加）的情况。
与MDS≤4相比，MDS为5时NPC的OR为0.83（95%CI：0.54 - 1.25），MDS≥6时为0.66（95%CI：0.44 - 0.99），风险有显著下降趋势（p = 0.043）。相应的人群归因分数为22%，表明将所有受试者转移到评分≥6的水平可避免该人群中22%的NPC病例。
我们的研究支持地中海饮食对NPC风险有有利作用。
