Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT.
Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Int J Cancer. 2019 Nov 1;145(9):2342-2348. doi: 10.1002/ijc.32162. Epub 2019 Feb 12.
Although the protective role of dietary fiber on cancer risk has been reported in several epidemiological studies, the association of fiber intake on head and neck cancer (HNC) risk is still unclear. We investigated the association between fiber intake and the risk of HNC using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Among 101,700 participants with complete dietary information, 186 participants developed HNC during follow-up (January 1998 to May 2011). Dietary data were collected using a self-administered food-frequency questionnaire (1998-2005). We estimated hazard ratios (HRs) and the corresponding 95% confidence intervals (CI), using the Cox proportional hazards model. Higher intake of total fiber, insoluble fiber and soluble fiber was associated with decreased HNC risks, with a significant trend. The HRs of highest vs. the lowest tertile of intake were 0.43 (95%CI: 0.25-0.76) for total fiber, 0.38 (95%CI: 0.22-0.65) for insoluble fiber, and 0.44 (95%CI: 0.25-0.79) for soluble fiber. These inverse association were consistent in oral cavity and pharyngeal cases, but the impact of fiber intake was weaker in laryngeal cases. We did not observe any significant interaction of potential confounders, including smoking and drinking, with total fiber intake on HNC risk. These findings support evidence of a protective role of dietary fiber on HNC risk.
尽管一些流行病学研究已经报道了膳食纤维对癌症风险的保护作用，但膳食纤维摄入量与头颈部癌症（HNC）风险之间的关联仍不清楚。我们使用前列腺癌、肺癌、结直肠癌和卵巢癌（PLCO）筛查试验的数据，调查了膳食纤维摄入量与 HNC 风险之间的关系。在 101700 名具有完整饮食信息的参与者中，186 名在随访期间（1998 年 1 月至 2011 年 5 月）患上了 HNC。饮食数据通过自我管理的食物频率问卷（1998-2005 年）收集。我们使用 Cox 比例风险模型估计了危险比（HRs）及其相应的 95%置信区间（CI）。总纤维、不溶性纤维和可溶性纤维的摄入量越高，HNC 的风险越低，且存在显著趋势。最高摄入量与最低摄入量 tertile 相比的 HR 分别为总纤维 0.43（95%CI：0.25-0.76）、不溶性纤维 0.38（95%CI：0.22-0.65）和可溶性纤维 0.44（95%CI：0.25-0.79）。这些逆相关在口腔和咽癌病例中是一致的，但纤维摄入量对喉癌病例的影响较弱。我们没有观察到任何潜在混杂因素（包括吸烟和饮酒）与总纤维摄入量对 HNC 风险的交互作用有统计学意义。这些发现支持了膳食纤维对 HNC 风险具有保护作用的证据。
