Diet and Hypopharyngeal Cancer: Results from a Multicenter Study in India

Purpose The Indian subcontinent has among the highest rates of hypopharyngeal cancer worldwide. The purpose of this study was to examine the associations between food intakes and hypopharyngeal cancer. Methods We used data from a hospital-based case-control study of 513 incident hypopharyngeal cancers done at four centers in India. Controls were 718 individuals hospitalized for diseases unrelated to tobacco or alcohol consumption or from visitors to the hospitals. A standardized questionnaire elicited information on demographics, clinical history, family history of cancer, tobacco, and alcohol consumption. Dietary information was assessed using a 67-item semi-quantitative food frequency questionnaire. Frequencies of intake of related foods were combined across food groups, and were categorized based on quartile cut-off points defined by consumption among controls. We used unconditional logistic regression modeling, stratified by ever tobacco use, to analyze the association between food intakes and hypopharyngeal cancer, adjusting for participating center, age, gender, SES, alcohol intake, and other food groups. Results Among persons who had ever smoked or chewed tobacco, protective associations were seen with daily intake of curds (OR=0.39, 0.21–0.70), and among those in the highest quartile of total fruit intake (OR=0.35, 0.18–0.65), citrus fruit intake (OR=0.30, 0.16–0.56), and total raw vegetable intake (OR=0.42, 0.21–0.81). Results were similar, although not as robust, among persons who had never used tobacco. An increased risk of disease was seen among those who drank milk daily, among both never tobacco users (OR=2.71, 1.16–6.33) and tobacco users (OR=1.89, 1.21–2.97). Conclusion Dietary factors might contribute to the high risk of hypopharyngeal cancer observed in India.