A recent JAMA Otolaryngoly-Head Neck Surgery explores the association between the chance of developing head and neck cancer (HNC) and smoking, drinking, and dietary habits.

Study: Smoking, Drinking, and Dietary Risk Aspects for Head and Neck Cancer in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Participants. Image Credit: create jobs 51 / Shutterstock.com

What causes HNC?

In 2020, HNC accounted for 3.4% of latest cancer cases and a pair of.5% of deaths in america. Smoking and drinking have been established as risk aspects for HNC; nevertheless, their association with various subsites of the top and neck stays unclear.

Previous studies have used the European Prospective Investigation into Cancer and Nutrition (EPIC) data to judge the consequences of alcohol, tobacco, and eating regimen on HNC. Large-scale prospective trials are perfect for identifying novel risk aspects; nevertheless, these kind of studies are sometimes expensive.

In regards to the study

In america, the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial used questionnaires and follow-up interviews with patients to assemble data on smoking, drinking, and eating regimen patterns. Data from this cohort was used to perform a nested cohort survival evaluation to elucidate the role of those risk aspects in the event of HNC. Relevant human papillomavirus (HPV) data was also included from previous studies. 

The participants were recruited across ten centers within the U.S. between November 1993 and July 2001. All study participants were between 55 and 74 years years of age, with HNC patients matched with healthy controls based on family history of HNC and demographics to research smoking habits.

To investigate eating regimen and drinking habits, matching was performed on smoking status and duration along with demographics and family history of HNC. Data were analyzed between January and November of 2023, and the first final result variable was the diagnosis of HNC.

Key findings

The smoking-associated cancer risk increased with greater proximity of the lungs to the top and neck subsite. Probably the most significant cancer risks were related to the larynx, oropharynx, and oral cavity in descending order. This is said to the airflow patterns during cigarette smoking, whereby smoke travels from the oral cavity to the oropharynx to the larynx. This finding is consistent with prior research on HNC risk related to smoking.

Statistically significant associations were observed between HNC risk and smoking status, frequency, and duration. Duration was more significantly related to HNC than frequency, which might be as a consequence of the wrong carcinogen exposure metric provided by the frequency measured by cigarettes every day.

Heavy drinking was related to an increased risk of HNC, particularly for the heavy consumption of liquor and beer quite than wine. There was no effect noted for moderate drinking, with the absence of any interaction effect between smoking and drinking also observed. Nevertheless, further research is required to find out whether a protected level of alcohol consumption exists in relation to the chance of developing HNC.

Overall, healthy eating was related to a modest reduction in HNC risk. Healthy eating was based on the increased consumption of dark green and orange vegetables, fruits, and whole grains. Non-whole grains, potatoes, and beef weren’t related to a reduced risk of HNC. 

Conclusions

The chance of smoking-associated HNC was higher for subsites that were closer to the lung, whereas heavy drinking of beer and liquor, quite than wine, was related to a greater risk of HNC. Overall healthy eating was also related to a modest reduction in HNC risk, particularly when a person reported consuming whole fruits and whole grains. These findings reiterate the importance of reducing smoking and drinking, in addition to engaging in healthy eating habits to cut back the chance of developing HNC. 

An important limitation of the present study included selection bias within the study population, which prevented the meaningful assessment of HNC risk related to dietary and drinking habits by subsite. A further limitation was related to small sample sizes for nasopharynx and hypopharynx cancer. Moreover, the shortage of racial and ethnic diversity within the PLCO cohort limits the generalizability of the study findings.