DIET AND CANCERS OF THE LARYNX AND HYPOPHARYNX - THE IARC MULTICENTERSTUDY IN SOUTHWESTERN EUROPE

The main causes of cancer of the larynx and hypopharynx are smoking ci garettes and drinking alcohol. However, for these as well as for other cancers of the upper aerodigestive tract, some dietary components, ma inly low consumption of fruit and vegetables, have been observed to be associated with increased cancer risk. We report results from a multi center case-control study carried out in six regions of Europe located in northern Spain, northern Italy, Switzerland, and France. A total o f 1,147 males with cancer (cases) and 3,057 population controls were i nterviewed on usual diet, lifelong drinking and smoking habits, and oc cupational history. Cancer cases had histologically verified epidermoi d carcinomas. The cancers were classified in two anatomic sub-entities : the epilarynx (hypopharynx and upper part of the larynx),which enter s into contact with the bolus and the air; and the endolarynx, through which air and tobacco smoke pass, but not the bolus. A previous repor t from this study found that alcohol drinking presents a greater risk factor for cancer of the epilarynx than for cancer of the endolarynx. The main results regarding diet indicate that high intake of fruit, ve getables, vegetable oil, fish, and low intake of butter and preserved meats were associated with reduced risk of both epilaryngeal and endol aryngeal cancers, after adjustment for alcohol, tobacco, socioeconomic status, and non-alcohol energy intake. Among nutrients, a reduced ris k was found for high intake of vitamins C and E and for a high polyuns aturated/saturated fatty acids (P/S) ratio. While these variables are relevant in scoring nutritional behaviour, it remains unresolved wheth er the biologic properties of these nutrients play a role in the appar ent protective effect.