Energy intake and dietary pattern in cancer of the oral cavity and pharynx

Objective: To explore the role of energy and macronutrients in cancers of the oral cavity and pharynx. Methods: Case-control study: 754 individuals with first incident cancer of the oral cavity and pharynx and 1775 controls in hospital for acute, non-neoplastic diseases were interviewed in two Italian areas and in the Swiss Canton of Vaud between 1992 and 1997. Results: Cases reported higher total energy intake, due to higher intake of alcohol energy. Non-alcohol energy intake was lower in cases than controls. The composition of diet also differed: proteins (OR for an addition of 100 kcal/day = 0.8) and monounsaturated fatty acids (OR = 0.8) were inversely associated, while saturated fatty acids (OR = 1.4) were directly associated with oral cancer risk. Vegetable intake, which was positively correlated with oil intake, was lower in cases than controls, but accounted only partly for the observed difference in fat intake pattern. Conclusions: Alcohol energy may not be used efficiently after some threshold. Protein deficiency may enhance cancer risk in heavy drinkers. An opposite influence of different types of fat is emerging for cancer of the oral cavity and pharynx as well as other sites of the upper aero-digestive tract.