Dietary risk factors for hypopharyngeal cancer in India

Objective: The Indian subcontinent has among the highest rates of hypopharyngeal cancer worldwide. The purpose of this study was to examine the associations between the Indian diet and hypopharyngeal cancer. Methods: We used data from a hospital-based case-control study of 513 incident hypopharyngeal cancers and 718 controls from four centers in India. Dietary information was assessed using a 67-item semi-quantitative food frequency questionnaire. Intakes of related foods were combined across food groups and were categorized by quartile. We used unconditional logistic regression modeling, stratified by ever tobacco use, to analyze the association between food intakes and hypopharyngeal cancer. Results: Among persons who had ever smoked or chewed tobacco, protective associations were seen at the highest quartiles of total fruit intake (OR = 0.37, 0.20-0.69), curds (OR = 0.35, 0.17-0.69), and leafy green (OR = 0.25, 95% CI 0.13-0.51), root (OR = 0.22, 95% CI 0.11-0.43), and cruciferous vegetable intakes (OR = 0.41, 0.20-0.84). Results were similar, although not as robust, among persons who had never smoked or chewed tobacco. An increased risk of disease was seen among tobacco users who drank milk daily (OR = 1.84, 1.14-2.98). Conclusions: Dietary factors might contribute to the high risk of hypopharyngeal cancer observed in India.