The main etiologic factors of cancers of the larynx and hypopharynx are alcohol and tobaeco, and their prevalence in different populations explains, to a large extent, the wide variations in incidence observed around the world. Besides these two main risk factors, however, diet also seems to play a role in determining the risk of these cancers. There is consistent evidence that low consumption of fruit and vegetables is associated with higher risk, after statistical adjustment for alcohol and tobacco. Consumption of vegetable oils and fish and a moderately high polyunsaturated/saturated fatty acid ratio (P/S ratio) were reported to be associated with reduced risk. Low intake of vitamin C, β-carotene and vitamin E were reported consistently to be associated with higher laryngeal cancer risk, but there was no clear evidence that these micronutrients are better predictors of cancer risk than the principal food groups from which their intake levels were estimated, i.e., fruits, vegetables, vegetable oils, and fish. Given the overwhelming role of tobacco and alcohol in the etiology of these cancers and the extremely low incidence among nonsmokers/nondrinkers, the available studies provide no estimate of the role of diet in subjects not exposed to these factors. The evidence indicates, however, that, in the presence of tobacco and/or alcohol, low intake of fruit and vegetables may account for 25 to 50 percent of the cases among men.
Similar content being viewed by others
References
International Agency for Research on Cancer. Tobacco Smoking. Lyon, France: IARC, 1986; IARC Monogr Eval Carcinog Risks Humans, Vol. 38.
International Agency for Research on Cancer. Alcohol Drinking. Lyon, France: IARC, 1988; IARC Monogr Eval Carcinog Risks Humans, Vol. 44.
Tuyns AJ, Estève J, Raymond L, et al. Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC international case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Calvados (France). Int J Cancer 1988; 41: 483–91.
International Agency for Research on Cancer. Tobacco Habits other than Smoking; Betel-Quid and Areca-nut Chewing; and Some Related Nitrosamines. Lyon, France: IARC, 1985; IARC Monogr Eval Carcinog Risks Humans, Vol. 37.
Elwood JM, Pearson JCG, Skippen DH, Jackson SM. Alcohol, smoking and occupational factors in the aetiology of cancer. Int J Cancer 1984; 34: 603–12.
Brugère J, Guènel P, Leclerc A, Rodriguez J. Differential effects of tobacco and alcohol in cancer of the larynx. pharynx and mouth. Cancer 1986; 57: 391–5.
Lehmann W. Les Cancers de l'Endolarynx. Bilan Clinique et Résultats Thérapeutiques de 417 Cas Traités à l'Institut Gustave-Roussy entre 1968 et 1972. Mémoire. Paris, France; Faculté de Médecine, 1977.
Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J. Cancer Incidence in Five Continents, Vol VI. Lyon: International Agency for Research on Cancer, 1992: IARC Sci, Pub. No 120.
Wynder EL, Bross IJ, Day E. A study of environmental factors in cancer of the larynx. Cancer 1956; 9: 86–110.
Graham S, Mettlin C, Marshall J, Priore R, Rzepka T, Shedd DP. Dietary factors in the epidemiology of cancer of the larynx. Am J Epidemiol 1981; 113: 675–80.
Mackerras D, Buffler PA, Randall DE, Nichaman MZ, Pickle LW, Mason TJ. Carotene intake and the risk of laryngeal cancer in coastal Texas. Am J Epidemiol 1988; 128: 980–8.
Freudenheim JL, Graham S, Byers T, et al. Diet, smoking, and alcohol in cancer of the larynx: A case-control study. Nutr Cancer 1992; 17: 33–45.
Rogers MAM, Thomas DB, Davis S, Vaughan TL, Nevissi AE. A case-control study of element levels and cancer of the upper aerodigestive tract. Cancer Epidemiol Biomark Prev 1993; 2: 305–12.
De Stefani E, Correa P, Oreggia F, et al. Risk factors for laryngeal cancer. Cancer 1987; 60: 3087–91.
Notani PN, Jayant K. Role of diet in upper aerodigestive tract cancers. Nutr Cancer 1987; 10: 103–13.
Zheng W, Blot WJ, Shu X, et al. Diet and other risk factors for laryngeal cancer in Shanghai, China. Am J Epidemiol 1992; 136: 178–91.
La Vecchia C, Negri E, D'Avanzo B, Franceschi S, Decarli A, Boyle P. Dietary indicators of laryngeal cancer risk. Cancer Res 1990; 50: 4497–500.
Zatonski W, Becher H, Lissowska J, Wahrendorf J. Tobacco, alcohol, and diet in the etiology of laryngeal cancer: a population-based case-control study. Cancer Causes Control 1991; 2: 3–10.
Sokic SI, Adanja BJ, Marinkovic JP, Vlajinac HD. Casecontrol study of risk factors in laryngeal cancer. Neoplasma 1994; 41: 43–7.
Estève J, Riboli E, Péquignot G, et al. Diet and cancers of the larynx and hypopharynx: The IARC multi-center study in south-western Europe. Cancer Causes Control, in press.
Chyou PH, Nomura AMY, Stemmermann GN. Diet, alcohol, smoking and cancer of the upper aerodigestive tract: a prospective study among Hawaii Japanese men. Int J Cancer 1995; 60: 616–21.
Ahlbom HE. Prädisponierende Faktoren für Plattenepithelkarzinom in Mund, Hals und Speiseröhre. Eine statistische Untersuchung am Material des Radiumhemmets, Stockholm. Acta Radiol 1937; 18: 163–85.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 1991; 2: 427–42.
Tuyns AJ, Riboli E, Doornbos G. Nutrition and cancer of the esophagus. In: Joossens JV, Hill MJ, Geboers J, eds. Diet and Human Carcinogenesis. Amsterdam, Netherlands: Elsevier, 1985: 71–9.
Mayne ST, Graham S, Zheng TZ. Dietary retinol: prevention or promotion of carcinogenesis in humans? Cancer Causes Control 1991; 2: 443–50.
Tuyns AJ, Riboli E, Doornbos G, Péquignot G. Diet and esophageal cancer in Calvados (France). Nutr Cancer 1987; 9: 81–92.
Riboli E. Nutrition and cancer: Background and rationale of the European Prospective Investigation into Cancer and Nutrition (EPIC). Ann Oncol 1992; 3: 783–91.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Riboli, E., Kaaks, R. & Estève, J. Nutrition and laryngeal cancer. Cancer Causes Control 7, 147–156 (1996). https://doi.org/10.1007/BF00115645
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00115645