High dietary glycaemic index (GI) and glycaemic load (GL) may increase cancer risk. However, limited information was available on GI and/or GL and head and neck cancer (HNC) risk. We conducted a pooled analysis on 8 case-control studies (4081 HNC cases; 7407 controls) from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of HNC, and its subsites, from fixed- or mixed-effects logistic models including centre-specific quartiles of GI or GL. GI, but not GL, had a weak positive association with HNC (ORQ4 vs. Q1 = 1.16; 95% CI = 1.02–1.31). In subsites, we found a positive association between GI and laryngeal cancer (ORQ4 vs. Q1 = 1.60; 95% CI = 1.30–1.96) and an inverse association between GL and oropharyngeal cancer (ORQ4 vs. Q1 = 0.78; 95% CI = 0.63–0.97). This pooled analysis indicates a modest positive association between GI and HNC, mainly driven by laryngeal cancer.
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Anantharaman, D., Marron, M., Lagiou, P., Samoli, E., Ahrens, W., Pohlabeln, H. et al. Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer. Oral. Oncol. 47, 725–731 (2011).
Su, H. I., Sammel, M. D., Velders, L., Horn, M., Stankiewicz, C., Matro, J. et al. Association of cyclophosphamide drug-metabolizing enzyme polymorphisms and chemotherapy-related ovarian failure in breast cancer survivors. Fertil. Steril. 94, 645–654 (2010).
Augustin, L. S., Kendall, C. W., Jenkins, D. J., Willett, W. C., Astrup, A., Barclay, A. W. et al. Glycemic index, glycemic load and glycemic response: an International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr. Metab. Cardiovasc. Dis. 25, 795–815 (2015).
Turati, F., Galeone, C., Augustin, L. S. A., La Vecchia, C. Glycemic index, glycemic load and cancer risk: an updated meta-analysis. Nutrients 11, pii: E2342, https://doi.org/10.3390/nu11102342 (2019).
Biddinger, S. B. & Ludwig, D. S. The insulin-like growth factor axis: a potential link between glycemic index and cancer. Am. J. Clin. Nutr. 82, 277–278 (2005).
Augustin, L. S., Gallus, S., Franceschi, S., Negri, E., Jenkins, D. J., Kendall, C. W. et al. Glycemic index and load and risk of upper aero-digestive tract neoplasms (Italy). Cancer Causes Control. 14, 657–662 (2003).
George, S. M., Mayne, S. T., Leitzmann, M. F., Park, Y., Schatzkin, A., Flood, A. et al. Dietary glycemic index, glycemic load, and risk of cancer: a prospective cohort study. Am. J. Epidemiol. 169, 462–472 (2009).
Edefonti, V., Hashibe, M., Parpinel, M., Turati, F., Serraino, D., Matsuo, K. et al. Natural vitamin C intake and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Int. J. Cancer 137, 448–462 (2015).
Hu, J., La Vecchia, C., Augustin, L. S., Negri, E., de Groh, M., Morrison, H. et al. Glycemic index, glycemic load and cancer risk. Ann. Oncol. 24, 245–251 (2013).
De Vito, R., Lee, Y. C. A., Parpinel, M., Serraino, D., Olshan, A. F., Zevallos, J. P. et al. Shared and study-specific dietary patterns and head and neck cancer risk in an International Consortium. Epidemiology 30, 93–102 (2019).
Mendez, M. A., Covas, M. I., Marrugat, J., Vila, J. & Schroder, H. Glycemic load, glycemic index, and body mass index in Spanish adults. Am. J. Clin. Nutr. 89, 316–322 (2009).
The authors would like to thank Marta Rossi for her useful suggestions in performing the statistical analysis on GI and GL.
Ethics approval and consent to participate
The Informed consent and institutional review board approval were obtained within the framework of the original studies, according to the rules existing at the time of data collection. In addition, a central Institutional Review Board approval was obtained from the University of Utah, #42912.
Consent to publish
The dataset used and analysed during the current study is available from the corresponding author on reasonable request.
The authors declare no competing interests.
The INHANCE Pooled Data Project was supported by grants from the National Institutes of Health (NIH), National Cancer Institute (NCI) [R03CA113157], and National Institute of Dental and Craniofacial Research (NIDCR) [R03DE016611]. Individual studies were funded by the following grants: (1) Italy multicenter study: Italian Association for Research on Cancer (AIRC), Italian League Against Cancer and Italian Ministry of Research; (2) North Carolina (2002–2006) study: NCI [R01CA90731–01] and National Institute of Environmental Health Sciences (NIEHS) [P30ES010126]; (3) Los Angeles study: NIH [P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134 and R21ES011667] and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center; (4) Swiss study: Swiss League against Cancer and the Swiss Research against Cancer/Oncosuisse [KFS-700, OCS-1633]; (5) Milan (2006–2009) study: AIRC and Italian Ministry of Education [PRIN 2009 X8YCBN]; (6) Boston study: NIH [R01CA078609 and R01CA100679]; (7) Seattle (1985–1995) study: NIH [R01CA048996 and R01DE012609]; (8) MSKCC study: NIH [R01CA051845].
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Chang, C., La Vecchia, C., Serraino, D. et al. Dietary glycaemic index, glycaemic load and head and neck cancer risk: a pooled analysis in an international consortium. Br J Cancer 122, 745–748 (2020). https://doi.org/10.1038/s41416-019-0702-4