Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium

Daisuke Kawakita, Yuan Chin Amy Lee, Federica Turati, Maria Parpinel, Adriano Decarli, Diego Serraino, Keitaro Matsuo, Andrew F. Olshan, Jose P. Zevallos, Deborah M. Winn, Kirsten Moysich, Zuo Feng Zhang, Hal Morgenstern, Fabio Levi, Karl Kelsey, Michael McClean, Cristina Bosetti, Werner Garavello, Stimson Schantz, Guo Pei YuPaolo Boffetta, Shu Chun Chuang, Mia Hashibe, Monica Ferraroni, Carlo La Vecchia, Valeria Edefonti

Research output: Contribution to journalArticlepeer-review


The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40–0.59; p for trend <0.001) and with laryngeal cancer (OR = 0.66, 95% CI: 0.54–0.82, p for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk.

Original languageEnglish
Pages (from-to)1811-1821
Number of pages11
JournalInternational Journal of Cancer
Issue number9
Publication statusPublished - Nov 1 2017


  • dietary fiber intake
  • head and neck cancer
  • laryngeal cancer
  • oral cavity and pharyngeal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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