Skip to main content
Log in

Nutrition and oral cancer

  • Review Papers
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Epidemiologic evidence on the relationship between nutrition and oral cancer is reviewed. Ecologic and case-control studies provide most of the evidence regarding the nutritional epidemiology of oral cancer. The ecologic evidence is that the considerable geographic variation in the incidence of oral cancer is consistent with variation in nutrition. Because incipient oral cancer is likely to affect the diets of oral cancer patients, even before diagnosis, case-control studies are limited by their ability to extract comparable information from subjects regarding their pre-illness diets. The case-control evidence is that a diet that emphasizes fruit and vegetable intake may protect against oral cancer. However, this case-control evidence is not highly consistent; individual foods that appear protective in some studies do not in others, and the effects of diet appear to be modest when compared with those of smoking and alcohol consumption. The nutritional epidemiology of oral cancer is marked by two risk factors that appear far more powerful than nutrition: tobacco use and alcohol consumption. As these likely are related to nutrition, they pose as important potential confounders. Oral hygiene also may confound the association of nutrition and oral cancer risk; it is likely to be associated with dietary practice, and it has been shown to be related to oral cancer risk. Thus, studies of nutrition in the epidemiology of oral cancer also must address the effects of tobacco and alcohol consumption and oral hygiene.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Boyle P, Zheng T, Macfarlane GJ, et al. Recent advances in the etiology and epidemiology of head and neck cancer. Curr Opin Oncol 1990; 2: 539–45.

    Google Scholar 

  2. Clemmesen J. Statistical studies in the aetiology of malignant neoplasms, Vol I. Acta Pathol Microbiol Scand 1965: Suppl. 174: 1–536.

  3. Macfarlane GJ, Boyle P, Evstifeeva TV, Robertson C, Scully C. Rising trends of oral cancer mortality among males worldwide: the return of an old public health problem. Cancer Causes Control 1994: 5: 259–65.

    Google Scholar 

  4. Parkin DM, Pisani P, Ferlag J. Estimates of the world-wide frequency of sixteen major cancer in 1980. Int J Cancer 1988; 41: 184–97.

    Google Scholar 

  5. Malaowalla AM, Silverman S, Mani N, Bilimoria K, Smith L. Oral cancer in 57,518 industrial workers of Gujarat, India. Cancer 1976; 37: 1882–6.

    Google Scholar 

  6. Smans M, Muir CS, Boyle P. Atlas of Cancer Mortality in the European Economic Community. Oxford, UK: Oxford University Press, 1992; International Agency for Research on Cancer Pub. Series 107.

    Google Scholar 

  7. Jensen OM, Estève J, Moller H, Renard H. Cancer in the European Community and its member states. Eur J Cancer 1990; 26: 1167–256.

    Google Scholar 

  8. La Vecchia C, Lucchini F, Negri E, Boyle P, Maisonneuve P. Trends in cancer mortality in Europe, 1955–1989. Digestive sites. Eur J Cancer 1992; 28: 132–235.

    Google Scholar 

  9. Boyle P, MacFarlane G, Blot WJ, et al. Oral carcinogenesis in Europe. Oral Oncol Eur J Cancer 1995; 31b: 1–11.

    Google Scholar 

  10. Graham S, Levin M, Lillienfeld A. The socioeconomic distribution of cancer at various sites in Buffalo NY, 1948–1955. Cancer 1960; 13: 180–91.

    Google Scholar 

  11. Greenberg RA, Haber MJ, Clark WS, et al. The relation of socioeconomic status to oral and pharyngeal cancer. Epidemiology 1991; 2: 194–200.

    Google Scholar 

  12. International Agency for Research on Cancer. Tobacco Habits Other than Smoking: Betal-quidane Areca-nut Chewing; and Some Related Nitrosamines Lyon, France: IARC, 1986; IARC Monogr Eval Carcinog Risks Humans, Vol. 37.

    Google Scholar 

  13. International Agency for Research on Cancer. Alcobol Drinking. Epidemiologic Studies of Cancer in Humans Lyon, France: IARC, 1988; IARC Monogr Eval Carcinog Risks Humans, Vol. 44.

    Google Scholar 

  14. International Agency for Research on Cancer. Tobacco Smoking, Lyon, France: IARC, 1986; IARC Monogr Eval Carcinog Risks Humans, Vol. 38.

    Google Scholar 

  15. Franco EL, Kowalski LP, Oliveira BV, et al. Risk factors for oral cancer in Brazil: a case-control study. Int J Cancer 1989; 43: 992–1000.

    Google Scholar 

  16. Graham S, Dayal H, Rohner T, et al. Dentition, diet, tobacco and alcohol in the epidemiology of oral cancer. JNCI 1977; 59: 1611–8.

    Google Scholar 

  17. La Vecchia C, Negri E, D'Avanzo B, Boyle P, Franceshi S. Dietary indicators of oral and pharyngeal cancer. Int J epidemiol 1991; 20: 39–44.

    Google Scholar 

  18. Blot WJ, McLaughlin J, Winn D, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988; 48: 3282–7.

    Google Scholar 

  19. Notani PN, Jayant K. Role of diet in upper digestive cancers. Nutr Cancer 1987; 10: 103–13.

    Google Scholar 

  20. Winn DM, Ziegler RG, Pickle LW, Gridley G, Biot WJ, Hoover RN. Diet in the etiology of oral and pharyngeal cancer among women from the southern United States. Cancer Res 1984; 44: 1216–22.

    Google Scholar 

  21. Nandakumar A, Thimmasetty KT, Sreeramareddy NM, et al. A population-based case-control investigation on cancers of the oral cavity in Bangalore, India. Br J Cancer 1990; 62: 847–51.

    Google Scholar 

  22. Sankaranarayanan R, Duffy SW, Padmakumary G, Day NF, Krishan Nair M. Risk factors for cancer of the buccal and labial mucosa in Kerala, southern India. J Epidemiol Comm Health 1990; 44: 286–92.

    Google Scholar 

  23. Marshall JR, Graham S, Haughey BP, et al. Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Oral Oncol Eur J Cancer 1992; 28B: 9–13.

    Google Scholar 

  24. Rothman K, Keller A. The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx. J Chronic Dis 1972; 25: 711–6.

    Google Scholar 

  25. Tanaka T. Chemoprevention of oral carcinogenesis. Oral Oncol Eur J Cancer 1995; 316: 3–15.

    Google Scholar 

  26. Zheng T, Boyle P, Hu H, et al. Dentition, oral hygiene, and risk of oral cancer: a case-control study in the People's Republic of China. Cancer Causes Control 1990; 1: 235–42.

    Google Scholar 

  27. Blot WJ, Winn DM, Fraumeni JFJr. Oral cancer and mouthwash. JNCI 1983; 70: 251–3.

    Google Scholar 

  28. Kabat GC, Hebert JR, Wynder EL. Risk factors for oral cancer in women. Cancer Res 1989; 49: 2803–6.

    Google Scholar 

  29. Winn DM, Blot WJ, McLaughlin JK, et al. Mouthwash use and oral conditions in the risk of oral and pharyngeal cancer. Cancer Res 1991; 51: 3044–7.

    Google Scholar 

  30. Steinmetz K, Potter J. Vegetables, fruits and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.

    Google Scholar 

  31. Marshall J, Graham S, Mettlin C, Shedd D, Swanson M. Diet in the epidemiology of oral cancer. Nutr Cancer 1982; 3: 145–9.

    Google Scholar 

  32. McLaughlin JK, Gridley G, Block G, et al. Dietary factors in oral and pharyngeal cancer. JNCI 1988; 80: 1237–43.

    Google Scholar 

  33. Franceschi S, Bidoli E, Baron AE, et al. Nutrition and cancer of the oral cavity and pharaynx in North East Italy. Int J Cancer 1991; 47: 20–5.

    Google Scholar 

  34. Franceschi S, Bidoli E, Baron AE, La Vecchia C. Maize and risk of cancers of the oral cavity, pharynx and esophagus in northeastern Italy. JNCI 1990; 82: 1407–11.

    Google Scholar 

  35. Rogers MAM, Thomas DB, Davis S, Weiss NS, Vaughan TL, Nevissi AE. A case-control study of oral cancer and pre-diagnostic concentrations of selenium and zinc in nail tissue. Int J Cancer 1991; 48: 182–8.

    Google Scholar 

  36. Zheng T, Boyle P, Hu H, et al. Tobacco smoking, alcohol consumption and risk of oral cancer: a case-control study in Beijing, People's Republic of China. Cancer Causes Control 1990; 1: 173–9.

    Google Scholar 

  37. McFarlane GJ, Zhang T, Marshall JR, et al. Alcohol, tobacco, diet and the risk of oral cancer. A pooled analysis of three case-control studies. Oral Oncol Eur J Cancer 1995.

  38. Gordis L. Should dead cases be matched to dead controls? Am J Epidemiol 1982; 115: 1–5.

    Google Scholar 

  39. Marshall J. The use of dual or multiple reports in epidemiologic studies. Stat Med 1989; 8: 1041–9.

    Google Scholar 

  40. Gregorio D, Marshall J, Zielezny M. Fluctuations in relative odds ratios due to variance differences in case-control studies. Am J Epidemiol 1985; 121: 767–74.

    Google Scholar 

  41. Greenland S. The effect of misclassification in the presence of covariates. Am J Epidemiol 1980; 112: 564–9.

    Google Scholar 

  42. Greenland S, Robins J. Confounding and misclassification. Am J Epidemiol 1985; 122: 495–506.

    Google Scholar 

  43. Marshall J, Hastrup J. Measurement and the resonance of strong confounders. Am J Epidemiol, in press.

  44. Willett WC. Nutritional Epidemiology, New York, NY (USA): Oxford University Press, 1990.

    Google Scholar 

  45. Feskanich D, Marshall J, Rimm EB, Litin LB, Willett WC. Simulated validation of a brief food frequency questionnaire. Ann Epidemiol 1994; 4: 181–7.

    Google Scholar 

  46. Hong WK, Lippmann SM, Itri L, et al. Prevention of second primary tumors with isotretinoin in squamous cell carcinoma of the head and neck. New Eng J Med 1990; 323: 513–26.

    Google Scholar 

  47. Benner SE, Lippmann SM, Hong WK. Chemoprevention of second primary tumours: a model for intervention trials. Eur J Cancer 1994; 30: 727–9.

    Google Scholar 

  48. Boyle P, Chiesa F, Scully C. Chemoprevention and oral cancer-(more) trials and (more) tribulations. Oral Oncol Eur J Cancer 1995; 316: 1–2.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marshall, J.R., Boyle, P. Nutrition and oral cancer. Cancer Causes Control 7, 101–111 (1996). https://doi.org/10.1007/BF00115642

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00115642

Key words

Navigation