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Chapter-12 Fruit and Vegetable Consumption and Oral Cancer: A Meta-analysis

BOOK TITLE: Herbal Medicine: A Cancer Chemopreventive and Therapeutic Perspective

Author
1. Pavia M
2. Bianco A
3. Nobile CGA
4. Angelillo IF
ISBN
9788184488418
DOI
10.5005/jp/books/11166_12
Edition
1/e
Publishing Year
2010
Pages
12
Author Affiliations
1. University of Catanzaro “Magna Græcia”, Via Tommaso Campanella, Italy
2. Medical School, University of Catanzaro “Magna Græcia”, Via Tommaso Campanella 88100 Catanzaro, Italy
3. Medical School, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
4. Medical School, Second University of Naples, Via Luciano Armanni, Naples, Italy
Chapter keywords

Abstract

Cancers of the oral cavity and oropharynx for both genders combined, ranks sixth regarding overall incidence in the world. Numerous epidemiological studies have documented that the primary factors associated with the risk of developing oral cancer include tobacco use and consumption of alcohol in the form of beer, wine, or liquors. There is strong scientific evidence that dietary patterns are related to cancer risk and approximately 35% of cancer deaths may be reduced by healthful dietary modifications, making diet second only to tobacco as a preventable cause of cancer. Particularly in developing countries, almost 60% of cancers of oral cavity, pharynx, and esophagus are thought to be related to dietary deficiencies, such as low fruit, vegetables, and animal products intake. A meta-analysis of published observational studies was performed to arrive at quantitative conclusions about the contribution of fruit and vegetables intake to the occurrence of oral cancer. A comprehensive systematic bibliographic search for medical literature published until August, 2007 was conducted to identify relevant studies. Separate meta-analyses were conducted for fruit and vegetables consumption. The effect on risk for oral cancer was calculated for portion/daily intake of fruit or vegetables. To explore heterogeneity, multivariate meta-regression analysis was performed to examine the effect of quality score, type of cancers included, citric fruit and green vegetables consumption, and time interval for dietary recall, on the role of fruit or vegetables consumption on risk of oral cancer. The presence of publication bias was assessed with a funnel plot for asymmetry. Sixteen studies met the inclusion criteria and were included in the meta-analysis. The combined adjusted Odds Ratio estimates demonstrated that each portion of fruit per day had an overall statistically significant effect on reducing risk of oral cancer by 49%. For vegetables consumption, meta-analysis revealed an overall significant reduction of risk of oral cancer by 50%. Multivariate meta-regression analysis showed that the reduction of risk of oral cancer related to fruit consumption was significantly influenced by type of fruit and time frame of dietary habits data collection. The results of this meta-analysis clearly indicate that the consumption of fruits and vegetables reduces the risk of oral cancer and prospective studies, less prone to recall and selection bias, are needed to confirm this result. In the case of further evidences supporting these results, the analysis of this review will have important public health and nutritional implications, both in terms of more detailed insight and understanding of the etiology of oral cancer and for the development of prevention strategies. Promoting dietary pattern, recommending high consumption of fruit and vegetables and enabling access to healthy food should be part of public health approaches for prevention of oral cancer.

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