Nutrient-based dietary patterns of head and neck squamous cell cancer: a factor analysis in Uruguay.

OBJECTIVE: The aim of this study was to investigate the association between nutrient-based dietary patterns and squamous cell cancers of the head and neck. METHODS: We used a case-control study which included 548 cases and 548 controls. From these participants, we derived 23 nutrients and they were then submitted to a factorability analysis in order to conduct a principal component factor analysis. RESULTS: We were able to identify four nutrient-derived patterns. The first pattern (meat-based pattern) was positively associated with squamous cell cancer of the head and neck (OR 2.85, 95 % CI 1.81-4.15), whereas the third pattern (fruit-based) was strongly protective (OR 0.43, 95 % CI 0.27-0.63). The other nutrient patterns were also significantly associated with head and neck squamous cell carcinoma with minor ORs. CONCLUSION: Both patterns suggest that red meat and fruits are major factors in the etiology of head and neck squamous cell cancer, replicating previous studies in the field.

Meat, milk and risk of lymphoid malignancies: a case-control study in Uruguay.

In the time period 1996-2004, 697 cases with lymphoid neoplasms and 3606 controls with nonneoplastic conditions were included in a case-control study conducted in the Cancer Institute of Uruguay. They were administered a routine questionnaire that included 8 sections and a food frequency questionnaire focused on intakes of total meat, red meat, salted meat, barbecued meat, processed meat, milk, total vegetables and total fruits, and alcoholic beverages. Lymphoid cancers were analyzed by multiple polytomous regression. Red meat, salted meat, and milk were positively associated with risk of lymphoid cancers [odds ratios (OR) for the highest tertile vs. the lowest one of red meat = 1.68, 95% confidence interval (CI) 1.37-2.08, OR for whole milk = 2.92, 95% CI 2.63-3.63). On the other hand, plant foods, particularly total fruits, and alcoholic beverages (mainly red wine) were protective. We could conclude that these foods could play a significant role in the etiology of lymphoid malignancies.

Dietary patterns and risk of cancers of the upper aerodigestive tract: a factor analysis in Uruguay.

In the time period 1996-2004, we conducted a case-control study in Montevideo, Uruguay with the objective of exploring the role of foods and alcoholic beverages in the etiology of cancers of the upper aerodigestive tract (UADT). In brief, 563 male cases and 1099 male controls were frequency matched on age and residence using random sampling. All the participants were drawn from the 4 major public hospitals in Montevideo. We used exploratory factor analysis among controls. Through Scree plot test, the model retained 4 factors, which were labeled as prudent, starchy plants, Western, and drinker. These dietary patterns explained 34.8% of the total variance. Whereas the prudent pattern was inversely associated with UADT cancer [odds ratios (OR) for the upper tertile vs. the lowest one 0.52, 95% confidence intervals 0.32-0.76, P value for trend = 0.0005), the remaining patterns were significantly and positively associated with UADT cancers. We conclude that these patterns were similar among the oral and laryngeal cancers, both in the direction of the ORs and in the magnitude of the associations, suggesting that these cancer sites share the effect of dietary patterns in the etiology of cancer of the upper aerodigestive tract.

Food groups and risk of prostate cancer: a case-control study in Uruguay.

OBJECTIVE: The role of foods and beverages has been studied in detail in order to establish probable risk factors for prostate cancer. METHODS: Data were derived from 326 cases with incident and microscopically confirmed adenocarcinomas of the prostate and 652 controls. Odds ratios and 95 % confidence intervals of prostate cancer were estimated by unconditional multiple logistic regression. RESULTS: We identified the following food items as risk factors: lamb meat, salted meat, whole milk, total eggs, and maté consumption. The highest OR was associated with total eggs (OR, 2.43; 95 % CI, 1.70-3.48), followed by salted meat (OR, 2.65; 95 % CI, 1.36-3.76), maté consumption (OR, 1.96; 95 % CI, 1.17-3.31), and whole milk (OR, 2.01; 95 % CI, 1.26-2.51). CONCLUSIONS: The final model, fitted by stepwise forward method, included total eggs, salted meat, whole milk, and maté consumption, whereas fruits were protective.

Meat consumption, cooking methods, mutagens, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay.

The role of meat in squamous cell carcinoma of the esophagus (ESCC) has been considered conflictive. For this reason, we decided to conduct a case-control study on meat consumption and ESCC. Data included 234 newly diagnosed and microscopically examined ESCC and 2,020 controls with conditions not related to tobacco smoking nor alcohol drinking and without changes in their diets. We studied total meat, red meat, beef, lamb, processed meat, poultry, fish, total white meat, liver, fried meat, barbecued meat, boiled meat, heterocyclic amines, nitrosodimethylamine, and benzo[a]pyrene in relation with the risk of ESCC. Red meat, lamb, and boiled meat were directly associated with the risk of ESCC, whereas total white meat, poultry, fish, and liver were mainly protective against this malignancy.

Dietary patterns and risk of adenocarcinoma of the lung in males: a factor analysis in Uruguay.

In the period 1996-2004, a hospital-based case-control study on diet and adenocarcinoma of the lung in men was conducted in Montevideo, Uruguay. The study included 200 cases and 800 controls, frequency matched on age, residence, and interviewers. Factor analysis (principal components) was used to identify the major food patterns associated with adenocarcinoma. The analysis of food groups led to the identification of 4 patterns, arbitrarily labeled as Western, starchy vegetables, prudent, and milk/coffee. Whereas the Western pattern (OR 1.94, 95% CI 1.08-3.45) and the milk/coffee pattern (OR 2.30, 95% CI 1.35-3.90) were positively associated with risk of adenocarcinoma of the lung, the starchy vegetables (OR 0.49, 95% 0.28-0.86) and prudent patterns (OR 0.54, 95% CI 0.32-0.92) were significantly protective against this malignancy. The results suggests that adenocarcinoma of the lung could be considered a different nosologic entity, compared with the other histologies of lung cancer.

Dietary patterns and risk of advanced prostate cancer: a principal component analysis in Uruguay.

OBJECTIVE: In order to explore the role of broader eating patterns in the etiology of prostate cancer, we conducted a principal components analysis among Uruguayan men. METHODS: The study included 345 newly diagnosed cases of advanced prostate cancer and 690 hospitalized controls. The factor analysis was performed using the control population. RESULTS: Factor analysis allowed the extraction of five patterns, labeled as prudent, traditional, substituter, drinker, and Western. Whereas the traditional and Western patterns were directly associated with risk of prostate cancer (OR for high quartile versus the low quartile of the Western diet was 2.35, 95% CI 1.44-3.85, p-value for trend < 0.0001), the prudent, drinker, and substituter patterns were not associated with risk of the disease. After adjustment of each pattern for the foods with high loadings, these three patterns did not modify substantially their original ORs. CONCLUSION: The Western and traditional patterns could partially explain the high incidence of advanced prostate cancer in Uruguay, a main producer of beef in the World.

Dietary patterns and risk of cancer: a factor analysis in Uruguay.

A multisite case-control study on factor analysis and several cancer sites (mouth and pharynx, esophagus, stomach, colon, rectum, larynx, lung, breast, prostate, bladder, kidney) was conducted in Uruguay. The study included 3,528 cases and 2,532 controls. Factor analysis (principal components) was modeled among controls. This patterning method retained 4 factors per sex, labeled as prudent, drinker, traditional and Western. Odds ratios for these cancer sites, stratified by sex, were estimated using polytomous regression. Whereas the prudent pattern was mainly negatively associated with cancers of the upper aerodigestive tract, the Western pattern showed a strong increase in breast, lung and colon cancers. The study allowed for the reproducibility of the prudent, drinker and Western patterns, whereas the traditional pattern appears to be country specific.

Legume intake and the risk of cancer: a multisite case-control study in Uruguay.

BACKGROUND: Previous studies have suggested that a high intake of legumes may decrease the risk of stomach and prostate cancer and some other cancers. However, the evidence is still limited. To further explore the association between legume intake and cancer risk we conducted a case-control study of 11 cancer sites in Uruguay between 1996 and 2004, including 3,539 cancer cases and 2,032 hospital controls. RESULTS: The highest versus the lowest tertile of legume intake was associated with a significant decrease in the risk of cancers of the oral cavity and pharynx (OR = 0.48, 95% CI: 0.34-0.68), esophagus (OR = 0.54, 95% CI: 0.38-0.77), larynx (OR = 0.55, 95% CI: 0.40-0.77), upper aerodigestive tract (OR = 0.50, 95% CI: 0.40-0.63), stomach (OR = 0.69, 95% CI: 0.49-0.97), colorectum (OR = 0.43, 95% CI: 0.32-0.59), kidney (OR = 0.41, 95% CI: 0.24-0.71), and all sites combined (OR = 0.68, 95% CI: 0.59-0.78). No significant association was observed between legume intake and cancers of the lung (OR = 1.03, 95% CI: 0.83-1.27), breast (OR = 0.89, 95% CI: 0.65-1.20), prostate (OR = 0.87, 95% CI: 0.64-1.18) or bladder (OR = 0.82, 95% CI: 0.57-1.17). Similar results were found for both beans and lentils. CONCLUSION: Higher intake of legumes was associated with a decreased risk of several cancers including those of the upper aerodigestive tract, stomach, colorectum, and kidney, but not lung, breast, prostate or bladder. Further investigations of these associations in prospective cohort studies are warranted.

Meat intake, meat mutagens and risk of lung cancer in Uruguayan men.

OBJECTIVE: To determine the role of meat consumption and related mutagens in the etiology of lung cancer, we conducted a case-control study among Uruguayan males in the time period 1996-2004. METHODS: The study included 846 cases and 846 controls, frequency matched on age and residence. Both series were drawn from the four major public hospitals in Montevideo, Uruguay. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) of lung cancer by quartiles of meat intake and mutagens. RESULTS: The highest vs. the lowest quartile of intake of total meat (OR = 2.04, 95% CI 1.42-2.92), red meat (OR = 2.33, 95% CI 1.63-3.32), and processed meat (OR = 1.79, 95% CI 1.22-2.65) was associated with increased risk of lung cancer, while intake of total white meat, poultry and fish was not. Heterocyclic amines (IQ, MeIQx, PhIP), nitrosamines and benzo[a]pyrene were directly associated with the risk of lung cancer (OR for PhIP 2.16, 95% CI 1.48-3.15). Moreover, both red meat and meat mutagens displayed higher risks among former smokers compared with current smokers. CONCLUSIONS: This study suggests that red and processed meat and meat mutagens may play a role in the etiology of lung cancer.

Dietary patterns and risk of bladder cancer: a factor analysis in Uruguay.

OBJECTIVE: To determine the major dietary patterns associated with bladder cancer risk, we conducted a principal components analysis (PCA) in a case-control study from Uruguay. METHODS: A total of 255 newly diagnosed and microscopically confirmed cases of transitional cell carcinoma of the bladder and 501 hospitalized controls were included in the study. Both series were drawn from the four major public hospitals in Montevideo, Uruguay. Cases and controls were frequency matched on age and sex. Controls were submitted to factor (principal components) analysis. RESULTS: We retained three factors that explained 25.1% of the total variance (including error variance). The first factor was labeled as the sweet beverages pattern. This factor was characterized by high loadings of coffee, tea, and added sugar and was strongly associated with risk of bladder cancer (OR 3.27, 95% CI 1.96-5.45). The second factor was labeled as the Western pattern and displayed high loadings of red meat, fried eggs, potatoes, and red wine. This pattern was directly associated with risk of bladder cancer (OR 2.35, 95% CI 1.42-3.89). Finally, the third factor was labeled as the prudent pattern and showed high loadings of fresh vegetables, cooked vegetables, and fruits. This pattern was not associated with risk of bladder cancer. CONCLUSIONS: According to our study, non-alcoholic beverages were the strongest risk factor for bladder cancer, whereas the Western pattern was also associated with a significant increase in risk of bladder cancer.

Nutrient patterns and risk of lung cancer: a factor analysis in Uruguayan men.

SUMMARY: In the time period 1996-2004, a case-control study on environmental factor risks and lung cancer was conducted in Montevideo, Uruguay. The study included 846 cases and 846 controls and was restricted to men. Forty nutrients and bioactive substances were submitted to exploratory (principal components) factor analysis. We retained three factors which were labeled as high-meat, antioxidants and carbohydrates. After that, score patterns (obtained from the retained factors) were correlated with sociodemographic variables, tobacco use, alcohol drinking and food groups. Finally, scored patterns were used as explanatory variables through multiple logistic regression analysis. The so-called antioxidants pattern was inversely associated with lung cancer risk (OR 0.69, 0.51-0.96) whereas the high-meat pattern was associated with a strong increase in risk (OR 2.90, 95% CI 1.91-4.40). The carbohydrates pattern was not associated with risk of lung cancer. Although nutrients could be important determinants in the etiology of lung cancer, stop smoking continue to be the major preventive measure for this disease.

Nutrient patterns and risk of squamous cell carcinoma of the esophagus: a factor analysis in uruguay.

BACKGROUND: Squamous cell carcinoma of the esophagus is a common disease, with an age-standardized incidence rate of 55 cases per 100,000 persons in the northern counties of Uruguay. These rates are comparable to those observed in Iran and China. MATERIALS AND METHODS: In order to contribute to the clarification of the etiology of this lethal disease, a case-control study which included 234 cases and 936 controls, frequency matched for age, sex and residence, was conducted. Factor analysis (principal components) was conducted on the controls and three factors were retained, high-fat, carbohydrates and antioxidants. These nutrient patterns were submitted to multiple logistic unconditional regression in order to estimate the odds ratios of esophageal cancer. RESULTS: The nutrient patterns (labeled as high-fat, carbohydrates and antioxidants) were significantly associated with the risk of esophageal squamous cell cancer. Whereas the high-fat and carbohydrates patterns were directly associated with an increased risk of esophageal cancer, the antioxidants pattern was strongly protective (OR 0.39, 95% CI 0.23-0.66). CONCLUSION: In squamous cell carcinoma of the esophagus an antioxidant dietary pattern is protective, probably due to its action against oxidative stress while high-fat and carbohydrates patterns are associated with an increased risk which may be due to the meat and sodium content, respectively.

Non-alcoholic beverages and risk of bladder cancer in Uruguay.

BACKGROUND: Bladder cancer is the fourth most frequent malignancy among Uruguayan men. A previous study from Uruguay suggested a high risk of bladder cancer associated with maté drinking. We conducted an additional case-control study in order to further explore the role of non-alcoholic beverages in bladder carcinogenesis. METHODS: In the time period 1996-2000, 255 incident cases with transitional cell carcinoma of the bladder and 501 patients treated in the same hospitals and in the same time period were frequency matched on age, sex, and residence. Both cases and controls were face-to-face interviewed on occupation, tobacco smoking, alcohol drinking and intake of maté, coffee, tea, and soft drinks. Statistical analysis was carried out by unconditional multiple logistic regression. RESULTS: Ever maté drinking was positively associated with bladder cancer (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.2-3.9) and the risk increased for increasing duration and amount of maté drinking. Both coffee and tea were strongly associated with bladder cancer risk (OR for coffee drinking 1.6, 95% CI 1.2-2.3; OR for tea drinking 2.3, 95% CI 1.5-3.4). These results were confirmed in a separate analysis of never-smokers. CONCLUSION: Our results suggest that drinking of maté, coffee and tea may be risk factors for bladder carcinoma in Uruguay.

Squamous and small cell carcinomas of the lung: similarities and differences concerning the role of tobacco smoking.

In the time period 1988-2000, a case-case study on environmental factors and lung cancer risk was conducted in Montevideo, Uruguay. This study was designed in order the establish possible differences between squamous cell carcinomas (SCC) and small cell carcinomas (SCLC) of the lung in relation to tobacco smoking. Three hundred and ninety one (391) patients with small cell carcinoma were compared with 1187 patients with squamous cell carcinoma. Regarding sex, the study included a small number of women (26 with SCLC and 20 with SCC). SCLC was associated with higher risks for smoking status, smoking intensity and cumulative exposure to tobacco smoking when compared with SCC. These three tobacco variables were significantly different between both cell types in men. Smoking duration was significantly higher among SCLC compared with SCC only in women. With decreasing age at starting to smoke, the proportion of SCLC increases at the expense of SCC. Finally, types of tobacco and cigarette were not different between cell types in both sexes. It should be noted that these tobacco variables were not associated with increased risks among SCC, when this cell type was compared with SCLC. These results suggests that SCLC display the strongest relation with tobacco smoking than SCC.

Alcohol intake and risk of adenocarcinoma of the lung. A case-control study in Uruguay.

In order to examine in detail the relationship between alcohol drinking and risk of adenocarcinoma of the lung, a case-control study involving 160 cases of this cell type and 520 hospitalized controls was conducted in Uruguay in the time period January 1998-July 2000. Total alcohol intake was not associated with risk of adenocarcinoma of the lung (OR 1.2, 95% CI 0.6-2.1). Also beer drinking was not associated with risk of carcinoma (OR 0.6, 95% CI 0.3-1.6). On the other hand, wine drinking displayed a marginally significant reduction in risk (OR 0.4, 95% CI 0.2-1.1). On the contrary, hard liquor intake was associated with a 40% increase in risk of adenocarcinoma of the lung. These findings suggest that wine drinking has a protective effect in adenocarcinoma of the lung, whereas hard liquor increases moderately the risk of this cell type of lung cancer.

Cigarette smoking and risk of large cell carcinoma of the lung: a case-control study in Uruguay.

In the time period 1988-2000, a case-control study on large cell carcinoma of the lung was conducted in Montevideo, Uruguay. The study included 149 cases (139 men and 10 women) and 596 controls (556 men and 40 women) afflicted with diseases not related with tobacco smoking. Cases and controls were frequency matched on age, sex, residence and urban/rural status. According to our results, large cell carcinoma was strongly related with cigarette smoking (OR for heavy smokers 155.2, 95% CI: 30.6-786.1). Furthermore, all cases displayed higher risks for intensity compared with smoking duration. Smokers of black tobacco showed odds ratios (ORs) significantly higher than those presented by smokers of blond tobacco and smoking cessation displayed a reduction in risk of 95%, close to the risk of never smokers. Finally, filter use was not associated with any reduction in risk. It could be concluded that undifferentiated large cell carcinoma of the lung could be included among those lung tumors classified as Kreyberg I cancers.

Diet and adenocarcinoma of the lung: a case-control study in Uruguay.

With the objective of examining the relationship between diet and adenocarcinoma of the lung, a case-control study was carried out in Uruguay. Red meat, total meat and fatty foods were associated with a significant increase in risk (odds ratios (OR) for red meat intake 1.92, 95% CI 1.27-2.90). On the other hand, fruits, tubers and all plant foods displayed significant inverse associations with adenocarcinoma of the lung (OR for total plant foods 0.39, 95% CI 0.26-0.61). Among nutrients, total fat, other fats (saturated fat) and cholesterol were associated with an increased risk of adenocarcinoma of the lung (OR for high consumption of total fat 2.28, 95% CI 1.48-3.54). The risk associated with cholesterol intake was even higher after controlling for total fat, suggesting that both nutrients (fat and cholesterol) have independent effects. Carotenoids and vitamin E displayed significantly protective effects. This effect was markedly attenuated, when these micronutrients were adjusted for total plant intake. Furthermore, red meat, fat, and cholesterol showed attenuation in its effects after adjustment for total plant foods. It could be concluded that tobacco smoking is the strongest risk factor for adenocarcinoma of the lung. Low consumption of plant foods, and in a lesser degree, high consumption of red meat, total fat and cholesterol contribute to a high risk of adenocarcinoma of the lung.

Meat consumption, animal products, and the risk of bladder cancer: a case-control study in Uruguayan men.

In the time period 1996-2004, all incident cases of bladder cancer were included in a case-control study in order to study the role of meat consumption and product animals in the etiology of urothelial cancer. The study included 225 cases and 1,510 hospitalized controls with non-neoplastic conditions, not related to smoking and alcohol drinking. Relative risks, approximated by the odds ratios, were calculated in order to clarify the effect of meat consumption in the etiology of urothelial cancer. Total meat consumption (OR 1.47, 95% CI 1.02-2.11), total processed meat (OR 1.57, 95% CI 1.08-2.27), frankfurters (hot dogs) (OR 2.03, 95% CI 1.28-3.21), ham (OR 1.79, 95% CI 1.21-2.67) and salted meat (OR 2.73, 95% CI 1.78-4.18) were positively associated with risk of bladder cancer. Animal products, like cheese, whole milk, and total eggs were also associated with bladder cancer risk (OR for eggs 4.05, 95% CI 2.68-6.12). In conclusion, total meat, processed meat, and eggs could play an important role in the etiology of bladder cancer in Uruguay.

Diet patterns and risk of squamous cell oesophageal carcinoma: a case-control study in Uruguay.

BACKGROUND: Oesophageal cancer presents high incidence rates in the so-called Brazilian-Uruguayan belt. MATERIALS AND METHODS: The present study included 1,170 participants (234 cases and 936 controls) which were analyzed by unconditional multiple logistic regression in order to examine risk of oesophageal squamous cell carcinoma (OESCC) associated with several food groups. RESULTS: Boiled red meat (OR 2.59, 95%CI 1.69-3.97), lamb meat (OR 1.64, 95%CI 1.07-2.51), processed meat (OR 1.49, 95%CI 1.01-2.21), whole milk (OR 1.78, 1.19-1.68), fresh vegetables and fruits (OR 0.42, 95%CI 0.27-0.63), mate consumption (OR 2.04, 95%CI 1.32- 3.16), and black tea (OR 0.10, 95%CI 0.04-0.28) were significantly associated with risk of OESCC. CONCLUSIONS: Hot beverages (mate) and hot foods (boiled meat) appear to be important determinants in the risk of OESCC, allowing the penetration of carcinogens in tobacco and alcohol into the oesophageal mucosa.