Vitamin E intake from natural sources and head and neck cancer risk: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium

Background: Evidence for the possible effect of vitamin E on head and neck cancers (HNCs) is limited. Methods: We used individual-level pooled data from 10 case-control studies (5959 cases and 12 248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the association between vitamin E intake from natural sources and cancer of the oral cavity/pharynx and larynx. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models applied to quintile categories of nonalcohol energy-adjusted vitamin E intake. Results: Intake of vitamin E was inversely related to oral/pharyngeal cancer (OR for the fifth vs the first quintile category = 0.59, 95% CI: 0.49-0.71; P for trend <0.001) and to laryngeal cancer (OR = 0.67, 95% CI: 0.54-0.83, P for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral/pharyngeal cancer. Inverse associations were generally observed for the anatomical subsites of oral and pharyngeal cancer and within covariate strata for both sites. Conclusion: Our findings suggest that greater vitamin E intake from foods may lower HNC risk, although we were not able to explain the heterogeneity observed across studies or rule out certain sources of bias.National Institutes of Health (NIH), National Cancer Institute, (NCI) [R03CA113157]; NIDCR [R03DE016611]; Italy Multicenter study: Italian Association for Research on Cancer (AIRC); Italy Multicenter study: Italian League Against Cancer; Italy Multicenter study: Italian Ministry of Research; Swiss study: Swiss Research against Cancer/Oncosuisse [KFS-700, OCS-1633]; Los Angeles study: NIH [P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, R21ES011667]; Los Angeles study: Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center; Boston study: NIH [R01CA078609, R01CA100679]; US multicenter study: Intramural Program of the NCI, NIH, USA; MSKCC study: NIH [R01CA051845]; Japan study: Scientific Research grant from the Ministry of Education, Science, Sports, Culture and Technology of Japan [20012005, 17015052]; North Carolina study; Buffalo study; Milan study: Italian Association for Cancer Research (AIRC) [10068]; Milan study: Italian Foundation for Cancer Research (FIRC); Milan study: Italian Ministry of Education [PRIN 2009 X8YCBN]; FIRC; Japan study: Ministry of Health, Labor and Welfare of JapanSCI(E)PubMedARTICLEvaleria.edefonti@unimi.it1182-19211