Tea consumption and its interactions with tobacco smoking and alcohol drinking on oral cancer in southeast China

Causal association between tea consumption and head and neck cancer: a Mendelian randomization study

Although evidence supports an observational association between tea consumption and susceptibility to head and neck cancer, the causal nature of this association remains unclear. We performed a two-sample Mendelian randomization (MR) analysis to determine the causal effects of tea consumption on head and neck cancer. We employed a fixed-effects inverse variance-weighted model for the MR analysis. Genome-wide association study (GWAS) summary data for tea consumption were obtained from the UK Biobank Consortium, and GWAS data for head and neck cancer were derived from two data sources and were used as the outcomes. Our MR analysis revealed limited evidence for a causal relationship between various types of tea intake and head and neck cancer. After adjustment for smoking and alcohol consumption, there was no causal relationship between tea consumption and head and neck cancer. Further experimental studies are required to confirm its potential role in these malignancies.

Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis

BACKGROUND

Oral cavity cancer (OCC) is traditionally associated with smoking, but there is an increasing prevalence of the disease among non-smokers. This review investigates possible modifiable risk factors in the development of OCC in non-smokers (OCCNS).

METHODS

PubMed, EMBASE, Web of Science, and Scopus were searched for publications prior to June 2021. Comparative studies investigating modifiable OCCNS risk factors were identified following PRISMA guidelines. Publication date, population size, and results were indexed. Study quality was assessed using MINORS (Methodological Index for Non-Randomized Studies). Factors examined by multiple studies were analyzed using random-effect meta-analysis framework.

RESULTS

Literature search resulted in 1,625 unique publications. 52 records met inclusion criterion, investigating alcohol (n = 22), chewing products (n = 18), diet (n = 7), dental health (n = 11), and medical comorbidities (n = 6).

CONCLUSION

This review demonstrates the paucity of large studies investigating OCCNS risk factors. Further investigation is warranted to help clinicians risk-stratify patients without traditional risk factors.

Consumption of Coffee and Green Tea and the Risk of Colorectal Cancer in Korea: The Health Examinees Study

Coffee and green tea may affect colorectal physiology and contain many bioactive components, such as polyphenol and caffeine, which have antioxidant and anti-carcinogenic activities. However, the association between coffee and green tea consumption and the risk of colorectal cancer (CRC) has been inconclusive. This study examined the association between coffee and green tea consumption and the risk of CRC in a large-scale prospective cohort study in Korea. Data from the Health Examinees study from 2004 to 2013 were analyzed, and 114,243 participants (39,380 men and 74,863 women) aged 40-79 years were included in the final analysis. A Cox proportional hazards regression model using age at time scale was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of coffee and green tea consumption for the risk of CRC by sex. In both men and women, no significant association was found between coffee and green tea consumption and the risk of CRC. Among women, there was a significant increase in the risk of colon cancer (HR, 1.66; 95% CI, 1.13-2.44) in the black coffee drinker group. Our findings suggest that consumption of coffee and green tea may not be associated with the CRC incidence in Korea; instead, the association may differ depending on cancer subsites and coffee types.

Oolong Tea Consumption and the Risk of Oral Squamous Cell Carcinoma: A Propensity Score-Based Analysis in Southeast China

Oolong tea is one of the world's most popular non-alcoholic beverages, particularly in coastal Southeast China. Hitherto, epidemiological studies on the association between oolong tea consumption and the risk of patients with oral squamous cell carcinoma (OSCC) are very limited. This study aimed to evaluate the potential effect of oolong tea consumption on OSCC risk in Southeast China. From January 2010 to October 2020, face-to-face interviews were conducted for 744 newly diagnosed OSCC patients and 1,029 healthy controls to collect information on demographics, oolong tea consumption behaviors, and other lifestyle factors. Propensity score matching (PSM), inverse probability of treatment weight (IPTW), and stabilized inverse probability of treatment weight (SIPTW) were utilized to minimize confounding effects. Multivariate, conditional, and weighted logistic regression was used to evaluate the associations of oolong tea consumption behaviors with OSCC risk. Participants who drank oolong tea showed a lower risk of OSCC when compared to their non-drink counterparts [PSM population, OR (95%CI): 0.69 (0.49–0.97); SIPTW population, OR (95%CI): 0.74 (0.58–0.94)]. Moreover, the reduced risk was found to be significantly associated with certain tea-drinking habits (consumed amount over 500 mL per day, a duration of <20 years, age at initiation older than 30 years, and warm and moderately concentrated tea). Similar results were yielded in the sensitivity analyses (Multivariate adjustment and the IPTW analysis). Furthermore, subgroup analysis revealed that the negative association of oolong tea drinking with OSCC risk was more evident among those with poor oral hygiene. This study provides supportive evidence that oolong tea consumption may have a potentially beneficial effect in preventing OSCC, especially for those with poor oral hygiene.

Association Between Dietary Fatty Acid Pattern and Risk of Oral Cancer

Objective

To investigate the association between dietary fatty acid (FA) patterns and the risk of oral cancer.

Method

A case-control study which included 446 patients with oral cancer and 448 controls subjects was conducted in Southeast China. A structured food frequency questionnaire was used to assess the dietary FA consumption before cancer diagnosis. FA patterns were identified using the principal component analysis, and the relationship between the dietary FA patterns and oral cancer was analyzed by logistic regression.

Results

General differences in FA intake were observed between the patient and control groups. The intakes of saturated FAs (SFAs) C14:0, C16:0, C18:0, and monounsaturated FA C18:1 were higher in the patient group than the control group (p < 0.001). Four FA patterns were derived by principal component analysis. The "SFA" pattern, "Polyunsaturated FA" pattern, "Monounsaturated FA" pattern, and "Medium- and long-chain FA" pattern, which could explain 75.7% of the variance of the dietary FA intake, were submitted to logistic regression analysis. A positive association was observed between the "SFA" pattern and oral cancer risk. Compared with the lowest quartile score, the OR of the highest quartile score was 3.71 (95%CI: 2.31, 5.94, P _trend < 0.001) in the multivariate logistic regression model. No significant association was found among the other three patterns and oral cancer risk.

Conclusions

General differences in dietary FA intake were observed between patients with oral cancer and controls. A positive association between the "SFA" pattern and risk of oral cancer was observed after adjusting for potential confounders.

U-Shaped Relationship of Rare Earth Element Lanthanum and Oral Cancer Risk: A Propensity Score-Based Study in the Southeast of China

As an important rare earth element (REE) extensively applied to industry, agriculture, and medicine, lanthanum (La) has attracted a host of health concerns. This study aimed to explore the relationship between La exposure and the risk of developing oral cancer through a case-control study with a large sample size. Serum La levels of 430 oral cancer patients and 1,118 healthy controls were detected by inductively coupled plasma mass spectrometry (ICP-MS). The association of La level with the risk of oral cancer was assessed in two ways: (1) as a continuous scale based on restricted cubic splines (RCS); (2) as a priori defined centile categories using multivariate logistic regression model, based on propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). The RCS revealed a non-linear U-shaped relationship between serum La and oral cancer risk. Serum La deficiency or excess was associated with an increased risk of oral cancer. When the La level was analyzed as a categorical variable, a similar U-shaped association was observed. Of note, compared to those with La concentrations of 0.243–0.341 μg/L (reference quantiles, 41st−60th), the risk was increased in those with the lower or higher quantiles (0.132–0.242 μg/L vs. 0.243–0.341 μg/L: OR = 1.80, 95%CI: 1.07–3.02; 0.342–0.497 μg/L vs. 0.243–0.341 μg/L: OR = 2.30, 95%CI: 1.38–3.84). The results were generally consistent with the PSM and IPTW analyses. This preliminary study provides strong evidence that there was a U-shaped relationship between serum La levels and oral cancer risk. Much additional work is warranted to confirm our findings.

Long-term tea consumption reduces the risk of frailty in older Chinese people: Result from a 6-year longitudinal study

Background

Vast accumulative evidence suggests that the consumption of tea and its components have various potential health benefits. This study used a longitudinal study to examine the causality between tea consumption and frailty in older Chinese people.

Methods

This study employed the longitudinal data from 2008 to 2014 of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which were systematically collected through face-to-face interviews. Two thousand four hundred and seventy three participants completed six-follow-up surveys in 2014 and were analyzed in this study. The frailty index recommended by Searle and co-authors, including 44 health deficits, was used. A Generalized Estimating Equation (GEE) was applied to determine the risk ratio (RR) with a 95% confidence interval (CI) for frailty, and further subgroup analyses were conducted to investigate whether the risk differed stratified by age, sex, and socioeconomic status. Additionally, the interaction between tea consumption with sex and frailty was tested.

Results

Of the 2,473 participants, 14.1% were consistent daily tea drinkers, and 22.6% reported frailty at the 6-year follow-up. Compared to non-tea drinkers, consistent daily tea drinkers reported a significantly lower ratio of having frailty [risk ratio (RR) = 0.54, 95% confidence interval (CI): 0.38-0.78], adjusting for sociodemographic characteristics, health behavior, socioeconomic status, and chronic illnesses. In further subgroup analyses, consistent daily tea consumption significantly reduced the risk of frailty for males (RR = 0.53, 95% CI: 0.32-0.87) but not females (RR = 0.65, 95% CI: 0.37-1.12); in the young (RR = 0.40, 95% CI: 0.22-0.74) but not in the oldest (aged ≥ 80) (RR = 0.66, 95% CI: 0.40-1.06); informal education (RR = 0.48, 95% CI: 0.28-0.84) but not formal education (RR = 0.62, 95% CI: 0.37-1.03); financial dependence (RR = 0.42, 95% CI: 0.25-0.71) but not financial independence (RR = 0.71, 95% CI: 0.41-1.23). Additionally, females showed a lower tea-mediated risk of frailty in occasional tea consumers (RR = 0.51, 95% CI: 0.29-0.89) and inconsistent tea drinkers (RR = 0.58, 95% CI: 0.37-0.93).

Conclusions

Habitual tea consumption can reduce the risk of frailty in older Chinese, and the benefit varied by age, sex, education, and financial support.

FERMT1 knockdown inhibits oral squamous cell carcinoma cell epithelial-mesenchymal transition by inactivating the PI3K/AKT signaling pathway

BACKGROUND

The metastasis of oral cancer is one of the main causes of death. However, the mechanisms underlying oral cancer metastasis have not been completely elucidated. Fermitin family member 1 (FERMT1) plays an -oncogene role in many cancers; however, the role of FERMT1 in oral squamous cell cancer (OSCC) remains unclear.

METHODS

In this study, OSCC cells were treated with 5 ng/ml recombinant human Transforming growth factor-β1 (TGF-β1) protein. FERMT1 expression was measured in OSCC cell lines by RT-qPCR and western blotting. The effect of FERMT1 knockdown on the migration and invasion of OSCC cells was evaluated by Transwell assay. The epithelial-mesenchymal transition (EMT) and PI3K/AKT signaling pathway-related mRNA expression and protein levels were assessed by RT-qPCR and western blotting.

RESULTS

We found that FERMT1 expression was elevated in TGF-β1-induced OSCC cell lines, and knockdown of FERMT1 inhibited the migration and invasion in TGF-β1-induced OSCC cells. FERMT1 silencing inhibited vimentin, N-cadherin, matrix metalloproteinase 9 (MMP-9) expression and promoted E-cadherin expression, suggesting that FERMT1 silencing inhibited EMT in TGF-β1-induced OSCC cells. Furthermore, FERMT1 silencing inactivated the PI3K/AKT signaling pathway in TGF-β1-induced OSCC cells. Activation of the PI3K/AKT signaling pathway reversed the effect of FERMT1 silencing on OSCC cell migration, invasion, and EMT.

CONCLUSIONS

FERMT1 silencing inhibits the migration, invasion, and EMT of OSCC cells via inactivation of the PI3K/AKT signaling pathway, suggesting that FERMT1 is a novel and potential therapeutic target for anti-metastatic strategies for OSCC.

A composite oral hygiene score and the risk of oral cancer and its subtypes: a large-scale propensity score-based study

OBJECTIVE

This study aimed to investigate the potential relationship between oral hygiene and the risk of oral cancer and its subtypes after controlling the effects of several confounding factors.

MATERIALS AND METHODS

A large-scale case-control study was conducted from January 2010 to August 2019, recruiting a total of 1,288 oral cancer cases with newly diagnosed and 4,234 healthy controls. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were utilized to minimize confounding effects. Conditional logistic regression was used to evaluate the effects of oral hygiene indicators on oral cancer.

RESULTS

A composite oral hygiene score was developed based on five indicators selected based on PSM and IPTW analysis (including tooth loss, dentures wearing, the frequency of tooth brushing, regular dental visits, and recurrent dental ulcer). Participants with a higher score, compared with their lower counterparts, showed a 49% increased risk (the odds ratio (OR) was 1.49 (95% confidence interval (CI): 1.26-1.75). A similar association pattern was found following IPTW analyses (OR = 1.32; 95% CI: 1.22-1.42). Of note, the adverse effects of poor oral hygiene were more evident among the sites of gingival and buccal (PSM analysis: 2.03-fold and 2.68-fold increased risk; IPTW analysis: 1.57-fold and 2.07-fold increased risk, respectively). Additionally, a greater positive association was observed between poor oral hygiene and oral squamous cell carcinoma, compared with other pathological types.

CONCLUSION

This study establishes a composite oral hygiene score and provides supportive evidence of poor oral hygiene associated with a higher risk of oral cancer, particularly in the gingival and buccal mucosa sites and in the squamous cell carcinoma.

CLINICAL RELEVANCE

The data highlights the importance of improving poor oral hygiene habits, which has public health implications for the prevention of oral cancer.

Drinking tea before menopause is associated with higher bone mineral density in postmenopausal women

BACKGROUND

Though tea drinking years and menopause stages have been indicated to be related with bone mineral density (BMD), most human studies have not considered the impact of tea drinking beginning time. Whether drinking tea before or after menopause plays a role in BMD is still unclear. This study aims to analyze whether drinking tea before or after menopause influences BMD in Chinese postmenopausal women.

METHODS

A total of 1377 postmenopausal women under 80 years were enrolled from the baseline survey of the Lanxi Cohort Study. Participants were initially categorized into non-tea drinking, tea drinking beginning after menopause and tea drinking beginning before menopause groups. Tea drinking groups were subdivided according to tea drinking frequency, concentration and type. Multiple linear regression models were applied to evaluate associations between tea drinking before or after menopause and BMD and the impacts of tea drinking frequency, concentration and type on their associations in analyses including all participants. Interactions of tea drinking frequency, concentration and type with drinking tea before or after menopause were further analyzed.

RESULTS

After adjusting for confounding factors, women who began drinking tea before menopause had significantly higher total and regional BMD than non-tea drinking participants and participants who began drinking tea after menopause. Differences in spine BMD were more significant among those who drank tea ≥four times per week. In addition, significant associations between tea drinking and BMD were found among participants who began drinking tea before menopause in both models, irrespective of the concentration and type of tea. No significant associations were found in subgroups of participants who began drinking tea after menopause in either model.

CONCLUSIONS

The results indicate that drinking tea before menopause is related to higher BMD in Chinese postmenopausal women. The relationship is independent of tea drinking concentration and type.

Epidemiological Assessment of Oral Cancer Burden in Pakistan

Oral cancer ranks first among males and is the primary cause of cancer-related deaths in Pakistan. We studied the epidemiology and risk factors associated with this cancer. The main risk factors in the Pakistani population include the usage of chewable and non-chewable tobacco, areca nut, betel leaf, poor dental hygiene practices, oncogenic viral infections, and genetic predispositions. The impact of socioeconomic status and the available health resources on the management of oral cancer is also discussed. It is concluded that being a low-middle economy efforts should be primarily focused on awareness for early screening, diagnosis, and prevention strategies.

Characteristics of spicy food consumption and its relation to lifestyle behaviours: results from 0.5 million adults

This study aimed to describe the characteristics and lifestyle differences of spicy food consumption in 0.5 million adults. Participants were recruited from 2004 to 2008 in the baseline research of the CKB study. Higher frequency and stronger pungency degree in spicy food positively correlated with preference for salty taste, eating snacks/deep-fried foods, tea/alcohol drinking and tobacco smoking. Among weekly tea/alcohol drinkers and current regular smokers, participants with a higher frequency of spicy food consumption or preference for stronger pungency degree were more likely to prefer strong tea, drink alcohol exceed the healthy amount, drink alcohol in the morning every day, smoke ≥ 40 cigarettes per day, consume a larger amount of tea leaves, alcohol and cigarettes each day, and start habitual tea/alcohol drinking or smoking at an earlier age. Differences existed in lifestyle factors related to major chronic diseases according to spicy food consumption frequency and pungency degree among the Chinese population.

Association between serum arsenic and oral cancer risk: A case-control study in southeast China

OBJECTIVES

Evidence on serum arsenic and oral cancer risk was limited. We aimed to evaluate the association between serum arsenic and the risk of oral cancer in a southeast China population.

METHODS

Serum arsenic was determined for 325 oral cancer patients and 648 controls using inductively coupled plasma-mass spectrometry (ICP-MS). Logistic regression and restricted cubic spline were analysed the association between serum arsenic level and oral cancer risk, and crude and adjusted odds ratios (aOR) with 95% confidence interval (95% CI) were calculated. Factors adjusted for included age, gender, BMI, smoking, drinking, education, residence, marital status and dietary factors. Stratification analysis was further performed according to drinking, smoking and dietary characteristics.

RESULTS

Serum arsenic level was lower in the case group (P₅₀  = 19.2μg/L, IQR = 11.6 ~ 26.4μg/L) than in the control group (P₅₀  = 30.2 μg/L, IQR = 25.0 ~ 36.4 μg/L). An inverse but nonlinear association was observed between arsenic level and oral cancer risk by restricted cubic spline. These with moderate serum arsenic levels had a lower risk of oral cancer than those with low levels (OR = 0.11; 95%CI: 0.07-0.18), after adjusting for demographic and dietary intake factors. We also kept serum arsenic as a continuous variable in a regression model, where a similar inverse association between arsenic and oral cancer was observed, with OR = 0.86 (95%CI: 0.84-0.88). Stratification analysis revealed no significant multiplicative interactions between serum arsenic and smoking, drinking or dietary intake.

CONCLUSION

Serum arsenic is inversely related to oral cancer risk. Relative to those with low levels of arsenic, people with moderate serum arsenic levels had a lower risk of oral cancer. If confirmed, serum arsenic level may be a useful predictive marker for oral cancer risk.

Joint effect of tobacco, alcohol, and oral HPV infection on head and neck cancer risk in the French West Indies

We investigated the role of tobacco and alcohol consumption on the occurrence of head and neck squamous cell carcinomas (HNSCC), and the joint effects of these factors with oral human papillomavirus (HPV) infection in the French West Indies, in the Caribbean. We conducted a population‐based case‐control study (145 cases and 405 controls). We used logistic regression models to estimate adjusted odds ratios (OR) and their 95% confidence intervals (CI). Two‐way interactions were assessed on both multiplicative and additive scales. Current smoking (OR = 11.6, 95% CI = 6.7‐20.1), drinking more than five glasses of alcohol per day (OR = 2.7, 95% CI = 1.2‐4.7), and oral infection with High‐risk HPV (OR = 2.4, 95% CI = 1.1‐5.0) were significantly associated with HNSCC. The combined exposure to tobacco and alcohol produced a significant synergistic effect on the incidence of HNSCC. Oral infection with High‐risk HPV increased the risk of HNSCC in never smokers and nondrinkers. The effects of tobacco, alcohol, and of the combined exposure of tobacco and alcohol were substantially lower in HPV‐positive than in HPV‐negative HNSCC. This is the first case‐control study to investigate the role of tobacco smoking, alcohol drinking and oral HPV infection in an Afro‐Caribbean population. Although each of these risk factors has a significant effect, our findings indicate that tobacco and alcohol play a less important role in Hr‐HPV‐positive HNSCC. Further investigations are warranted notably on the interaction of these three risk factors by cancer site.

Green tea (Camellia sinensis) for the prevention of cancer

BACKGROUND

This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (2009, Issue 3).Tea is one of the most commonly consumed beverages worldwide. Teas from the plant Camellia sinensis can be grouped into green, black and oolong tea, and drinking habits vary cross-culturally. C sinensis contains polyphenols, one subgroup being catechins. Catechins are powerful antioxidants, and laboratory studies have suggested that these compounds may inhibit cancer cell proliferation. Some experimental and nonexperimental epidemiological studies have suggested that green tea may have cancer-preventative effects.

OBJECTIVES

To assess possible associations between green tea consumption and the risk of cancer incidence and mortality as primary outcomes, and safety data and quality of life as secondary outcomes.

SEARCH METHODS

We searched eligible studies up to January 2019 in CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and reference lists of previous reviews and included studies.

SELECTION CRITERIA

We included all epidemiological studies, experimental (i.e. randomised controlled trials (RCTs)) and nonexperimental (non-randomised studies, i.e. observational studies with both cohort and case-control design) that investigated the association of green tea consumption with cancer risk or quality of life, or both.

DATA COLLECTION AND ANALYSIS

Two or more review authors independently applied the study criteria, extracted data and assessed methodological quality of studies. We summarised the results according to diagnosis of cancer type.

MAIN RESULTS

In this review update, we included in total 142 completed studies (11 experimental and 131 nonexperimental) and two ongoing studies. This is an additional 10 experimental and 85 nonexperimental studies from those included in the previous version of the review. Eleven experimental studies allocated a total of 1795 participants to either green tea extract or placebo, all demonstrating an overall high methodological quality based on 'Risk of bias' assessment. For incident prostate cancer, the summary risk ratio (RR) in the green tea-supplemented participants was 0.50 (95% confidence interval (CI) 0.18 to 1.36), based on three studies and involving 201 participants (low-certainty evidence). The summary RR for gynaecological cancer was 1.50 (95% CI 0.41 to 5.48; 2 studies, 1157 participants; low-certainty evidence). No evidence of effect of non-melanoma skin cancer emerged (summary RR 1.00, 95% CI 0.06 to 15.92; 1 study, 1075 participants; low-certainty evidence). In addition, adverse effects of green tea extract intake were reported, including gastrointestinal disorders, elevation of liver enzymes, and, more rarely, insomnia, raised blood pressure and skin/subcutaneous reactions. Consumption of green tea extracts induced a slight improvement in quality of life, compared with placebo, based on three experimental studies. In nonexperimental studies, we included over 1,100,000 participants from 46 cohort studies and 85 case-control studies, which were on average of intermediate to high methodological quality based on Newcastle-Ottawa Scale 'Risk of bias' assessment. When comparing the highest intake of green tea with the lowest, we found a lower overall cancer incidence (summary RR 0.83, 95% CI 0.65 to 1.07), based on three studies, involving 52,479 participants (low-certainty evidence). Conversely, we found no association between green tea consumption and cancer-related mortality (summary RR 0.99, 95% CI 0.91 to 1.07), based on eight studies and 504,366 participants (low-certainty evidence). For most of the site-specific cancers we observed a decreased RR in the highest category of green tea consumption compared with the lowest one. After stratifying the analysis according to study design, we found strongly conflicting results for some cancer sites: oesophageal, prostate and urinary tract cancer, and leukaemia showed an increased RR in cohort studies and a decreased RR or no difference in case-control studies.

AUTHORS' CONCLUSIONS

Overall, findings from experimental and nonexperimental epidemiological studies yielded inconsistent results, thus providing limited evidence for the beneficial effect of green tea consumption on the overall risk of cancer or on specific cancer sites. Some evidence of a beneficial effect of green tea at some cancer sites emerged from the RCTs and from case-control studies, but their methodological limitations, such as the low number and size of the studies, and the inconsistencies with the results of cohort studies, limit the interpretability of the RR estimates. The studies also indicated the occurrence of several side effects associated with high intakes of green tea. In addition, the majority of included studies were carried out in Asian populations characterised by a high intake of green tea, thus limiting the generalisability of the findings to other populations. Well conducted and adequately powered RCTs would be needed to draw conclusions on the possible beneficial effects of green tea consumption on cancer risk.

Propensity score analysis exploring the impact of smoking and drinking on the prognosis of patients with oral cancer

BACKGROUND

To explore the effect of smoking and drinking on survival of patients with oral cancer by comparing the characteristics and survival of nonsmoking and nondrinking (NSND) patients in contrast to smoking and/or drinking (SD) patients.

METHODS

This prospective study including 1165 patients with oral cancer was conducted in Fujian, China from January 2005 to January 2019. The patients were categorized to two groups, the NSND group and SD group. We compared overall survival and disease-specific survival between the two groups using the Kaplan-Meier method and Cox proportional hazards regression before and after propensity score matching (PSM) to explore the effect of smoking and drinking on the prognosis of patients with oral cancer.

RESULTS

NSND patients accounted for 55.45% (646 patients) of all the patients with oral cancer. SD patients with oral cancer tended to be older and mainly are male (98.46%) and with more advanced disease status. There are trends toward both higher risk of all-cause death (HR = 1.678; 95% CI: 1.086-2.594) and oral cancer specific death (HR = 1.632; 95% CI: 1.044-2.552) in SD patients with oral cancer before PSM. After PSM, the association is still significant, with adjusted HR of 1.897 (95% CI: 1.138-3.165) for all-cause death and adjusted HR of 1.764 (95% CI: 1.043-2.983) for oral cancer-specific death. Additionally, PSM can improve the HR value and result in a stronger association.

CONCLUSIONS

Social and clinical characteristics of NSND patients differed from SD patients with oral cancer. SD patients with oral cancer have higher all-cause mortality and oral cancer-specific mortality than NSND patients.

Oolong tea consumption and its interactions with a novel composite index on esophageal squamous cell carcinoma

Background

No previous study has investigated the association between oolong tea consumption and esophageal squamous cell carcinoma (ESCC), we aim to elucidate the association between oolong tea consumption and ESCC and its joint effects with a novel composite index.

Methods

In a hospital-based case-control study, 646 cases of ESCC patients and 646 sex and age matched controls were recruited. A composite index was calculated to evaluate the role of demographic characteristics and life exposure factors in ESCC. Unconditional logistic regression was used to calculate the point estimates between oolong tea consumption and risk of ESCC.

Results

No statistically significant association was found between oolong tea consumption and ESCC (OR = 1.39, 95% CI: 0.94–2.05). However, drinking hot oolong tea associated with increased risk of ESCC (OR = 1.60, 95% Cl: 1.06–2.41). Furthermore, drinking hot oolong tea increased ESCC risk in the high-risk group (composite index> 0.55) (OR = 3.14, 95% CI: 1.93–5.11), but not in the low-risk group (composite index≤0.55) (OR = 1.16, 95% CI: 0.74–1.83). Drinking warm oolong tea did not influence the risk of ESCC.

Conclusions

No association between oolong tea consumption and risk of ESCC were found, however, drinking hot oolong tea significantly increased the risk of ESCC, especially in high-risk populations.

Protective Effect of Green Tea Consumption on Colorectal Cancer Varies by Lifestyle Factors

The inconsistent findings regarding green tea intake and colorectal cancer (CRC) risk in several epidemiological studies might result from variations in lifestyle factors. Therefore, we examined whether increased green tea intake was associated with a decreased risk of CRC and how the risk of CRC was altered by the protective effect of green tea consumption and five health-related factors. A case-control study including 2742 participants (922 cases and 1820 controls) was conducted in Korea. Green tea consumption was assessed using a semiquantitative food frequency questionnaire. The risk of CRC was approximately 40% less in the participants in the highest green tea intake tertile than in participants in the lowest green tea intake tertile. Of the five lifestyle factors examined, high body mass index and physical inactivity were independent risk factors for CRC. Regarding the interactions between tea consumption and lifestyle factors, high green tea consumption was associated with a decreased risk of CRC, with or without considering lifestyle factors. However, moderate green tea consumption increased the risk of CRC among ever-smokers, ever-drinkers and the high-inflammatory diet group. Increased consumption of green tea might be helpful to reduce the risk of CRC in those with an unhealthy lifestyle.

Association between dietary inflammatory index and the risk of oral cancer in the southeast of China

BACKGROUND/OBJECTIVES

To evaluate the role of the potential inflammatory effects of diet using the Energy adjusted Dietary Inflammatory Index (E-DII) for oral cancer.

SUBJECTS/METHODS

A case-control study including 295 oral cancer cases and 425 controls from September 2010 to June 2018 was performed in Fujian Province, China. The E-DII was calculated based on the food frequency questionnaire (FFQ) and adjusted by total energy intake. The association between E-DII and the risk of oral cancer was estimated with unconditional logistic regression model.

RESULTS

Compared with E-DII score in the lowest quartile, those with E-DII score in the fourth quartile were at the higher risk of oral cancer (OR = 2.57; 95% CI: 1.54, 4.29, P_trend = 0.013). When analyses were carried out using E-DII as a continuous variable, one-unit increase in E-DII increased the odds of having oral cancer by 3% (95% CI: 1.00, 1.06). Moreover, there was a significant interaction between the E-DII and oral hygiene for oral cancer (P_interaction < 0.001, in those without and with poor hygiene, the OR (95% CI) were 1.96 (0.96, 4.00) and 4.23 (1.83, 9.81), respectively).

CONCLUSIONS

The present study suggests that the higher E-DII score, indicated a pro-inflammatory diet, may be a risk factor for oral cancer in southeast of China. More large samples and prospective studies need to validate our results and explore the prevention strategies of oral cancer via changing dietary habits.

Tea consumption is associated with decreased risk of oral cancer: A comprehensive and dose-response meta-analysis based on 14 case-control studies (MOOSE compliant)

The associations of tea consumption with risk of oral cancer remain not clear. The present meta-analysis aims to clarify the real relationship between tea intake and the risk of oral cancer and quantifies the potential dose-response relationship between them.A Web search was performed within Pubmed, Embase, and Web of Science databases to identify potential studies that evaluated the relationship between tea consumption and the risk of oral cancer on Mar 21th, 2018 without language restriction. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were extracted and combined to evaluate the strength of associations. Dose-response analysis was performed to quantitate the relationship between tea intake and risk of oral cancer.Total 14 articles were included in the final analysis. The pooled OR for evaluating the risk of oral cancer and tea intake was 0.700 (95% CI = 0.609-0.805, P <.001). The linearity model of dose-response analysis indicated that with increased 1 cup daily, the risk of oral cancer decreased by 6.2% degree (OR = 0.938, 95% CI = 0.922-0.955, P <.001). Subgroup analysis indicated an inverse association between tea intake and the risk of oral cancer except subgroup analysis of black tea and American people.These results suggest tea intake provides protection against oral cancer carcinogenesis. Additionally, more large-scale pooling and high-quality studies are necessary for detecting the precise relationship between tea intake and oral cancer risk in the future.

Serum copper and zinc levels and the risk of oral cancer: A new insight based on large-scale case-control study

OBJECTIVE

Limited evidence exists on the roles of serum copper (Cu) and zinc (Zn) in oral cancer risk. We aimed to preliminarily explore the association between serum Cu and Zn levels and oral cancer risk with relatively large-scale samples.

METHODS

Serum Cu and Zn levels of 344 oral cancer patients and 1,122 matched healthy controls in this case-control study were measured by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS

Restricted cubic spline revealed the U-shaped relationship between serum Cu or Zn levels and the risk of oral cancer. Serum deficient or elevated levels of Cu were significantly associated with the risk of oral cancer: The ORs were 1.38 (95% CI: 1.01-1.89) and 2.82 (95% CI: 1.60-4.98), respectively. The positive association of serum low or high levels of Zn with oral cancer risk was also observed: The ORs were 2.72 (95% CI: 1.60-4.62) and 12.41 (95% CI: 9.09-16.93), respectively. Additionally, there were multiplicative interactions between the aforementioned trace elements and smoking.

CONCLUSIONS

This preliminary study suggests that both serum excess and deficient levels of Cu or Zn were significant correlation with oral cancer risk, which may provide a new insight on the roles of serum Cu and Zn in oral cancer.

Nomograms and risk scores for predicting the risk of oral cancer in different sexes: a large-scale case-control study

Background: Although previous studies have explored the associations of modifiable lifestyle factors with oral cancer risk, few studies integrated these factors and established predictive tools for oral cancer risk in different sexes.

Methods: Using a case-control study design, a total of 978 oral cancer cases and 2646 healthy controls were recruited in this study. Nomograms were constructed according to significant factors in multivariable logistic regression. Risk scores were calculated based on the nomograms and quantified the risk of oral cancer using restricted cubic spline.

Results: Multivariate analyses demonstrated that smoking, alcohol drinking, tea, intake of fish, seafood, vegetables, fruits, teeth loss, regular dental visits and repetitive dental ulcer were independent factors for male oral cancer. Passive smoking, age at first intercourse, cooking oil fumes exposure, tea, intake of beans, vegetables, fruits, teeth loss, regular dental visits and repetitive dental ulcer were associated with female oral cancer. Then, two nomograms were developed for predicting the probability of oral cancer in men and women with the C-index of 0.768 (95% CI: 0.723-0.813) and 0.700 (95% CI: 0.635-0.765), respectively. Restricted cubic splines graphically revealed the risk of oral cancer in individuals with different risk scores. Moreover, the risk escalated continuously with the increasing number of the risk scores among both sexes.

Conclusions: Combining nomograms with risk scores developed in this study could precisely predict oral cancer occurrence and provide an accurate risk assessment.

A functional haplotype of NFKB1 influence susceptibility to oral cancer: a population-based and in vitro study

Genetic variations of NF‐κB and its inhibitor IκB genes and their biological mechanism in oral cancer were not well recognized. The purpose of this study was to evaluate the associations of polymorphisms in NFKB1 and NFKBIA with oral cancer susceptibility, and further explore their potential mechanism in vitro. First, the polymorphisms of NFKB1 and NFKBIA were genotyped through iPLEX Sequenom MassARRAY platform in a case–control study with 425 oral cancer patients and 485 healthy controls. Then, the function was explored by a luciferase reporter assay and an electrophoretic mobility shift assay (EMSA) in human tongue squamous cell carcinoma cell lines. The results indicated that NFKB1 rs28362491 Del/Del and rs72696119 G/G genotypes were associated with the risk of oral cancer, with a strong linkage disequilibrium (D′ = 0.991, r² = 0.971). Moreover, DG haplotype of NFKB1 also showed a significant increased risk (OR = 1.25, 95% CI: 1.02–1.53, P = 0.030). Dual‐luciferase reporter assays further revealed that the plasmids with DG or IG or DC haplotype transfected with Tca‐8113 cells or CAL‐27 cells had a lower luciferase expression than that with IC haplotype. EMSA demonstrated that 4‐bp ATTG deletion in the promoter of NFKB1 abolished the binding site of transcription factor. Our preliminary findings suggest that the haplotype of rs28362491 and rs72696119 in NFKB1 could act as a novel genetic marker to predict oral cancer risk in the southeast of China, but much more extensive researches still need to be conducted.

Dietary score and the risk of oral cancer: a case-control study in southeast China

This study aims to develop a simple dietary score to comprehensively evaluate the role of diet in the risk of oral cancer. A case-control study including 930 oral cancer cases and 2667 frequency-matched controls was performed in Fujian, China. Unconditional logistic regression model was used to estimate the effects of dietary factors on oral cancer. After adjustment for potential confounders, less intake of domestic meat (< 3 times per week), fish (< 3 times per week), seafood (< 3 times per week), leafy vegetables (< 1 time per day), other vegetables (< 1 time per day), fruits (< 3 times per week), milk and dairy products (< 1 time per week) and eggs (< 5 times per week) were significant risk factors for oral cancer. Then these variables were incorporated to establish dietary risk score. Assessed by the receiver operating characteristic curve, the score showed a satisfactory discriminatory capacity, with an area under the curve of 0.682 (95% CI: 0.662–0.702). Moreover, the score was positively associated with the risk of oral cancer as quartiles, and the association was apparently stronger in tobacco smokers or alcohol drinkers. Additionally, there were significant multiplicative interactions between the score and tobacco smoking or alcohol drinking for oral cancer. In the present study, a convenient dietary score with satisfactory discriminatory capacity was developed to assess the collected effect of dietary factors on oral cancer, which could provide a new strategy for the prevention of oral cancer through changing in dietary habits.

Differences in modifiable factors of oral squamous cell carcinoma in the upper and lower of oral fissure

The aim of this study was to explore differences in the effects of modifiable factors on oral squamous cell carcinoma (OSCC) occurring in the lower oral fissure (LOF) and upper oral fissure (UOF). We conducted a case-control study with 697 OSCC patients (119 UOF and 578 LOF) and 1910 frequency-matched controls in Fujian province, China. Data on demographic characteristics and possible modifiable factors was collected using a structured questionnaire. Unconditional logistic regression was utilized to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Alcohol drinking was more strongly associated with an increased risk of OSCC-LOF than OSCC-UOF. Tobacco smoking, the number of teeth lost ≥5, wearing denture, and recurrent oral ulceration showed similarly associations with OSCC-LOF and -UOF risk. Similarly, the beneficial effects of tea consumption, tooth-brushing ≥2times per day, high intake of fresh fish, seafood, green-leafy vegetables, other vegetables and fruits were not significantly different on OSCC-LOF and -UOF. Although most of the modifiable factors exert similar effects on both OSCC sites, this study suggests that the sites of oral cavity in LOF may be affected more by alcohol drinking than the sites in UOF. Further studies with larger samples are warranted to confirm our findings.