Maté, coffee, and tea consumption and risk of cancers of the upper aerodigestive tract in southern Brazil

Cumulative Coffee Consumption as a Protective Factor for Head and Neck Cancer in Brazil

There is still no consensus in the literature regarding the role of coffee in head and neck cancer. Thus, we sought to analyze the cumulative consumption of coffee as a protective factor in the genesis of head and neck cancer in Brazil, one of the main coffee producing countries, from January 2011 to February 2017. We carried out a case-control study in 5 referral centers for head and neck cancer with 839 cases and 842 non-cancer hospital controls matched by sex, data collection center and age group. The results of logistic regression analysis showed that the cumulative consumption of >2 cups of coffee per day is an important protective factor (OR: 0.73, 95% CI: 0.5-0.9) against head and neck cancer. Smoking increased the risk by 22 times (OR: 22.19; 95% CI: 13.7-35.8) in individuals who smoke more than 50 packs per year, and the habit of ingesting more than 155 ml of alcohol per day represented approximately twice as high risk (OR: 2.20; 95% CI: 1.4-3.4). In summary, this study suggests that coffee consumption is associated with a lower chance of head and neck cancer.

Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies

The association between coffee intake and the risk of oral cavity cancer has been inconsistent in previous studies. Therefore, we conducted a meta-analysis to summarize the evidence regarding the strength of association between coffee intake and oral cavity cancer. PubMed, Embase, and Cochrane Library were searched to select studies on the relationship between coffee intake and oral cavity cancer conducted up to September 2018. Case-control or cohort studies and those that have reported about the effect estimates with 95% confidence intervals (CIs) of oral cavity cancer according to the different categories of coffee intake were included. The odds ratio (OR) and its corresponding 95% CI were calculated using the random-effects model. Fourteen case-control and five cohort studies that recruited 6456 patients with oral cavity cancer were included in the final quantitative meta-analysis. High versus low coffee intake was associated with a reduced risk of oral cavity cancer (OR: 0.68; 95% CI: 0.56-0.82; P < 0.001) in case-control studies (OR: 0.70; 95% CI: 0.55-0.90; P = 0.006) and cohort studies (OR: 0.65; 95% CI: 0.48-0.87; P = 0.004). Moreover, intermediate coffee intake was significantly associated with a reduced risk of oral cavity cancer (OR: 0.85; 95% CI: 0.77-0.94; P = 0.002), and such associations were mainly observed in case-control studies (OR: 0.86; 95% CI: 0.76-0.98; P = 0.021) but not in cohort studies (OR: 0.83; 95% CI: 0.67-1.02; P = 0.071). High or intermediate coffee intake might have protective effects against oral cavity cancer. However, the underlying mechanisms must be further evaluated in large-scale prospective cohort studies.

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.

Maté consumption association with upper aerodigestive tract cancers: A systematic review and meta-analysis

Maté is a beverage regularly consumed by Latin American populations. Upper aerodigestive tract (UADT) cancers are frequent in this region and are suspected to be associated with maté consumption. The aim of this systematic review and meta-analysis was to answer a focused question: "Is there an association between maté consumption and occurrence of the UADT cancer?". Studies investigating any association between maté consumption and occurrence of UADT cancer were included. Out of the 569 studies, 18 met the inclusion criteria for qualitative and 15 for quantitative analysis. An increased odds was observed regarding maté consumption and overall occurrence of UADT cancer (OR = 2.24; 95%CI = 1.74-2.87). Consistent evidence of a positive association was found for all UADT subsites, oral, pharynx, esophagus and larynx. No differences in effect were found between consumption of cold/warm and hot/very hot mate (OR = 1.08; 95%CI = 0.83-1.41). Consumption of more than one liter of maté per day was associated with increased odds of having UADT cancer compared to an intake of less than one liter per day (OR = 1.72; 95%CI = 1.47-2.01). According to published data, regardless of the temperature, maté consumption significantly increased the odds of occurrence of UADT cancer.

Coffee is protective against oral and pharyngeal cancer: A systematic review and meta-analysis

OBJECTIVES

Coffee is one of the most popular and consumable drinks worldwide. However, there are conflicting results on the influence of this drink in oral and pharyngeal cancer risk. To clarify this, we aimed to systemically review and carry out a meta-analysis of the relevant literature on the association between coffee and oral and pharyngeal cancer.

STUDY DESIGN

We carried out an electronic search of publications up to August 2016 from PubMed, National Library of Medicines Medline, Embase, Science Direct and the Cochrane Central Register. The Newcastle-Ottawa scale was used to address the quality of the studies a meta-analysis was carried out using random-effects models.

RESULTS

From the 22,515 entries identified in the search, 13 case-control and 4 cohort studies were selected. With regards to quality on the Newcastle-Ottawa scale, an overall value of 6.06 was obtained. The analysis for oral and pharyngeal cancer grouped together indicated a pooled OR of .69 (95% CI of .57-.84; p<.001) for high versus low coffee consumption with a moderate heterogeneity (I2: 50.3%; p=.009). Regarding studies on oral cavity cancers we observed a pooled OR of 0.82; 95% CI =.58-1.16; p=.257) and for pharyngeal cancers a pooled OR of .72 (95% CI of 0.54-.95; p=.019). There was no significant publication bias.

CONCLUSION

The results show an inverse association between high coffee consumption and the risk of oral and pharyngeal cancers, which indicates that coffee may have a protective role against these cancers. Further larger prospective observational cohort studies are needed to address any effect of other possible co-factors.

Antiproliferative and cytotoxic effects of green coffee and yerba mate extracts, their main hydroxycinnamic acids, methylxanthine and metabolites in different human cell lines

This work aimed at studying the effects of green coffee bean (GCBE) and yerba mate (YME) extracts, their main phenolic components (5-caffeoylquinic acid, 5-CQA; 3,5-dicaffeoylquinic acid, 3,5-DCQA) and metabolites (ferulic acid, FA; caffeic acid, CA; dihydrocaffeic acid, DHCA; and dihydroferulic acid, DHFA) along with caffeine (CAF) on the viability and proliferation of different human cell lines. Extracts (10-1000 μg/mL) and standards (10-1000 μM) were assayed in colon (Caco-2), lung (A549), oesophageal (OE-33), urinary bladder (T24) human carcinoma cells, and a non-cancer cell line (CCD-18Co). YME significantly reduced viability of cancer cells at all assayed concentrations, the higher doses also reducing cell proliferation. GCBE effects on cell viability were more effective at 100 and 1000 μg/mL, showing modest effects on cell proliferation. The highest doses of 5-CQA and 3,5-DCQA reduced cell viability and proliferation in all cell lines, whereas FA, DHCA and DHFA had lower and variable effects. Caffeine had no effect. Dietary-attainable concentrations (0.1, 1 and 10 μg/mL) of YME were tested for cytotoxicity and reactive oxygen species generation, showing no cytotoxic effect. Low concentrations of all tested compounds were non-cytotoxic to CCD-18Co cells.

CONCLUSION

YME and to a lower degree GCBE, their phenolic components and metabolites may decrease cancer cell viability and proliferation.

Coffee consumption associated with reduced risk of oral cancer: a meta-analysis

OBJECTIVE

Currently, there is no consensus on the effect of coffee consumption on the risk of oral cancer. We performed a meta-analysis based on published studies to uncover the association.

STUDY DESIGN

We searched PubMed (1946-2015), Embase (1976-2015), and the bibliographies of all retrieved articles for relevant citations. We performed random-effects meta-analyses of observational studies on coffee consumption and oral cancer.

RESULTS

A total of 11 case-control studies and 4 cohort studies comprising 2,832,706 controls and 5021 cases of oral cancer were included in our analysis. The results indicated that the summary odds ratio for the highest versus the lowest or no category consumption of coffee was 0.63 (95% confidence interval [CI]: 0.52-0.75). The odds ratios were 0.60 (95% CI: 0.49-0.74) for case-control studies and 0.66 (95% CI: 0.45-0.98) for cohort studies.

CONCLUSION

Overall, our results suggested that coffee consumption appears to have a protective benefit in oral cancer.

Tea and coffee consumption and risk of laryngeal cancer: a systematic review meta-analysis

Background

Tea and coffee are the most commonly consumed beverages in the worldwide. The relationship between tea and coffee consumption on the risk of laryngeal cancer was still unclear.

Methods

Relevant studies were identified by searching electronic database (Medline and EMBASE) and reviewing the reference lists of relevant articles until Oct. 2013. Observational studies that reported RRs and 95% CIs for the link of tea and coffee consumption on the risk of laryngeal cancer were eligible. A meta-analysis was obtained to combine study-specific RRs with a random-effects model.

Results

A total of 2,803 cases and 503,234 controls in 10 independent studies were identified. The overall analysis of all 10 studies, including the case-control and cohort studies, found that tea drinking was not associated with laryngeal carcinoma (RR = 1.03; 95% CI: 0.66–1.61). However, coffee consumption was significantly associated with the laryngeal carcinoma (RR = 1.47; 95% CI: 1.03–2.11). A dose-response relationship between coffee intake and laryngeal carcinoma was detected; however, no evidence of dose-response link between tea consumption and laryngeal carcinoma risk was detected.

Conclusions

The results from this meta-analysis of observational studies demonstrate that coffee consumption would increase the laryngeal cancer risk, while tea intake was not associated with risk of laryngeal carcinoma.

Tea intake and risk of oral, pharyngeal, and laryngeal carcinoma: a meta-analysis

Background

The association between tea intake and risk of oral, pharyngeal, and laryngeal carcinoma is still unclear. The aim of this meta-analysis was to quantify the effect of tea consumption on the incidence of oral, pharyngeal, and laryngeal cancer to provide a better understanding on this issue.

Material/Methods

A literature search was conducted before January 2014 in MEDLINE and EMBASE databases. The relative risk (RR) estimates that extracted or calculated from all included studies were combined together. Given the existing heterogeneity in the study design and data source, a random-effects model was obtained.

Results

A total of 20 articles were included in the quantitative synthesis. Fourteen RR estimates (11 from case-control studies and 3 from cohort studies) were pooled together and the result demonstrated that tea consumption reduced the incidence of oral cancer (RR=0.85; 95% CI 0.76–0.96). The summary RR of 4 observational studies (3 case-control studies and 1 cohort study) for pharyngeal cancer was 0.87 (95% CI 0.74–1.04). The association between tea consumption and oral and pharyngeal carcinoma was reported. The summary RR for laryngeal carcinoma was 1.05 (95% CI 0.70–1.57). The Begg’s funnel plot and the Egger’s test showed no evidence of publication bias.

Conclusions

Tea consumption was associated with decreased risk of oral cancer, while no association was detected with oral/pharyngeal, pharyngeal, or laryngeal cancer.

Tea consumption and risk of head and neck cancer

Background

The current study evaluated the association between tea consumption and head and neck cancer (HNC) in Taiwan, where tea is a major agricultural product and a popular beverage.

Methods

Interviews regarding tea consumption (frequency, duration, and types) were conducted with 396 HNC cases and 413 controls. Unconditional logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of HNC risk associated with tea drinking, adjusted for sex, age, education, cigarette smoking, betel quid chewing, and alcohol drinking.

Results

A reduced HNC risk associated with tea drinking (OR for every cup per day = 0.96, 95% CI: 0.93–0.99; OR for ≧5 cups per day = 0.60, 95% CI: 0.39–0.94) was observed. The association was especially significant for pharyngeal cancer (OR for every cup per day = 0.93, 95% CI: 0.88–0.98; OR for ≧5 cups per day = 0.32, 95% CI: 0.16–0.66). A significant inverse association between HNC and tea consumption was observed particularly for green tea.

Conclusions

This study suggests that tea drinking may reduce the risk of HNC. The anticancer property of tea, if proven, may offer a natural chemopreventive measure to reduce the occurrence of HNC.

Association of tea consumption and the risk of oral cancer: a meta-analysis

OBJECTIVES

Epidemiological studies evaluating the association of tea consumption and the risk of oral cancer risk have produced inconsistent results. Thus, we conducted a meta-analysis to assess the relationship between tea consumption and oral cancer risk.

METHODS

Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. The fixed or random effect model was used based on heterogeneity test. Publication bias was estimated using Egger's regression asymmetry test.

RESULTS

Finally, 14 articles with 19 studies comprising 4675 oral cancer cases were included in this meta-analysis. The relative risk (95% confidence interval) of oral cancer for the highest versus the lowest category of tea consumption was 0.853 (0.779-0.934), and the association was significant between oral cancer risk and green tea consumption [0.798 (0.673-0.947)] but not in the black tea consumption [0.953 (0.792-1.146)]. The associations were also significant in Asian and Caucasian.

CONCLUSIONS

Our analysis indicated that tea consumption may have a protective effect on oral cancer, especially in green tea consumption.

Coffee and green tea consumption is associated with upper aerodigestive tract cancer in Japan

The impact of coffee and green tea consumption on upper aerodigestive tract (UADT) cancer risk has not been established. Evaluation of the possible anticarcinogenic properties of their ingredients is confounded by the potential increase in risk owing to the high temperatures at which these beverages are generally consumed. We conducted a case-control study to evaluate the association between coffee and tea consumption and the risk of UADT cancer. The study enrolled 961 patients with UADT cancer and 2,883 noncancer outpatients who visited Aichi Cancer Center between 2001 and 2005. Information on coffee and green tea consumption and other lifestyle factors was collected via a self-administered questionnaire. Consumption of three or more cups of coffee per day had a significant inverse association with UADT cancer [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.55-0.96]. In contrast, consumption of three or more cups of green tea per day had a significant positive association with UADT cancer (OR 1.39, 95% CI 1.13-1.70). These associations were evident for head and neck cancer but not for esophageal cancer. The association of coffee consumption with head and neck cancer was observed only among never smokers and alcohol drinkers. Similarly, the association of green tea consumption was observed among never smokers and never alcohol drinkers. No change in these associations was seen on stratification by each confounding factors. These findings suggest that consumption of coffee might be associated with a decreased risk of UADT cancer, whereas that of green tea might be associated with an increased risk.

Tea consumption and the risk of oral cancer incidence: a case-control study from China

OBJECTIVES

To evaluate the relation of tea consumption with the risk of oral cancer incidence.

SUBJECTS AND METHODS

A multicenter case-control study based on hospitalized population was conducted for evaluating the association of tea consumption with oral cancer risk in China. Black tea and green tea were separately analyzed. 723 cases and 857 controls were included. Unconditional multiple logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of oral cancer for tea consumption.

RESULTS

The ORs for green tea consumption⩾8g/day compared with<4g/day were 0.72 (95% CI 0.54, 0.93) for men, and 0.93 (95% CI 0.74, 1.26) for women. The ORs for black tea consumption⩾6g/day compared with<2g/day were 0.97 (95% CI 0.74, 1.20) for men, and 0.91 (95% CI 0.68, 1.23) for women. Green tea intake was significantly associated with reduced risk of oral cancer in men, but not in women, and the association was stronger in heavily smoking men. There was no indication that black tea consumption was associated with decreased oral cancer risk.

CONCLUSION

The results of this study indicated that green tea consumption may decrease the risk of oral cancer in men especially for those smoking heavily.

Tea and coffee consumption and risk of oral cavity cancer: results of a large population-based case-control study, the ICARE study

BACKGROUND

Results on the relationship between coffee and tea drinking and the risk of oral cavity cancer are contrasted. The aim of this study was to evaluate the relation between coffee and tea drinking and the risk of oral cavity cancer in France, a high incidence area.

MATERIAL AND METHODS

We conducted a population based case-control study with face-to-face interviews and standardized questionnaires (the ICARE study, Investigation of occupational and environmental causes of respiratory cancers). We used data from 689 cases of oral cavity squamous cell carcinoma and 3481 controls. Odds-ratios (ORs) and 95% confidence intervals (95% CI) associated with tea and coffee consumption (quantity, duration, cumulative consumption) were estimated by unconditional logistic regression with adjustment for age, gender, area of residence, education, body mass index, tobacco smoking and alcohol drinking.

RESULTS

We observed inverse associations between oral cavity cancer and tea or coffee consumption (odds ratio, 0.39; 95% CI 0.21-0.70, for the highest quartile of tea consumption, and 0.60, 95% CI 0.34-1.05, for the highest quartile of coffee consumption). Exclusive tea or coffee consumption was associated with a reduced risk of oral cavity cancer and their joint effect was multiplicative. No differences in risk between men and women or between consumers of tobacco and alcohol and non-consumers were observed. The odds ratios related to the subsites usually included in the oropharynx (soft palate and base of the tongue) did not differ significantly from that observed for the other subsites of the oral cavity.

CONCLUSIONS

Tea and coffee drinking may decrease the risk of oral cavity cancer through antioxidant components which play a role in the repair of cellular damages. These findings need further investigation in prospective studies and the underlying mechanisms in humans remain to be clarified.

Polycyclic aromatic hydrocarbons and esophageal squamous cell carcinoma

Esophageal cancer (EC) is the 8th most common cancer and the 6th most frequent cause of cancer mortality worldwide. Esophageal squamous cell carcinoma (ESCC) is the most common type of EC. Exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested as a risk factor for developing ESCC. In this paper we will review different aspects of the relationship between PAH exposure and ESCC. PAHs are a group of compounds that are formed by incomplete combustion of organic matter. Studies in humans have shown an association between PAH exposure and development of ESCC in many populations. The results of a recent case-control study in a high risk population in northeastern Iran showed a dramatic dose-response relationship between PAH content in non-tumor esophageal tissue (the target tissue for esophageal carcinogenesis) and ESCC case status, consistent with a causal role for PAH exposure in the pathogenesis of ESCC.  Identifying the main sources of exposure to PAHs may be the first and most important step in designing appropriate PAH-reduction interventions for controlling ESCC, especially in high risk areas. Coal smoke and drinking mate have been suggested as important modifiable sources of PAH exposure in China and Brazil, respectively. But the primary source of exposure to PAHs in other high risk areas for ESCC, such as northeastern Iran, has not yet been identified. Thus, environmental studies to determining important sources of PAH exposure should be considered as a high priority in future research projects in these areas.

Coffee, tea, and fatal oral/pharyngeal cancer in a large prospective US cohort

Epidemiologic studies suggest that coffee intake is associated with reduced risk of oral/pharyngeal cancer. The authors examined associations of caffeinated coffee, decaffeinated coffee, and tea intake with fatal oral/pharyngeal cancer in the Cancer Prevention Study II, a prospective US cohort study begun in 1982 by the American Cancer Society. Among 968,432 men and women who were cancer free at enrollment, 868 deaths due to oral/pharyngeal cancer occurred during 26 years of follow-up. Cox proportional hazards regression was used to estimate multivariable-adjusted relative risk. Intake of >4 cups/day of caffeinated coffee was associated with a 49% lower risk of oral/pharyngeal cancer death relative to no/occasional coffee intake (relative risk = 0.51, 95% confidence interval: 0.40, 0.64) (1 cup/day = 237 ml). A dose-related decline in relative risk was observed with each single cup/day consumed (P(trend) < 0.001). The association was not modified by sex, smoking status, or alcohol use. An inverse association for >2 cups/day of decaffeinated coffee intake was suggested (relative risk = 0.61, 95% confidence interval: 0.37, 1.01). No association was found for tea drinking. In this large prospective study, caffeinated coffee intake was inversely associated with oral/pharyngeal cancer mortality. Research is needed to elucidate biologic mechanisms whereby coffee might help to protect against these often fatal cancers.

A review of risk factors for oral cavity cancer: the importance of a standardized case definition

The aim of this work is to review the literature on risk factors of oral cavity cancer with a special attention to the definition of the cases, in order to highlight special features of these cancers and of their subsites. PubMed database was systematically searched to access relevant articles published between 1980 and 2010. Reference lists of selected papers were examined to identify further articles. One hundred and two studies met the inclusion criteria. Their results were difficult to compare because of the lack of uniformity in defining oral cavity. In addition, few studies examined risk factors other than alcohol and tobacco, and studies differentiating between subsites were rare. Despite these limitations, some characteristics of oral cavity cancers may be emphasized: smoked tobacco seems to be a stronger risk factor for oral cavity cancer than alcohol, and the floor of the mouth seems to be more sensitive to the harmful effects of alcohol and smoked tobacco. Studies limited strictly to oral cavity cancers and distinguishing between subsites are needed to better understand the aetiology of these cancers, and better define risk groups to target prevention efforts and screening.

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.

Safety assessment of yerba mate (Ilex paraguariensis) dried extract: results of acute and 90 days subchronic toxicity studies in rats and rabbits

Acute toxicity of yerba mate dried extract (YMDE) was investigated in Wistar rats (6/sex/group) from single dose of 2g/kg body weight by intragastric administration and 14days monitoring. Subchronic toxicity was investigated in Wistar rats, by intragastric administration (10/sex/group), and in New Zealand rabbits by oral administration (3/sex/group) of 2g/kg body weight for 12weeks. Toxicological parameters included clinical signs, body weight, water, and food consumption, hematological and serum parameters, and histopathological assessment. Acute YMDE administration showed no effects on survival, clinical observations, macroscopic examination of organs, body weight or food, and water consumption. Sub-chronic administration of YMDE did not change behavior, body weight, and histopatological assessment of stomach, kidney, liver, and small gut. Moreover, most of biochemical and hematological parameters remained unchanged. In summary, the results of our preclinical toxicological investigation are indicative that the YMDE is well tolerated for both single and chronic administration.

Recent advances on Ilex paraguariensis research: minireview

Ilex paraguariensis dried and minced leaves are made into a brewed tea, prepared in a sui generis manner by large populations in South America, having evolved from a tea drunk by the Guarani ethnic group to a beverage that has a social and almost ritualistic role in some South American modern societies. It is used both as a source of caffeine, in lieu or in parallel with tea and coffee, but also as a therapeutic agent for its alleged pharmacological properties. Although with some exceptions, research on biomedical properties of this herb has had a late start and strongly lags behind the impressive amount of literature on green tea and coffee. However, in the past 15 years, there was a several-fold increase in the literature studying Ilex paraguariensis properties showing effects such as antioxidant properties in chemical models and ex vivo lipoprotein studies, vaso-dilating and lipid reduction properties, antimutagenic effects, controversial association with oropharyngeal cancer, anti-glycation effects and weight reduction properties. Lately, promising results from human intervention studies have surfaced and the literature offers several developments on this area. The aim of this review is to provide a concise summary of the research published in the past three years, with an emphasis on translational studies, inflammation and lipid metabolism. Ilex paraguariensis reduces LDL-cholesterol levels in humans with Ilex paraguariensis dyslipoproteinemia and the effect is synergic with that of statins. Plasma antioxidant capacity as well as expression of antioxidant enzymes is positively modulated by intervention with Ilex paraguariensis in human cohorts. A review on the evidence implicating Ilex paraguariensis heavy consumption with some neoplasias show data that are inconclusive but indicate that contamination with alkylating agents during the drying process of the leaves should be avoided. On the other hand, several new studies confirm the antimutagenic effects of Ilex paraguariensis in different models, from DNA double breaks in cell culture models to mice studies. Novel interesting work has emerged showing significant effect on weight reduction both in mice and in rat models. Some mechanisms involved are inhibition of pancreatic lipase, activation of AMPK and uncoupling of electron transport. Intervention studies in animals have provided strong evidence of anti-inflammatory effects of Ilex paraguariensis, notably protecting cigarette-induced lung inflammation acting on macrophage migration and inactivating matrix-metalloproteinase. Research on the effects of Ilex paraguariensis in health and disease has confirmed its antioxidant, anti-inflammatory, antimutagenic and lipid-lowering activities. Although we are still waiting for the double-blind, randomized prospective clinical trial, the evidence seems to provide support for beneficial effects of mate drinking on chronic diseases with inflammatory component and lipid metabolism disorders.

Coffee intake and oral-oesophageal cancer: follow-up of 389,624 Norwegian men and women 40-45 years

Background:

The evidence on the relationship between coffee intake and cancer of the oral cavity and oesophagus is conflicting and few follow-up studies have been done.

Methods:

A total of 389 624 men and women 40–45 years who participated in a national survey programme were followed with respect to cancer for an average of 14.4 years by linkage to the Cancer Registry of Norway. Coffee consumption at baseline was reported as a categorical variable (0 or <1 cup, 1–4, 5–8, 9+ cups per day).

Results

Altogether 450 squamous oral or oesophageal cancers were registered during follow-up. The adjusted hazard ratios with 1–4 cups per day as reference were 1.01 (95% confidence interval: 0.70, 1.47), 1.16 (0.93, 1.45) and 0.96 (0.71, 1.14) for 0 or <1 cup, 5–8 and 9+ cups per day, respectively. Stratification by sex, type of coffee, smoking status and dividing the end point into oral and oesophageal cancers gave heterogeneous and non-significant estimates.

Conclusion:

This study does not support an inverse relationship between coffee intake and incidence of cancer in the mouth or oesophagus, but cannot exclude a weak inverse relationship.

Coffee and cancers of the upper digestive and respiratory tracts: meta-analyses of observational studies

BACKGROUND

Data of epidemiological studies on the relation between coffee drinking and upper aerodigestive tract cancer risk are scattered and inconclusive. We therefore conducted systematic meta-analyses of observational studies published before October 2009.

MATERIALS AND METHODS

We combined relative risks (RR) with 95% confidence intervals (CI) for cancers of the oral cavity/pharynx (OP) and larynx, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), comparing the highest versus the lowest categories of coffee consumption, using random-effects models.

RESULTS

For OP cancer, the pooled RR was 0.64 (95% CI 0.51-0.80) for highest versus lowest coffee drinking, based on a total of 2633 cases from one cohort and eight case-control studies, with no significant heterogeneity across studies. The RRs were 0.61 (95% CI 0.41-0.89) for European, 0.58 (95% CI 0.36-0.94) for American and 0.74 (95% CI 0.48-1.15) for Asian studies, where coffee consumption is lower. The corresponding RRs were 1.56 (95% CI 0.60-4.02) for laryngeal cancer (732 cases from three case-control studies), 0.87 (95% CI 0.65-1.17) for ESCC (2115 cases from one cohort and six case-control studies) and 1.18 (95% CI 0.81-1.71) for EAC (415 cases from three case-control studies).

CONCLUSION

Coffee drinking is inversely related to OP cancer risk, while there is no relation with laryngeal cancer, ESCC and EAC.

Drinking of maté and the risk of cancers of the upper aerodigestive tract in Latin America: a case-control study

Cancers of the upper aerodigestive tract (UADT: oral cavity, oropharynx, hypopharynx, larynx, esophagus) have high incidence rates all over the world and they are especially frequent in some parts of Latin America. In this study, we have evaluated the role of the consumption of maté, a hot herb-based beverage, based on 1168 UADT squamous-cell carcinoma cases and 1,026 frequency-matched controls enrolled from four centers in Brazil and Argentina. The effect of maté drinking on the risk of head-and-neck cancers was borderline significant. A significant effect was observed only for cancer of the esophagus (OR 3.81 (95% CI 1.75-8.30)). While duration of maté drinking was associated with the risk of all UADT cancers, the association with cumulative maté consumption was restricted to esophageal cancer (p-value of linear trend 0.006). The analyses of temperature at which maté was drunk were not conclusive. The increased risk associated with maté drinking was more evident in never-smokers and never-alcohol drinkers than in other individuals. Our study strengthens the evidence of an association between maté drinking and esophageal cancer; the hypothesis of an association with other UADT cancers remains to be clarified.

Coffee and tea intake and risk of head and neck cancer: pooled analysis in the international head and neck cancer epidemiology consortium

BACKGROUND

Only a few studies have explored the relation between coffee and tea intake and head and neck cancers, with inconsistent results.

METHODS

We pooled individual-level data from nine case-control studies of head and neck cancers, including 5,139 cases and 9,028 controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI), adjusting for potential confounders.

RESULTS

Caffeinated coffee intake was inversely related with the risk of cancer of the oral cavity and pharynx: the ORs were 0.96 (95% CI, 0.94-0.98) for an increment of 1 cup per day and 0.61 (95% CI, 0.47-0.80) in drinkers of >4 cups per day versus nondrinkers. This latter estimate was consistent for different anatomic sites (OR, 0.46; 95% CI, 0.30-0.71 for oral cavity; OR, 0.58; 95% CI, 0.41-0.82 for oropharynx/hypopharynx; and OR, 0.61; 95% CI, 0.37-1.01 for oral cavity/pharynx not otherwise specified) and across strata of selected covariates. No association of caffeinated coffee drinking was found with laryngeal cancer (OR, 0.96; 95% CI, 0.64-1.45 in drinkers of >4 cups per day versus nondrinkers). Data on decaffeinated coffee were too sparse for detailed analysis, but indicated no increased risk. Tea intake was not associated with head and neck cancer risk (OR, 0.99; 95% CI, 0.89-1.11 for drinkers versus nondrinkers).

CONCLUSIONS

This pooled analysis of case-control studies supports the hypothesis of an inverse association between caffeinated coffee drinking and risk of cancer of the oral cavity and pharynx.

IMPACT

Given widespread use of coffee and the relatively high incidence and low survival of head and neck cancers, the observed inverse association may have appreciable public health relevance.

Tea, coffee, carbonated soft drinks and upper gastrointestinal tract cancer risk in a large United States prospective cohort study

The authors investigated the relationship between hot tea, iced tea, coffee and carbonated soft drinks consumption and upper gastrointestinal tract cancers risk in the NIH-AARP Study. During 2,584,953 person-years of follow-up on 481,563 subjects, 392 oral cavity, 178 pharynx, 307 larynx, 231 gastric cardia, 224 gastric non-cardia cancer, 123 Oesophageal Squamous Cell Carcinoma (ESCC) and 305 Oesophageal Adenocarcinoma (EADC) cases were accrued. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated by multivariate-adjusted Cox regression. Compared to non-drinking, the hazard ratio for hot tea intake of > or =1 cup/day was 0.37 (95% CI: 0.20, 0.70) for pharyngeal cancer. The authors also observed a significant association between coffee drinking and risk of gastric cardia cancer (compared to <1 cup/day, the hazard ratio for drinking >3 cups/day was 1.57 (95% CI: 1.03, 2.39)), and an inverse association between coffee drinking and EADC for the cases occurring in the last 3 years of follow-up (compared to <1 cup/day, the hazard ratio for drinking >3 cups/day was 0.54 (95% CI: 0.31, 0.92)), but no association in earlier follow-up. In summary, hot tea intake was inversely associated with pharyngeal cancer, and coffee was directly associated with gastric cardia cancer, but was inversely associated with EADC during some follow-up periods.

Environmental causes of esophageal cancer

This article reviews the environmental risk factors and predisposing conditions for the two main histologic types of esophageal cancer. Tobacco smoking, excessive alcohol consumption, drinking maté, low intake of fresh fruits and vegetables, achalasia, and low socioeconomic status increase the risk of esophageal squamous cell carcinoma. Results of investigations on other potential risk factors, including opium consumption, intake of hot drinks, eating pickled vegetables, poor oral health, and exposure to human papillomavirus, polycyclic aromatic hydrocarbons, N-nitroso compounds, acetaldehyde, and fumonisins are discussed. Gastroesophageal reflux, obesity, tobacco smoking, hiatal hernia, achalasia, and, probably, absence of H pylori in the stomach increase the risk of esophageal adenocarcinoma. Results of studies investigating other factors are also discussed.

Coffee consumption and the risk of oral, pharyngeal, and esophageal cancers in Japan: the Miyagi Cohort Study

An inverse association between coffee consumption and the risk of oral, pharyngeal, and esophageal cancers has been suggested in case-control studies, but few results from prospective studies are available. Data from the Miyagi Cohort Study in Japan were used to clarify the association between coffee consumption and the risk of these cancers. Information about coffee consumption was obtained from self-administered food frequency questionnaires in 1990. Among 38,679 subjects aged 40-64 years with no previous history of cancer, 157 cases of oral, pharyngeal, and esophageal cancers were identified during 13.6 years of follow-up. Hazard ratios were estimated by the Cox proportional hazards regression model. The risk of oral, pharyngeal, and esophageal cancers was inversely associated with coffee consumption. The multivariate-adjusted hazard ratio of these cancers for > or =1 cups of coffee per day compared with no consumption was 0.51 (95% confidence interval: 0.33, 0.77). This inverse association was consistent regardless of sex and cancer site and was observed both for subjects who did not drink or smoke and for those who currently drank or smoked at baseline. In conclusion, coffee consumption was associated with a lower risk of oral, pharyngeal, and esophageal cancers, even in the group at high risk of these cancers.

High levels of carcinogenic polycyclic aromatic hydrocarbons in mate drinks

BACKGROUND

Drinking mate has been associated with cancers of the esophagus, oropharynx, larynx, lung, kidney, and bladder. We conducted this study to determine whether drinking mate could lead to substantial exposure to polycyclic aromatic hydrocarbons (PAH), including known carcinogens, such as benzo[a]pyrene.

METHODS

The concentrations of 21 individual PAHs were measured in dry leaves of eight commercial brands of yerba mate and in infusions made with hot (80 degrees C) or cold (5 degrees C) water. Measurements were done using gas chromatography/mass spectrometry, with deuterated PAHs as the surrogates. Infusions were made by adding water to the leaves, removing the resulting infusion after 5 min, and then adding more water to the remaining leaves. This process was repeated 12 times for each infusion temperature.

RESULTS

The total concentrations of the 21 PAHs in different brands of yerba mate ranged from 536 to 2,906 ng/g dry leaves. Benzo[a]pyrene concentrations ranged from 8.03 to 53.3 ng/g dry leaves. For the mate infusions prepared using hot water and brand 1, 37% (1,092 of 2,906 ng) of the total measured PAHs and 50% (25.1 of 50 ng) of the benzo[a]pyrene content were released into the 12 infusions. Similar results were obtained for other hot and cold infusions.

CONCLUSION

Very high concentrations of carcinogenic PAHs were found in yerba mate leaves and in hot and cold mate infusions. Our results support the hypothesis that the carcinogenicity of mate may be related to its PAH content.

Dietary habits, ethanol and tobacco consumption as predictive factors in the development of esophageal carcinoma in patients with head and neck neoplasms

Patients with primary head and neck cancers have a higher risk of developing esophageal cancer. The aim of this study was to investigate esophageal cancer prevalence, its risk factors (ethanol and tobacco consumption) and dietary habits in patients with head and neck cancer. Three hundred and twenty-six adults with primary head and neck cancer were followed by a retrospective observational study in a general university hospital in Sao Paulo, Brazil. Flexible videoendoscopy with lugol chromoscopy was the method used to investigate esophageal cancer prevalence. All subjects were interviewed face-to-face, revealing detailed information about their tobacco and alcohol use, as well as their dietary habits. Thirty-six patients with esophageal cancer were diagnosed and the overall prevalence rate was 11.04%. Patients who developed second esophageal tumors had the following characteristics: earlier age of initial ethanol consumption (P < 0.05), longer duration period of ethanol consumption (P < 0.05) and higher weekly consumption rate (P < 0.05). There was an increased risk of esophageal carcinoma in those patients who both smoked and drank (P < 0.05). There was no association between carcinoma of the esophagus and dietary habits in patients who developed esophageal neoplasms, compared with those who did not. Prevalence rate of esophageal neoplasms was 11.04% in patients with head and neck carcinoma, whose ethanol consumption was associated with esophageal cancer. There was an increased risk between ethanol and tobacco consumption and esophageal carcinoma development. On the other hand, there was no association regarding dietary habits between patients who developed esophageal cancer and those who did not.

Yerba Mate Tea (Ilex paraguariensis): a comprehensive review on chemistry, health implications, and technological considerations

Yerba Mate tea, an infusion made from the leaves of the tree Ilex paraguariensis, is a widely consumed nonalcoholic beverage in South America which is gaining rapid introduction into the world market, either as tea itself or as ingredient in formulated foods or dietary supplements. The indigenous people have used it for centuries as a social and medicinal beverage. Yerba Mate has been shown to be hypocholesterolemic, hepatoprotective, central nervous system stimulant, diuretic, and to benefit the cardiovascular system. It has also been suggested for obesity management. Yerba Mate protects DNA from oxidation and in vitro low-density lipoprotein lipoperoxidation and has a high antioxidant capacity. It has also been reported that Yerba Mate tea is associated to both the prevention and the cause of some types of cancers. Yerba Mate has gained public attention outside of South America, namely the United States and Europe, and research on this tea has been expanding. This review presents the usage, chemistry, biological activities, health effects, and some technological considerations for processing of Yerba Mate tea. Furthermore, it assesses in a concise and comprehensive way the potential of Ilex paraguariensis as a source of biological compounds for the nutraceutical industry.

A prospective study of green tea consumption and oral cancer incidence in Japan

PURPOSE

To examine the relation of green tea consumption with oral carcinogenesis, we prospectively analyzed data from a nationwide large-scale cohort study in Japan.

METHODS

A total of 20,550 men and 29,671 women aged 40-79 years, without any history of oral and pharyngeal cancer at baseline survey, were included in the present study. During a mean follow-up period of 10.3 years, 37 oral cancer cases were identified. The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for oral cancer according to green tea consumption by sex, while adjusting for age, smoking, alcohol drinking, and other dietary factors.

RESULTS

For women, the HRs of oral cancer for green tea consumption of 1-2, 3-4, and 5 or more cups per day were 0.51 (95% CI: 0.10-2.68), 0.60 (95% CI: 0.17-2.10), and 0.31 (95% CI: 0.09-1.07), respectively, compared with those who drank less than one cup per day (p for trend, 0.08). For men, no such trends were observed.

CONCLUSIONS

Our findings did not suggest a prominent inverse association of green tea consumption with oral cancer, although there was a tendency for a reduced risk in women.

Câncer do esôfago em paciente com megaesôfago chagásico

RACIONAL: O megaesôfago constitui problema de saúde pública em nosso país, pois acomete indivíduos em sua fase de maior produtividade. Os doentes com essa afecção podem apresentar em sua evolução associação com câncer do esôfago. OBJETIVO: Analisar os aspectos clínicos e epidemiológicos de pacientes com megaesôfago e câncer do esôfago. MÉTODOS: Foram avaliados de maneira retrospectiva 20 pacientes com megaesôfago e câncer (grupo 1) e 20 com câncer do esôfago (grupo 2). Estudaram-se os dados demográficos, hábitos (etilismo e tabagismo), tipo histológico do tumor, localização da lesão, diferenciação celular, estádio, tratamento e sobrevida. RESULTADOS: Não foi observada diferença entre os grupos, com relação à idade, sexo, localização da lesão, tipo histológico do tumor, diferenciação celular, estádio e sobrevida. Com relação aos hábitos de vida, a associação de etilismo e tabagismo foi observada em maior número de pacientes com câncer do esôfago sem o antecedente de megaesôfago. CONCLUSÃO: As características clínicas dos pacientes com megaesôfago e câncer não diferem daqueles com neoplasia maligna esofágica não associada ao megaesôfago, principalmente no que se refere ao prognóstico desfavorável frente ao tratamento instituído. Nos pacientes com megaesôfago o tumor pode se localizar em qualquer porção do órgão.

Bladder cancer and mate consumption in Argentina: a case-control study

Mate is a 'tea', made from Ilex paraguariensis, widely consumed in South America, as mate con bombilla and mate cocido. Mate consumption has been associated with esophageal, oral, lung, and bladder cancers. This bladder cancer case-control study involved 114 Argentinean case-control pairs. Mate consumption was recorded for time of interview, and 20 and 40 years previously. Mate con bombilla consumed 20 years ago was associated with bladder cancer in ever-smokers (odds ratio=3.77, 95% confidence interval: 1.17-12.1), but not in never-smokers. Mate cocido was not associated with bladder cancer. These results are consistent with a previous study in Uruguay.

IDENTIFICAÇÃO DE FUNGOS FILAMENTOSOS EM ERVA-MATE (ILEX PARAGUARIENSIS ST. HIL.)

RESUMO A erva-mate (Ilex paraguariensis St. Hil.), espécie nativa da América do Sul, é amplamente utilizada na fabricação da bebida mais tradicional e consumida no Rio Grande do Sul, que é o chimarrão. A presença de fungos neste material orgânico pode ser dependente de sua composição e acondicionamento. Para a realização deste trabalho foram adquiridas amostras de erva-mate comercializadas em diferentes estabelecimentos do Município de Pelotas, RS. As amostras foram transportadas até o Laboratório de Micologia onde foram processadas as análises de contagem e identificação de fungos filamentosos, de acordo com a metodologia padrão para alimentos. Foram analisadas 34 amostras sendo os gêneros Aspergillus sp. e Penicillium sp. os principais contaminantes fúngicos encontrados. As amostras pura folha apresentaram contaminação superior às moídas, assim como as embaladas em pacotes metalizados frente às embaladas em pacotes de papel.

Habitual risk factors for head and neck cancer

Chronic tobacco smoking and alcohol consumption are well-established risk factors for the development of squamous cell carcinoma (SCC) of the head and neck. There are, however, a variety of other habitual and culturally based activities that are less commonly seen in the Western world and that are also risks factors for the development of this type of cancer. In this era of globalization, many of these habits have now crossed borders and appear in various areas throughout the world. This article reviews habitual and social risk factors for cancer of the head and neck, excluding smoking and alcohol consumption. These factors include chewing tobacco and snuff, areca nut in its various forms, Khat leaves, and the drinking of Mate.

EBM RATING

D.

Molecular and cellular effects of green tea on oral cells of smokers: A pilot study

Studies in cell culture and laboratory animals have shown that green tea and its major component, epigallocatechin-3-gallate, inhibit cell growth and reduce tumor incidence. However, results of epidemiological studies have generated inconsistent, sometimes conflicting data regarding protection by green tea against human cancers. To clarify the findings of these laboratory studies in application to humans, we conducted a pilot intervention study with three heavy smokers (> 10 cigarettes/day) and three nonsmokers (never smokers) in order to evaluate the molecular and cellular effects of drinking green tea using human oral cells as an investigative tool. Green tea total extract (400-500 mg/cup, 5 cups/day) was administered in drinking water to the subjects for four weeks. Two oral cytology samples were taken weekly for measurements of tobacco carcinogen-induced DNA damage, including bulky adducts and oxidized bases, cell growth, DNA content, and apoptosis. The study showed that during the course of green tea administration smoking-induced DNA damage was decreased, cell growth was inhibited, and the percentage of cells in S phase was reduced, cells accumulated in G1 phase (cyclin D1 positive), DNA content became more diploid and less aneuploid, and p53, Caspase-3, and TUNEL, markers of apoptosis, were increased. The study, although preliminary, indicates that drinking green tea reduced the number of damaged cells in smokers by inducing cell growth arrest and apoptosis, a mechanism similar to that observed in cultured cells and animals. These results warrant a large-scale intervention trial to further verify the role of green tea in the prevention of oral cancer in smokers.

Coffee and tea intake and risk of oral, pharyngeal and esophageal cancer

The relation between coffee, decaffeinated coffee, tea and oral/pharyngeal, and esophageal cancer risk is inadequately quantified. Data were derived from hospital-based case-control studies conducted in Italy and Switzerland. The study on oral/pharyngeal cancer included 749 cases and 1772 controls, and that of esophageal cancer 395 cases and 1066 controls. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were computed. The OR for >3 cups/day of coffee compared with </=1 were 0.6 (95% CI 0.5-0.9) for oral/pharyngeal, and 0.6 (95% CI 0.4-0.9) for esophageal cancer, consistent across strata of age, sex, education and alcohol. The inverse trends in risk were significant. No association emerged with decaffeinated coffee (OR 1.1 for oral/pharyngeal and 0.6 for esophageal cancer) or tea (OR 0.9 for both cancers), consumed in low amounts by these populations. Coffee may decrease the risk of oral/pharyngeal and esophageal cancer.

The beverage maté: a risk factor for cancer of the head and neck

BACKGROUND

Maté is a tealike beverage consumed habitually in South America and among South Americans throughout the world. It is brewed from the dried leaves and stemlets of the perennial tree Ilex paraguariensis (yerba maté), a species that belongs to the Aquifoliaceae family. Maté consumption has been associated with an increased rate of oral, oropharyngeal, esophageal, and laryngeal cancers. The purpose of this study is to review the literature and discuss the role of Maté consumption as a risk factor for head and neck cancers.

MATERIALS AND METHODS

We performed a thorough review of the relevant literature linking maté consumption with head and neck cancer and the proposed carcinogenicity of maté. Case control studies on maté-drinking populations and in vivo and in vitro studies on the carcinogenicity of maté were reviewed. The populations included in many of these studies also used alcohol and tobacco products, confounding the influence of maté as an independent risk factor.

RESULTS

Evidence in the literature suggests that maté consumption is carcinogenic and plays a role in the development of cancers of the oral cavity, pharynx, larynx, and esophagus.

CONCLUSIONS

The exact mechanism of carcinogenesis of maté is unknown. Both chemical and thermal carcinogenesis mechanisms have been suggested. Available information suggests that maté drinking is a risk factor for upper aerodigestive tract cancer.

The epidemiology of oral and pharynx cancer in Brazil

A study was carried out on the occurrence of oral and pharynx cancer among populations living in five Brazilian geographic regions, by using incidence and mortality rates and trends. Information on survival was also analyzed. Complementary information regarding prevalence of the disease risk factors has been supplied in the attempt to establish some etiological connections with the incidence and mortality observed. Two clear patterns for the occurrence of oral and pharyngeal cancer have been detected: a pattern for the north (including the northern, northeastern and midwestern regions, which are the poorest ones) and a pattern for the south (including the southern and southeastern regions). The southern pattern revealed incidence rates higher than 15 per 100,000 among males, and the northern pattern displayed lower rate levels. Similarly, mortality rates in the south were higher than three per 100,000 and the northern pattern was characterized by lower rates. Other cancers linked to tobacco smoking, such as esophagus, larynx, lung and bladder cancer kept the same pattern of incidence and mortality rates related to oral and pharyngeal cancer in males per region. Information on survival of patients with oral and pharyngeal cancer was very restricted in Brazil, thus hindering the survival analysis per region, but the studies conducted allowed to conclude that the majority of diagnoses were conducted in advanced stages of the disease and implied the low 5-year survival rate observed in Brazil. Tongue tumors displayed the worst survival rates. The southern region shares specific risk factors involved in the oral and pharyngeal cancer present in the Argentinean and Uruguayan populations, namely heavy tobacco smoking and alcohol consumption, as well as high intake of charcoal-grilled red meat and mate. In addition to these risks, part of the oral and pharyngeal cancer registered in Brazil might be linked to a few factors present among people with low life standards, including poor oral hygiene and nutrition.