Saba Narmcheshm
1,2 
, Monireh Sadat Seyyedsalehi
2,3, Bahareh Sasanfar
2,4,5, Hamideh Rashidian
2, Maryam Hadji
2,6, Elham Mohebbi
7, Ahmad Naghibzadeh-Tahami
8,9, Paolo Boffetta
3,10,11, Fatemeh Toorang
2,3, Kazem Zendehdel
2,3,12* 1 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
2 Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Medical and Surgical Sciences, University of Bologna, Italy
4 Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5 Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
6 Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
7 School of Medicine, Department of Oncology, Georgetown University, Washington, DC, USA
8 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
9 Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
10 Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
11 Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
12 Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: 12Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Islamic Republic of Iran Email kazendeh@tums.ac.ir@gmail.com
Abstract
Background: The inflammatory potential of diet may affect carcinogenesis. This study aimed to determine the association between dietary inflammatory index (DII) and the risk of head and neck cancer (HNC), as well as the interaction between DII and cigarette smoking in HNC development within the Iranian population.
Study Design: This is a case-control study.
Methods: In this multicenter case-control study, participants’ dietary intake was assessed using a validated 130-item food frequency questionnaire, from which DII was computed. The study recruited 876 new cases from referral hospitals across 10 provinces and 3409 healthy controls who were frequency-matched based on age, gender, and residential place. Logistic regression was used to obtain odds ratios (ORs) for HNC across tertiles of DII, which were adjusted for confounding variables.
Results: A higher pro-inflammatory diet was associated with an increased risk of all HNC (OR T3 vs. T1 [95% CI]: 1.31 [1.06, 1.62]; P-trend=0.013). There was a significant association between lip and oral cavity cancers and DII (OR T3 vs. T1 [95% CI]: 1.56 [1.16, 1.66]; P-trend=0.004). Furthermore, an inflammatory diet was associated with an increased risk of pharynx cancer (OR T3 vs. T1 [95% CI]: 2.08 [1.14, 3.79]; P-trend=0.02). Additionally, no significant association was observed between DII and larynx cancer, while an interaction was found between DII and tobacco use on the risk of HNC (OR T3 vs. T1 [95% CI]: 2.52 [1.78, 3.57]; P-interaction=0.03).
Conclusion: DII was positively associated with HNC risk. There was a significant association between DII and the risk of lip, oral cavity, and pharynx cancers. Additionally, there was an interaction between tobacco use and DII in determining the risk of HNC.