Diet and other risk factors for laryngeal cancer in Shanghai, China

Our plain-English summary of Diet and other risk factors for laryngeal cancer in Shanghai, China, by W. Zheng, W.J. Blot, X.O. Shu, et al (American Journal of Epidemiology, 1992).

The study

• Authors: W. Zheng, W.J. Blot, X.O. Shu, Y.T. Gao, B.T. Ji, R.G. Ziegler, J.F. Fraumeni
• Journal: American Journal of Epidemiology
• Published: 1992;136(2):178-91
• Cited by: 113 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A population-based, case-control study of laryngeal cancer was conducted in Shanghai, China, during 1988-1990, in which 201 incident cases (177 males, 24 females) and 414 controls (269 males, 145 females) were interviewed. Cigarette smoking was the major risk factor, accounting for 86% of the male and 54% of the female cases. After adjusting for smoking, there was little increase in risk associated with drinking alcoholic beverages. Among men, cases more often reported occupational exposures to asbestos and coal dust. A protective effect was associated with the intake of fruits (particularly oranges and tangerines), certain dark green/yellow vegetables, and garlic, but there was an increased risk with the intake of salt-preserved meat and fish. The findings suggest that risk factors for laryngeal cancer in Shanghai resemble those in Western countries, and they provide further evidence that dietary factors play an important etiologic role.

In plain English

This population-based case-control study looked for risk factors for cancer of the larynx (voice box) in urban Shanghai, China. The authors interviewed 201 people newly diagnosed during 1988-1990 (177 men, 24 women) and 414 residents randomly selected from the general population (269 men, 145 women). Interviews covered smoking, drinking, diet, and jobs and workplace exposures. Detailed analyses were done for men only. Cigarette smoking was the strongest factor: men who had ever smoked had an odds ratio of 8.7 (95 percent confidence interval 3.8-19.6) compared with never smokers. After accounting for smoking, heavy drinkers showed no excess risk. Among men, self-reported workplace asbestos exposure was linked to an odds ratio of 2.0 (95 percent confidence interval 1.0-4.3), but risk did not rise with more frequent or longer exposure. Coal dust exposure had an odds ratio of 2.6 (1.4-4.8). Salt-preserved meat and fish were linked to higher risk. Some vegetables, garlic and oranges/tangerines were linked to lower risk. The authors concluded that asbestos and coal dust appear to contribute to some cases among men. They noted that the small sample prevented detailed occupational analyses.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: population-based case-control study using in-person interviews
• Who was studied: Residents of urban Shanghai aged 20-75 newly diagnosed with laryngeal cancer from January 1, 1988 to February 28, 1990. 201 cases were interviewed (177 males, 24 females) out of 263 eligible; the others had died or could not be located. 414 controls (269 males, 145 females) were randomly selected from the general population of urban Shanghai. Detailed analyses were for males only.
• Exposure: Cigarette smoking, alcohol drinking, diet (30 fruits and vegetables and 11 animal foods), and occupational history and self-reported occupational exposures, including asbestos (no fiber type given), coal dust, silica, wood dust, metal dust, benzene and others.
• Main results:
  • Males: ever versus never smoking gave an odds ratio of 8.7 (95% CI 3.8-19.6), adjusted for age and education.
  • Smoking accounted, at least in part, for 86 percent of the male cases and 54 percent of the female cases.
  • Males: after adjusting for smoking, heavy drinkers had no excess risk compared with nondrinkers.
  • Males: no job category showed a significantly elevated risk after adjusting for smoking.
  • Males: self-reported occupational asbestos exposure was associated with an odds ratio of 2.0 (95% CI 1.0-4.3). No dose-response relation with frequency or duration of exposure was observed.
  • Males: self-reported occupational coal dust exposure was associated with an odds ratio of 2.6 (95% CI 1.4-4.8), adjusted for age, education and smoking.
  • Males: risk rose with increasing consumption of salt-preserved meat and fish.
  • Males: reduced risks were seen with higher intake of most fruit and vegetable subgroups, especially dark green vegetables other than bok choy, dark yellow vegetables, garlic, and oranges/tangerines.
  • Females: odds ratios for smoking were 9.4 (under 10 pack-years) and 20.2 (10 or more pack-years). The population attributable risk for smoking was 54 percent (95% CI 32-76).
• The authors' conclusion: The authors concluded that cigarette smoking was the most important risk factor. They concluded that occupational exposures to asbestos and coal dust appear to contribute to some cases among men.
• Limitations the authors state:
  • Detailed occupational analyses were not possible because the sample was relatively small.
  • Only 24 female cases were included, so detailed analyses were limited to males.
  • Recall of past diet may be influenced by current diet, which the cancer may have changed.
  • Residual confounding by smoking had to be considered. The authors judged it unlikely to be substantial after several ways of adjusting.
  • Vitamin C intake from vegetables was estimated imprecisely.
  • The liver consumption finding may be due to chance because of multiple comparisons.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Case-Control Study, Occupational Exposure, Fluorescence In Situ Hybridization (FISH).

Related studies

• A case-control study of occupational risk factors for laryngeal cancer — P. Wortley, T.L. Vaughan, et al. (1992)
• Occupational risk factors for laryngeal carcinoma: Connecticut, 1975-1980 — R.T. Zagraniski, J.L. Kelsey, et al. (1986)
• Occupation and the risk of laryngeal cancer in Uruguay — E. De Stefani, P. Boffetta, et al. (1998)
• Exposure to cement dust, related occupational groups and laryngeal cancer risk: results of a population based case-control study — A. Dietz, H. Ramroth, et al. (2004)
• The joint effect of asbestos exposure, tobacco smoking and alcohol drinking on laryngeal cancer risk: evidence from the French population-based case-control study, ICARE — G. Menvielle, A. Fayossé, et al. (2016)
• Association between diet and lung cancer location — B.W. Lee, J.C. Wain, et al. (1998)

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