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Shared and Study-specific Dietary Patterns and Head and Neck Cancer Risk in an International Consortium

De Vito, R.a; Lee, Yuan Chin Amyb; Parpinel, M.c; Serraino, D.d; Olshan, Andrew Ferguse; Zevallos, Jose Pedrof; Levi, F.g; Zhang, Zhuo Fengh; Morgenstern, H.i; Garavello, W.j; Kelsey, K.k; McClean, M.l; Schantz, S.m; Yu, Guo Pein; Boffetta, P.o; Chuang, Shu Chunp; Hashibe, M.q; La Vecchia, C.r; Parmigiani, G.s,t; Edefonti, V.r

doi: 10.1097/EDE.0000000000000902
Cancer

Background: A few papers have considered reproducibility of a posteriori dietary patterns across populations, as well as pattern associations with head and neck cancer risk when multiple populations are available.

Methods: We used individual-level pooled data from seven case–control studies (3844 cases; 6824 controls) participating in the International Head and Neck Cancer Epidemiology consortium. We simultaneously derived shared and study-specific a posteriori patterns with a novel approach called multi-study factor analysis applied to 23 nutrients. We derived odds ratios (ORs) and 95% confidence intervals (CIs) for cancers of the oral cavity and pharynx combined, and larynx, from logistic regression models.

Results: We identified three shared patterns that were reproducible across studies (75% variance explained): the Antioxidant vitamins and fiber (OR = 0.57, 95% CI = 0.41, 0.78, highest versus lowest score quintile) and the Fats (OR = 0.80, 95% CI = 0.67, 0.95) patterns were inversely associated with oral and pharyngeal cancer risk. The Animal products and cereals (OR = 1.5, 95% CI = 1.1, 2.1) and the Fats (OR = 1.8, 95% CI = 1.4, 2.3) patterns were positively associated with laryngeal cancer risk, whereas a linear inverse trend in laryngeal cancer risk was evident for the Antioxidant vitamins and fiber pattern. We also identified four additional study-specific patterns, one for each of the four US studies examined. We named them all as Dairy products and breakfast cereals, and two were associated with oral and pharyngeal cancer risk.

Conclusion: Multi-study factor analysis provides insight into pattern reproducibility and supports previous evidence on cross-country reproducibility of dietary patterns and on their association with head and neck cancer risk. See video abstract at, http://links.lww.com/EDE/B430.

From the aDepartment of Computer Science, Princeton University, Princeton, NJ

bDivision of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT

cDepartment of Medicine, University of Udine, Udine, Italy

dEpidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, IRCCS, Aviano, Italy

eUniversity of North Carolina School of Public Health, Chapel Hill, NC

fDepartment of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC

gInstitute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland

hDepartment of Epidemiology, UCLA School of Public Health, Los Angeles, CA

iDepartments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI

jDepartment of Otorhinolaryngology, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy

kDepartment of Epidemiology and Pathology and Laboratory Medicine, Brown University, Providence, RI

lDepartment of Environmental Health, Boston University School of Public Health, Boston, MA

mDepartment of Otolaryngology, New York Eye and Ear Infirmary, New York, NY

nMedical Informatics Center, Peking University, Peking, China

oThe Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY

pInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan

qDivision of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT

rBranch of Medical Statistics, Biometry and Epidemiology “G. A. Maccacaro,” Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy

sDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA

tDepartment of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA.

Submitted October 6, 2017; accepted July 24, 2018.

Article notes: We are finalizing an R package, named MSFA, to implement the method presented in De Vito et al. [De Vito R, Bellio R, Trippa L, et al. Multi-study factor analysis. arXiv preprint arXiv:161106350 2016.] and its application in nutritional epidemiology. The package is available on GitHub: https://github.com/rdevito/MSFA.

The scientific coordinators of the INHANCE Consortium are Professor P. Boffetta and Professor M. Hashibe, to whom requests of data for replication of the present findings should be sent.

Supported by grants from the National Cancer Institute at the National Institutes of Health (grants R03CA113157 to the INHANCE Pooled Data Project; R01CA90731-01 to the North Carolina [2002–2006] study; 4P30CA006516-51 to G.P.), National Institutes of Health (grants P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, R21ES011667 to the Los Angeles study; R01CA078609, R01CA100679 to the Boston study; R01CA051845 to the MSKCC study), the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center for the Los Angeles study, the National Institute of Dental and Craniofacial Research at the National Institutes of Health (grant R03DE016611 to the INHANCE Pooled Data Project), the National Institute of Environmental Health Sciences (grant P30ES010126 to the North Carolina [2002–2006] study), the Italian Association for Research on Cancer (no grant number provided for the Italy Multicenter study; grant 10068 to the Milan [2006–2009] study), Italian League Against Cancer to the Italy Multicenter study, Italian Ministry of Research to the Italy Multicenter study, the Swiss Research against Cancer/Oncosuisse (grant KFS-700, OCS-1633 to the Swiss study), Italian Ministry of Education - PRIN 2009 Program (grant X8YCBN to the Milan [2006–2009] study), Italian Foundation for Cancer Research to the Milan (2006–2009) study, and Università degli Studi di Milano “Young Investigator Grant Program 2015” to V.E.

The authors report no conflicts of interest.

G.P., R.D.V., and V.E. designed research; D.S., C.L.V., A.O., J.P.Z., Z.F.Z., H.M., F.L., K.K., M.M., V.E., W.G., S.S., and G.P.Y. conducted research and provided single-study databases; S.C.C. and Y.A.L. prepared the pooled dataset for the analysis; M.H. and P.B. are the scientific coordinators of the INHANCE consortium and pooled data coordinators; M.P. provided advice on nutritional issues; R.d.V. and V.E. performed all statistical analyses; G.P. provided advice on statistical issues; V.E. wrote the paper and had primary responsibility for final content. All authors read and approved the final manuscript.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com).

Correspondence: Valeria Edefonti, Branch of Medical Statistics, Biometry and Epidemiology “G. A. Maccacaro,” Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via Venezian 1, 20133 Milano, Italy. E-mail: valeria.edefonti@unimi.it.

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