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Fish/shellfish intake and the risk of head and neck cancer

McClain, Kathleen M.a; Bradshaw, Patrick T.c; Khankari, Nikhil K.d; Gammon, Marilie D.a; Olshan, Andrew F.a,b

European Journal of Cancer Prevention: March 2019 - Volume 28 - Issue 2 - p 102–108
doi: 10.1097/CEJ.0000000000000431
Research Papers: Lifestyle

Fish intake and other dietary sources of omega-3 fatty acids have been shown to be associated with a reduced risk for some cancers. Although previous studies of head and neck cancer have reported associations with different dietary factors, including reduced risks for fruits and vegetables and putatively healthy dietary patterns, associations specific to fish intake are unclear. This study investigated the association between fish/shellfish intake and risk of squamous cell carcinoma of the head and neck (SCCHN) using data from the Carolina Head and Neck Cancer Epidemiology Study, a population-based case–control study conducted in 46 North Carolina counties with cases recruited from 2002 through 2006. Controls were frequency matched to the cases on age, sex, and race; the final sample size was 1039 cases and 1375 controls. Demographic, lifestyle, and dietary information were collected using an in-person interviewer-administered structured questionnaire. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with unconditional logistic regression. Patients whose fish/shellfish intake was among the highest tertile had a 20% lower odds of SCCHN compared with those in the lowest tertile (OR: 0.80; 95% CI: 0.60–1.07) after adjustment for the matching and other factors (income, energy intake, fruit intake, cigarette smoking, and alcohol intake). The inverse association was more pronounced for oral cavity and oropharyngeal tumors, for African Americans, and for females, but CIs were wide. To further investigate this potential risk reduction strategy for SCCHN, future studies should consider examining specific fish/shellfish, cooking practices, and other omega-3 fatty acid sources.

Departments of aEpidemiology

bOtolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina

cDivision of Epidemiology, School of Public Health, University of California, Berkeley, California

dDivision of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence to Kathleen M. McClain, MS, Department of Epidemiology, University of North Carolina, CB #7435, McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435, USA Tel: +1 919 966 7430; fax: +1 919 966 2089; e-mail:

Received May 1, 2017

Accepted July 13, 2017

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