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Home Other HPV Cancers Other HPV Cancers Fruit Consumption and Head and Neck Cancers

Fruit Consumption and Head and Neck Cancers

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Fruit intake is associated with lower rates of head and neck cancers, but may increase the risk for these diseases in those with HPV-16, according to a recent study.

Head and neck cancers include those of the oral cavity, and most HPV-related head and neck cancers are of the oropharynx (tongue, soft palate, and tonsils). The American Cancer Society estimates there are about 34,000 cases of oropharyngeal cancer each year in the U.S.
Heavy tobacco and alcohol use is strongly linked to these diseases, but “high risk” HPV (almost always HPV-16) appears to play a role with some oropharyngeal cancers. Research published in 2007 (D’souza et al.) found HPV 16 DNA present in 72% of tumors taken from patients with oropharyngeal cancer (n=100). 57% of cancer patients were seropositive for HPV 16 antibodies, compared to 7% of the control group.

There is evidence that HPV-linked diseases are a unique subset among head and neck cancers. This notion is supported by a study with 763 subjects (270 cancer cases and 493 controls) that found fruit consumption is associated with a much lower overall risk of head and neck cancer, but not for those with HPV-16.

The investigators, led by Dr. Mara Meyer, found that increasing fruit intake reduces the risk of head and neck cancers. Among those with antibodies to HPV-16 detected through blood tests, however, higher fruit consumption increased the risk of head and neck cancers approximately 1.4 times. The results were especially striking when citrus intake alone was considered, as the risk increased more than 3-fold.  

The researchers say the reason for this interaction isn’t clear, but speculate it may be due to inflammatory aspects of acidic fruits making mucosal surfaces more vulnerable to HPV infections. Another possibility may be that intake of citrus fruits might affect the immune response to viral infections like HPV.

So just how worried should someone be about digging into a holiday fruit basket? It should be pointed out that the vast majority of cases of HPV don’t lead to cancer, and cancers of the oropharynx are not common and don’t develop quickly: in the D’souza article’s discussion the authors note that “exposure to HPV can precede the appearance of oropharyngeal cancer by 10 years or more.”

Meyer S. et al. Human Papillomavirus-16 Modifies the Association between Fruit Consumption and Head and Neck Squamous Cell Carcinoma. Cancer, Epidemiology, Biomarkers & Prevention 2008. 17: 3419-26.
D’souza G. et al. Case–Control Study of Human Papillomavirus and Oropharyngeal Cancer. New England Journal of Medicine 2007. 356:1944-56