Women who consume large amounts of alcoholic beverages and have low consumption of folates have a three times greater risk of developing oral cancers than women who also drink a lot but have high folate intake, according to researchers from Columbia University Medical Center and Harvard School of Public Health (Cancer Epidemiology Biomarkers and Prevention, October 2010, Vol. 19:10, pp. 2516-2524).
While the number of women diagnosed with oral and pharyngeal cancers is expected to surpass the number of women affected with cervical cancer, very little information currently exists about oral and pharyngeal cancers in women because most studies have focused on men, according to the authors.
To provide clues about the etiology of oral and pharyngeal cancers specifically among women, researchers at Columbia University Medical Center and the Harvard School of Public Health studied a group of more than 87,000 female nurses who have been followed since 1976. The authors found that heavy tobacco and alcohol use are the main risk factors for developing head and neck cancer in women.
While this finding was expected because it has been described previously among men, the authors noted that women who drank large quantities of alcohol did not have as high a risk if their folate consumption levels were also high (> 350 mcg/day). In contrast, women with high alcohol consumption who did not consume enough folate had a more than threefold increase in risk (as compared with nondrinkers at the same folate levels).
Cancer epidemiologist Athanasios Zavras, D.M.D., M.S, D.M.Sc., study co-author and head of the division of oral epidemiology and biostatistics at Columbia University Medical Center, said that folate depletion has been associated with chromosomal breaks and serious disruptions in DNA repair. It is also known that alcohol drinking leads to decreased folate metabolism and increased acetaldehyde (carcinogen) production. The more a woman drinks, the more acetaldehyde is created in the epithelial tissues, leading to reductions of available folate.
Folates are a form of vitamin B, essential to numerous bodily functions, such the synthesis and repair of DNA and the prevention of cancer. In pregnant women, one consequence of not consuming enough folate is the development of neural tube defects in embryos. Common sources of folates include leafy vegetables such as spinach, asparagus, and turnip greens.
Every year, more than 36,000 people in the U.S. are newly diagnosed with oral and pharyngeal cancers and close to 8,000 die from the cancers, according to the Centers for Disease Control and Prevention. Heavy smoking and heavy alcohol drinking are the main risk factors, but oral sex and human papillomavirus (HPV) infections have also been linked with the disease. Approximately one-third of the newly diagnosed patients are women.
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