Näytönastekatsaukset

Dietary Factors Associated with Decreased Risk of Oral Cancer

Näytönastekatsaukset
26.5.2026
Tarja Kaipainen

Level of evidence: C

Higher intake of vegetables, fruits, fish, coffee and tea (including non-smokers) may decrease oral cancer risk.

The evidence is mostly based on observational studies, with heterogeneity, and potential residual confounding by tobacco and alcohol; several syntheses note small-study and publication-bias concerns. Findings are drawn largely from adult populations in Europe, Asia and the Americas; exposures are commonly self-reported with variable dose categories, limiting dose–response precision.

Table 1. Description of the included studies
ReferenceStudy typePopulationIntervention and comparisonOutcomesRisk of bias «Additional comments for included studies»2
«Pavia M, Pileggi C, Nobile CG, ym. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr 2006;83(5):1126-34 »1MAEuropean, USA, East AsiaObservational studiesThe contribution of fruit and vegetable intakes to the occurrence
of oral cancer		Moderate
«He T, Guo X, Li X, ym. Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2020;29(1):80-88 »2 MAChina, USA, Japan, Europe, Brazil, India Patients with oral cavity cancerCase-control and cohort studiesAssociation between high versus low coffee intake and the risk of oral cavity cancerLow
«Heller MA, Nyirjesy SC, Balsiger R, ym. Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis. Oral Oncol 2023;137():106300 »3SR, MAChina
Non-smokers		Case-control and cohort studiesAssociation between tea consumption and oral cavity cancer riskModerate
«Zhou H, Wu W, Wang F, ym. Tea consumption is associated with decreased risk of oral cancer: A comprehensive and dose-response meta-analysis based on 14 case-control studies (MOOSE compliant). Medicine»4MAAsia, America, Europe, AfricaCase-control studiesThe association between tea intake and the risk of oral cancerModerate
«Hu S, Yu J, Wang Y, ym. Fish consumption could reduce the risk of oral cancer in Europeans: A meta-analysis. Arch Oral Biol 2019;107():104494 »5MA
European, USA, AsiaCase-control and cohort studiesAssociation between fish consumption and oral cancer riskModerate

SR=systematic review; MA=meta-analysis

Table 2. Additional comments for included studies
ReferenceComments
«Pavia M, Pileggi C, Nobile CG, ym. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr 2006;83(5):1126-34 »1The assessment methods for fruit and vegetable consumption may vary between the studies. The possibility of selection bias, misclassification bias related to exposure, and failure to consider potential confounders cannot be ruled out.
«Heller MA, Nyirjesy SC, Balsiger R, ym. Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis. Oral Oncol 2023;137():106300 »3Mostly observational studies, small non-smoker subgroup, possible residual confounding, heterogeneity
«Zhou H, Wu W, Wang F, ym. Tea consumption is associated with decreased risk of oral cancer: A comprehensive and dose-response meta-analysis based on 14 case-control studies (MOOSE compliant). Medicine»4Studies were case-control studies, about half of the studies had a lower NOS score, heterogeneity was moderate and the exposure measure and dose conversions varied.
«Hu S, Yu J, Wang Y, ym. Fish consumption could reduce the risk of oral cancer in Europeans: A meta-analysis. Arch Oral Biol 2019;107():104494 »5Selection/memory bias, variation in exposure definitions and adjustments.

NOS=Newcastle–Ottawa Quality Assessment Scale

Results

Table 3. Decrease the risk
ReferenceNumber of studies and number of patients (I/C)Absolute number of events (%) IAbsolute number of events (%) CRelative effect (95% CI)
Level of evidence: low
The quality of evidence is downgraded due to study limitations.
«Pavia M, Pileggi C, Nobile CG, ym. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr 2006;83(5):1126-34 »1
Per additional portion of fruit consumed per day 		16
4918/65802		N/AN/AOR 0.51 (0.40-0.65)
«Pavia M, Pileggi C, Nobile CG, ym. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr 2006;83(5):1126-34 »1
Per additional portion of vegetables consumed per day		15
4826/57993		N/AN/AOR 0.50 (0.38-0.65)
«He T, Guo X, Li X, ym. Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2020;29(1):80-88 »2
Coffee (high intake vs. low intake) 		19
6456 /1969484		N/AN/AOR 0.68 (0.56-0.82)
«He T, Guo X, Li X, ym. Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2020;29(1):80-88 »2
Coffee (moderate intake vs. low intake) 		18
6295/1969084		N/AN/AOR 0.85 (0.77−0.94)
«Heller MA, Nyirjesy SC, Balsiger R, ym. Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis. Oral Oncol 2023;137():106300 »3
Tea (yes versus no) 		2
740/2329		N/AN/AOR 0.53 (0.29-0.96)
«Zhou H, Wu W, Wang F, ym. Tea consumption is associated with decreased risk of oral cancer: A comprehensive and dose-response meta-analysis based on 14 case-control studies (MOOSE compliant). Medicine»4
Tea (higher intake versus lower intake) 		14
5920/10553		N/AN/AOR 0.70 (0.61–0.81)
«Hu S, Yu J, Wang Y, ym. Fish consumption could reduce the risk of oral cancer in Europeans: A meta-analysis. Arch Oral Biol 2019;107():104494 »5
Fish (highest category compared with lowest category consumption) 		15
5211/64794		N/AN/AOR 0.74 (0.64–0.85)

I=intervention; C=comparison; CI=confidence interval; N/A=no value is available; OR=odds ratio

References

  1. Pavia M, Pileggi C, Nobile CG, ym. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr 2006;83(5):1126-34 «PMID: 16685056»PubMed
  2. He T, Guo X, Li X, ym. Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2020;29(1):80-88 «PMID: 31021885»PubMed
  3. Heller MA, Nyirjesy SC, Balsiger R, ym. Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis. Oral Oncol 2023;137():106300 «PMID: 36638697»PubMed
  4. Zhou H, Wu W, Wang F, ym. Tea consumption is associated with decreased risk of oral cancer: A comprehensive and dose-response meta-analysis based on 14 case-control studies (MOOSE compliant). Medicine (Baltimore) 2018;97(51):e13611 «PMID: 30572470»PubMed
  5. Hu S, Yu J, Wang Y, ym. Fish consumption could reduce the risk of oral cancer in Europeans: A meta-analysis. Arch Oral Biol 2019;107():104494 «PMID: 31404781»PubMed