The role of dietary factors in the aetiology of Nasopharyngeal carcinoma: a case-control study in Yogyakarta, Indonesia.

Syafiq, Ahmad (2006). The role of dietary factors in the aetiology of Nasopharyngeal carcinoma: a case-control study in Yogyakarta, Indonesia. PhD Thesis, School of Population Health, University of Queensland.

       
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Author Syafiq, Ahmad
Thesis Title The role of dietary factors in the aetiology of Nasopharyngeal carcinoma: a case-control study in Yogyakarta, Indonesia.
School, Centre or Institute School of Population Health
Institution University of Queensland
Publication date 2006
Thesis type PhD Thesis
Supervisor Associate Professor Geoffrey Marks
Abstract/Summary Nasopharyngeal carcinoma (NPC) is the most common cancer among males in Yogyakarta, Indonesia and rank second among males in Indonesia after skin cancer. NPC is associated with Epstein-Barr Virus, genetic susceptibility, and chemical carcinogens from occupational exposures and diet. Dietary factors might play role both as promoter and protector to NPC development. This study aims at investigating the role of dietary factors in NPC development in Yogyakarta, Indonesia. Design of the study was case-control with two types of controls, that is hospital controls and community controls. Cases were 73 histopathologically confirmed NPC patients, while hospital controls were 73 other cancer patients matched by diagnostic year and community controls were 73 healthy closest neighbours of cases matched for age and sex. Dietary exposures were collected retrospectively using specifically developed and validated food-frequency questionnaires. Design of the study also allows the collection of early information on survival analysis of NPC, which availability is very limited in Indonesia. The study was successfully developed food-frequencyquestionnaires modified from the available existing questionnaires through combination of different qualitative methods. In general, the questionnaires had a relatively moderate to high reliability and validity coefficients, although for some food items the reliability and validity was considered as poor. Results of the study showed that the risk of NPC was higher for those who consumed fermented salted fish during childhood period (OR: 9.3 CI 1.1-76.6). The risk of NPC was higher for those who consumed shrimp paste during the adult period (OR: 2.1 CI 1.1-4.0). Results on the fruit and vegetables hypotheses are a little mixed and uncertain because even though consumption of carrot during weaning period showed significant protective effect (OR: 0.4 CI 0.1-0.9), several other fruit and vegetable items showed significant risks as promotive factor of NPC. One possible explanation was related to low validity of measurement of distant past intake of fruit and vegetables. Hypotheses that we could not test due to small numbers of subjects were hypotheses related to duration of exposure and hypotheses related to dose response relationship.

 
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