Metabolic Diseases and Risk of Head and Neck Cancer: A Cohort Study Analyzing Nationwide Population-Based Data

SIMPLE SUMMARY: Head and neck cancer has been increasing in recent years, and it seriously deteriorates the quality of life because it directly affects the organs of eating, talking and breathing. Therefore, studies to prevent and treat it are being actively conducted. In the present study, we investigated the effects of metabolic diseases on the development of head and neck cancer as part of research to identify risk factors for head and neck cancer and to prevent it. Obesity lowered the risk of HNC in men. Underweight was a strong risk factor for HNC in both men and women. High LDL cholesterol and TC levels had protective effects on HNC in men, but not in women. Diabetes increased the risk of HNC in both men and women, whereas hypertension increased the risk of HNC only in men. ABSTRACT: The aim of the study was to investigate the association between metabolic diseases and the risk of head and neck cancer (HNC) using nationwide population-based big data. This retrospective cohort study was conducted using the Korean National Health Insurance Service health checkup database. A total of 4,575,818 participants aged >40 years who received a health checkup in 2008 were enrolled, and we studied the incidence of HNC until 2019. We analyzed the risk of HNC according to the presence of metabolic diseases, such as obesity, dyslipidemia, hypertension, and diabetes. Although metabolic syndrome itself was not associated with HNC, each component of metabolic syndrome was associated with HNC. Underweight and diabetes were risk factors for HNC (HR: 1.694). High total cholesterol and high low-density lipoprotein cholesterol levels were factors that decreased the risk (HR 0.910 and 0.839). When we analyzed men and women separately, low total cholesterol level, low low-density lipoprotein cholesterol level, and hypertension were risk factors only in men. In addition, pre-obesity, obesity, and central obesity decreased the risk only in men. Each metabolic disease affects HNC in different ways. Underweight and diabetes increased the risk of HNC, whereas high total cholesterol and high low-density lipoprotein cholesterol levels decreased the risk of HNC.