We analyzed the potential role of pizza on cancer risk, using data from an integrated network of case-control studies conducted in Italy between 1991 and 2000. Cancer sites were: oral cavity and pharynx (598 cases), esophagus (304 cases), larynx (460 cases), colon (1,225 cases) and rectum (728 cases). Controls were 4,999 patients admitted for acute, non-neoplastic conditions to the same hospital network as cases. Odds ratios for regular pizza consumers were 0.66 (95% confidence interval, CI = 0.47–0.93) for oral and pharyngeal cancer, 0.41 (95% CI = 0.25–0.69) for oesophageal, 0.82 (95% CI = 0.56–1.19) for laryngeal, 0.74 (95% CI = 0.61–0.89) for colon and 0.93 (95% CI = 0.75–1.17) for rectal cancer. Pizza appears therefore to be a favorable indicator of risk for digestive tract neoplasms in this population. © 2003 Wiley-Liss, Inc.