TY - JOUR
T1 - Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer
T2 - Pooled analysis in the international head and neck cancer epidemiology consortium
AU - Hashibe, Mia
AU - Brennan, Paul
AU - Benhamou, Simone
AU - Castellsague, Xavier
AU - Chen, Chu
AU - Curado, Maria Paula
AU - Maso, Luigino Dal
AU - Daudt, Alexander W.
AU - Fabianova, Eleonora
AU - Wünsch-Filho, Victor
AU - Franceschi, Silvia
AU - Hayes, Richard B.
AU - Herrero, Rolando
AU - Koifman, Sergio
AU - La Vecchia, Carlo
AU - Lazarus, Philip
AU - Levi, Fabio
AU - Mates, Dana
AU - Matos, Elena
AU - Menezes, Ana
AU - Muscat, Joshua
AU - Eluf-Neto, Jose
AU - Olshan, Andrew F.
AU - Rudnai, Peter
AU - Schwartz, Stephen M.
AU - Smith, Elaine
AU - Sturgis, Erich M.
AU - Szeszenia-Dabrowska, Neonilia
AU - Talamini, Renato
AU - Wei, Qingyi
AU - Winn, Deborah M.
AU - Zaridze, David
AU - Zatonski, Witold
AU - Zhang, Zuo Feng
AU - Berthiller, Julien
AU - Boffetta, Paolo
PY - 2007/5/16
Y1 - 2007/5/16
N2 - Background: At least 75% of head and neck cancers are attributable to a combination of cigarette smoking and alcohol drinking. A precise understanding of the independent association of each of these factors in the absence of the other with the risk of head and neck cancer is needed to elucidate mechanisms of head and neck carcinogenesis and to assess the efficacy of interventions aimed at controlling either risk factor. Methods: We examined the extent to which head and neck cancer is associated with cigarette smoking among never drinkers and with alcohol drinking among never users of tobacco. We pooled individual-level data from 15 case - control studies that included 10 244 head and neck cancer case subjects and 15 227 control subjects, of whom 1072 case subjects and 5775 control subjects were never users of tobacco and 1598 case subjects and 4051 control subjects were never drinkers of alcohol. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. All statistical tests were two-sided. Results: Among never drinkers, cigarette smoking was associated with an increased risk of head and neck cancer (OR for ever versus never smoking = 2.13, 95% CI = 1.52 to 2.98), and there were clear dose - response relationships for the frequency, duration, and number of pack-years of cigarette smoking. Approximately 24% (95% CI = 16% to 31%) of head and neck cancer cases among nondrinkers in this study would have been prevented if these individuals had not smoked cigarettes. Among never users of tobacco, alcohol consumption was associated with an increased risk of head and neck cancer only when alcohol was consumed at high frequency (OR for three or more drinks per day versus never drinking = 2.04, 95% CI = 1.29 to 3.21). The association with high-frequency alcohol intake was limited to cancers of the oropharynx/hypopharynx and larynx. Conclusions: Our results represent the most precise estimates available of the independent association of each of the two main risk factors of head and neck cancer, and they exemplify the strengths of large-scale consortia in cancer epidemiology.
AB - Background: At least 75% of head and neck cancers are attributable to a combination of cigarette smoking and alcohol drinking. A precise understanding of the independent association of each of these factors in the absence of the other with the risk of head and neck cancer is needed to elucidate mechanisms of head and neck carcinogenesis and to assess the efficacy of interventions aimed at controlling either risk factor. Methods: We examined the extent to which head and neck cancer is associated with cigarette smoking among never drinkers and with alcohol drinking among never users of tobacco. We pooled individual-level data from 15 case - control studies that included 10 244 head and neck cancer case subjects and 15 227 control subjects, of whom 1072 case subjects and 5775 control subjects were never users of tobacco and 1598 case subjects and 4051 control subjects were never drinkers of alcohol. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. All statistical tests were two-sided. Results: Among never drinkers, cigarette smoking was associated with an increased risk of head and neck cancer (OR for ever versus never smoking = 2.13, 95% CI = 1.52 to 2.98), and there were clear dose - response relationships for the frequency, duration, and number of pack-years of cigarette smoking. Approximately 24% (95% CI = 16% to 31%) of head and neck cancer cases among nondrinkers in this study would have been prevented if these individuals had not smoked cigarettes. Among never users of tobacco, alcohol consumption was associated with an increased risk of head and neck cancer only when alcohol was consumed at high frequency (OR for three or more drinks per day versus never drinking = 2.04, 95% CI = 1.29 to 3.21). The association with high-frequency alcohol intake was limited to cancers of the oropharynx/hypopharynx and larynx. Conclusions: Our results represent the most precise estimates available of the independent association of each of the two main risk factors of head and neck cancer, and they exemplify the strengths of large-scale consortia in cancer epidemiology.
UR - http://www.scopus.com/inward/record.url?scp=34447266437&partnerID=8YFLogxK
U2 - 10.1093/jnci/djk179
DO - 10.1093/jnci/djk179
M3 - Article
C2 - 17505073
AN - SCOPUS:34447266437
SN - 0027-8874
VL - 99
SP - 777
EP - 789
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 10
ER -