Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium

Tatiana Natasha Toporcov; Ariana Znaor; Zuo Feng Zhang; Guo Pei Yu; Deborah M. Winn; Qingyi Wei; Marta Vilensky; Thomas Vaughan; Peter Thomson; Renato Talamini; Neonila Szeszenia-Dabrowska; Erich M. Sturgis; Elaine Smith; Oxana Shangina; Stephen M. Schwartz; Stimson Schantz; Peter Rudnai; Lorenzo Richiardi; Heribert Ramroth; Mark P. Purdue; Andrew F. Olshan; José Eluf-Neto; Joshua Muscat; Raquel Ajub Moyses; Hal Morgenstern; Ana Menezes; Michael McClean; Keitaro Matsuo; Dana Mates; Tatiana V. Macfarlane; Jolanta Lissowska; Fabio Levi; Philip Lazarus; Carlo La Vecchia; Pagona Lagiou; Sergio Koifman; Kristina Kjaerheim; Karl Kelsey; Ivana Holcatova; Rolando Herrero; Claire Healy; Richard B. Hayes; Silvia Franceschi; Leticia Fernandez; Eleonora Fabianova; Alexander W. Daudt; Otávio Alberto Curioni; Luigino Dal Maso; Maria Paula Curado; David I. Conway; Chu Chen; Xavier Castellsague; Cristina Canova; Gabriella Cadoni; Paul Brennan; Stefania Boccia; José Leopoldo Ferreira Antunes; Wolfgang Ahrens; Antonio Agudo; Paolo Boffetta; Mia Hashibe; Yuan Chin Amy Lee; Victor Wünsch Filho

doi:10.1093/ije/dyu255

Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium

Tatiana Natasha Toporcov, Ariana Znaor, Zuo Feng Zhang, Guo Pei Yu, Deborah M. Winn, Qingyi Wei, Marta Vilensky, Thomas Vaughan, Peter Thomson, Renato Talamini, Neonila Szeszenia-Dabrowska, Erich M. Sturgis, Elaine Smith, Oxana Shangina, Stephen M. Schwartz, Stimson Schantz, Peter Rudnai, Lorenzo Richiardi, Heribert Ramroth, Mark P. PurdueAndrew F. Olshan, José Eluf-Neto, Joshua Muscat, Raquel Ajub Moyses, Hal Morgenstern, Ana Menezes, Michael McClean, Keitaro Matsuo, Dana Mates, Tatiana V. Macfarlane, Jolanta Lissowska, Fabio Levi, Philip Lazarus, Carlo La Vecchia, Pagona Lagiou, Sergio Koifman, Kristina Kjaerheim, Karl Kelsey, Ivana Holcatova, Rolando Herrero, Claire Healy, Richard B. Hayes, Silvia Franceschi, Leticia Fernandez, Eleonora Fabianova, Alexander W. Daudt, Otávio Alberto Curioni, Luigino Dal Maso, Maria Paula Curado, David I. Conway, Chu Chen, Xavier Castellsague, Cristina Canova, Gabriella Cadoni, Paul Brennan, Stefania Boccia, José Leopoldo Ferreira Antunes, Wolfgang Ahrens, Antonio Agudo, Paolo Boffetta, Mia Hashibe, Yuan Chin Amy Lee, Victor Wünsch Filho

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Abstract

Background: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults 45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity/oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI=9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking=5.3% (11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR=2.27 (95% CI=1.26, 4.10)], but not in the older adults [OR=1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (2.41%, 5.80%) in older adults. Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.

Original language	English
Pages (from-to)	169-185
Number of pages	17
Journal	International Journal of Epidemiology
Volume	44
Issue number	1
DOIs	https://doi.org/10.1093/ije/dyu255
State	Published - 1 Feb 2015

Keywords

Adult
Alcohol drinking
Diet
Head and neck neoplasms
Smoking

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10.1093/ije/dyu255

Cite this

Toporcov, T. N., Znaor, A., Zhang, Z. F., Yu, G. P., Winn, D. M., Wei, Q., Vilensky, M., Vaughan, T., Thomson, P., Talamini, R., Szeszenia-Dabrowska, N., Sturgis, E. M., Smith, E., Shangina, O., Schwartz, S. M., Schantz, S., Rudnai, P., Richiardi, L., Ramroth, H., ... Filho, V. W. (2015). Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium. International Journal of Epidemiology, 44(1), 169-185. https://doi.org/10.1093/ije/dyu255

@article{3632f8e697444905846b53a6c1dfd33d,

title = "Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium",

abstract = "Background: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults 45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity/oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI=9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking=5.3% (11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR=2.27 (95% CI=1.26, 4.10)], but not in the older adults [OR=1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (2.41%, 5.80%) in older adults. Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.",

keywords = "Adult, Alcohol drinking, Diet, Head and neck neoplasms, Smoking",

author = "Toporcov, {Tatiana Natasha} and Ariana Znaor and Zhang, {Zuo Feng} and Yu, {Guo Pei} and Winn, {Deborah M.} and Qingyi Wei and Marta Vilensky and Thomas Vaughan and Peter Thomson and Renato Talamini and Neonila Szeszenia-Dabrowska and Sturgis, {Erich M.} and Elaine Smith and Oxana Shangina and Schwartz, {Stephen M.} and Stimson Schantz and Peter Rudnai and Lorenzo Richiardi and Heribert Ramroth and Purdue, {Mark P.} and Olshan, {Andrew F.} and Jos{\'e} Eluf-Neto and Joshua Muscat and Moyses, {Raquel Ajub} and Hal Morgenstern and Ana Menezes and Michael McClean and Keitaro Matsuo and Dana Mates and Macfarlane, {Tatiana V.} and Jolanta Lissowska and Fabio Levi and Philip Lazarus and Vecchia, {Carlo La} and Pagona Lagiou and Sergio Koifman and Kristina Kjaerheim and Karl Kelsey and Ivana Holcatova and Rolando Herrero and Claire Healy and Hayes, {Richard B.} and Silvia Franceschi and Leticia Fernandez and Eleonora Fabianova and Daudt, {Alexander W.} and Curioni, {Ot{\'a}vio Alberto} and Maso, {Luigino Dal} and Curado, {Maria Paula} and Conway, {David I.} and Chu Chen and Xavier Castellsague and Cristina Canova and Gabriella Cadoni and Paul Brennan and Stefania Boccia and Antunes, {Jos{\'e} Leopoldo Ferreira} and Wolfgang Ahrens and Antonio Agudo and Paolo Boffetta and Mia Hashibe and Lee, {Yuan Chin Amy} and Filho, {Victor W{\"u}nsch}",

note = "Funding Information: This work was supported by the US National Institutes of Health, the National Cancer Institute [R03CA113157] and the National Institute of Dental and Craniofacial Health [R03DE016611]. The individual studies were funded by the following grants: Milan study: Italian Association for Research on Cancer (AIRC); Aviano study: Italian Association for Research on Cancer (AIRC), Italian League Against Cancer and Italian Ministry of Research; France study: Swiss League against Cancer [KFS1069-09-2000], Fribourg League against Cancer [FOR381.88], Swiss Cancer Research [AKT 617] and Gustave-Roussy Institute [88D28]; Italy multicentre study: Italian Association for Research on Cancer (AIRC), Italian League against Cancer and Italian Ministry of Research; Swiss study: Swiss League against Cancer and the Swiss Research against Cancer/ Oncosuisse [KFS-700, OCS-1633]; Central Europe study: World Cancer Research Fund and the European Commission INCO-COPERNICUS Program [Contract No. IC15-CT98-0332]; New York study: National Institutes of Health (NIH) US [P01CA068384 K07CA104231]; Seattle study: NIH [R01CA048996, R01DE012609]; Iowa study: NIH [NIDCR R01DE11979, NIDCR R01DE13110, NIH FIRCA TW01500] and Veterans Affairs Merit Review Funds; North Carolina study: NIH [R01CA61188] and in part by a grant from the National Institute of Environmental Health Sciences [P30ES010126]; Tampa study: NIH [P01CA068384, K07CA104231, R01DE13158]; Los Angeles study: NIH [P50CA90388, R01DA11386, R03CA77954, T32CA09142, U01CA96134, R21ES011667] and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center; Houston study: NIH [R01ES11740, R01CA100264]; Puerto Rico study: jointly funded by National Institutes of Health (NCI) US and NIDCR intramural programmes; Latin America study: Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina, IMIM (Barcelona), Fundac¸{\~a}o de Amparo {\`a} Pesquisa no Estado de Sao Paulo (FAPESP) [No 01/ 01768-2] and European Commission [IC18-CT97-0222]; IARC multicentre study: Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government [FIS 97/ 0024, FIS 97/0662, BAE 01/5013], International Union Against Cancer (UICC) and Yamagiwa-Yoshida Memorial International Cancer Study Grant; Boston study: National Institutes of Health (NIH) US [R01CA078609, R01CA100679]; Rome study: AIRC (Italian Agency for Research on Cancer) [10068]; US multicentre study: the Intramural Program of the NCI, NIH, United States; S{\~a}o Paulo study: Fundac¸{\~a}o de Amparo a Pesquisa no Estado de S{\~a}o Paulo (FAPESP) [04/12054-9, 10/51168-0]; MSKCC study: NIH [R01CA51845]; Seattle study: NIH [R01CA30022]; European study: European Community (5th Framework Programme) [QLK1-CT-2001-00182]; Germany-Heidelberg study: German Ministry of Education and Research [01GB9702/3]; Japan study: Scientific Research grant from the Ministry of Education, Science, Sports, Culture and Technology of Japan [17015052] and a grant for the Third-Term Comprehensive 10-Year Strategy for Cancer Control from the Ministry of Health, Labour and Welfare of Japan [H20-002].",

year = "2015",

month = feb,

day = "1",

doi = "10.1093/ije/dyu255",

language = "English",

volume = "44",

pages = "169--185",

journal = "International Journal of Epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

number = "1",

}

Toporcov, TN, Znaor, A, Zhang, ZF, Yu, GP, Winn, DM, Wei, Q, Vilensky, M, Vaughan, T, Thomson, P, Talamini, R, Szeszenia-Dabrowska, N, Sturgis, EM, Smith, E, Shangina, O, Schwartz, SM, Schantz, S, Rudnai, P, Richiardi, L, Ramroth, H, Purdue, MP, Olshan, AF, Eluf-Neto, J, Muscat, J, Moyses, RA, Morgenstern, H, Menezes, A, McClean, M, Matsuo, K, Mates, D, Macfarlane, TV, Lissowska, J, Levi, F, Lazarus, P, Vecchia, CL, Lagiou, P, Koifman, S, Kjaerheim, K, Kelsey, K, Holcatova, I, Herrero, R, Healy, C, Hayes, RB, Franceschi, S, Fernandez, L, Fabianova, E, Daudt, AW, Curioni, OA, Maso, LD, Curado, MP, Conway, DI, Chen, C, Castellsague, X, Canova, C, Cadoni, G, Brennan, P, Boccia, S, Antunes, JLF, Ahrens, W, Agudo, A, Boffetta, P, Hashibe, M, Lee, YCA & Filho, VW 2015, 'Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium', International Journal of Epidemiology, vol. 44, no. 1, pp. 169-185. https://doi.org/10.1093/ije/dyu255

TY - JOUR

T1 - Risk factors for head and neck cancer in young adults

T2 - A pooled analysis in the INHANCE consortium

AU - Toporcov, Tatiana Natasha

AU - Znaor, Ariana

AU - Zhang, Zuo Feng

AU - Yu, Guo Pei

AU - Winn, Deborah M.

AU - Wei, Qingyi

AU - Vilensky, Marta

AU - Vaughan, Thomas

AU - Thomson, Peter

AU - Talamini, Renato

AU - Szeszenia-Dabrowska, Neonila

AU - Sturgis, Erich M.

AU - Smith, Elaine

AU - Shangina, Oxana

AU - Schwartz, Stephen M.

AU - Schantz, Stimson

AU - Rudnai, Peter

AU - Richiardi, Lorenzo

AU - Ramroth, Heribert

AU - Purdue, Mark P.

AU - Olshan, Andrew F.

AU - Eluf-Neto, José

AU - Muscat, Joshua

AU - Moyses, Raquel Ajub

AU - Morgenstern, Hal

AU - Menezes, Ana

AU - McClean, Michael

AU - Matsuo, Keitaro

AU - Mates, Dana

AU - Macfarlane, Tatiana V.

AU - Lissowska, Jolanta

AU - Levi, Fabio

AU - Lazarus, Philip

AU - Vecchia, Carlo La

AU - Lagiou, Pagona

AU - Koifman, Sergio

AU - Kjaerheim, Kristina

AU - Kelsey, Karl

AU - Holcatova, Ivana

AU - Herrero, Rolando

AU - Healy, Claire

AU - Hayes, Richard B.

AU - Franceschi, Silvia

AU - Fernandez, Leticia

AU - Fabianova, Eleonora

AU - Daudt, Alexander W.

AU - Curioni, Otávio Alberto

AU - Maso, Luigino Dal

AU - Curado, Maria Paula

AU - Conway, David I.

AU - Chen, Chu

AU - Castellsague, Xavier

AU - Canova, Cristina

AU - Cadoni, Gabriella

AU - Brennan, Paul

AU - Boccia, Stefania

AU - Antunes, José Leopoldo Ferreira

AU - Ahrens, Wolfgang

AU - Agudo, Antonio

AU - Boffetta, Paolo

AU - Hashibe, Mia

AU - Lee, Yuan Chin Amy

AU - Filho, Victor Wünsch

N1 - Funding Information: This work was supported by the US National Institutes of Health, the National Cancer Institute [R03CA113157] and the National Institute of Dental and Craniofacial Health [R03DE016611]. The individual studies were funded by the following grants: Milan study: Italian Association for Research on Cancer (AIRC); Aviano study: Italian Association for Research on Cancer (AIRC), Italian League Against Cancer and Italian Ministry of Research; France study: Swiss League against Cancer [KFS1069-09-2000], Fribourg League against Cancer [FOR381.88], Swiss Cancer Research [AKT 617] and Gustave-Roussy Institute [88D28]; Italy multicentre study: Italian Association for Research on Cancer (AIRC), Italian League against Cancer and Italian Ministry of Research; Swiss study: Swiss League against Cancer and the Swiss Research against Cancer/ Oncosuisse [KFS-700, OCS-1633]; Central Europe study: World Cancer Research Fund and the European Commission INCO-COPERNICUS Program [Contract No. IC15-CT98-0332]; New York study: National Institutes of Health (NIH) US [P01CA068384 K07CA104231]; Seattle study: NIH [R01CA048996, R01DE012609]; Iowa study: NIH [NIDCR R01DE11979, NIDCR R01DE13110, NIH FIRCA TW01500] and Veterans Affairs Merit Review Funds; North Carolina study: NIH [R01CA61188] and in part by a grant from the National Institute of Environmental Health Sciences [P30ES010126]; Tampa study: NIH [P01CA068384, K07CA104231, R01DE13158]; Los Angeles study: NIH [P50CA90388, R01DA11386, R03CA77954, T32CA09142, U01CA96134, R21ES011667] and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center; Houston study: NIH [R01ES11740, R01CA100264]; Puerto Rico study: jointly funded by National Institutes of Health (NCI) US and NIDCR intramural programmes; Latin America study: Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina, IMIM (Barcelona), Fundac¸ão de Amparo à Pesquisa no Estado de Sao Paulo (FAPESP) [No 01/ 01768-2] and European Commission [IC18-CT97-0222]; IARC multicentre study: Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government [FIS 97/ 0024, FIS 97/0662, BAE 01/5013], International Union Against Cancer (UICC) and Yamagiwa-Yoshida Memorial International Cancer Study Grant; Boston study: National Institutes of Health (NIH) US [R01CA078609, R01CA100679]; Rome study: AIRC (Italian Agency for Research on Cancer) [10068]; US multicentre study: the Intramural Program of the NCI, NIH, United States; São Paulo study: Fundac¸ão de Amparo a Pesquisa no Estado de São Paulo (FAPESP) [04/12054-9, 10/51168-0]; MSKCC study: NIH [R01CA51845]; Seattle study: NIH [R01CA30022]; European study: European Community (5th Framework Programme) [QLK1-CT-2001-00182]; Germany-Heidelberg study: German Ministry of Education and Research [01GB9702/3]; Japan study: Scientific Research grant from the Ministry of Education, Science, Sports, Culture and Technology of Japan [17015052] and a grant for the Third-Term Comprehensive 10-Year Strategy for Cancer Control from the Ministry of Health, Labour and Welfare of Japan [H20-002].

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults 45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity/oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI=9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking=5.3% (11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR=2.27 (95% CI=1.26, 4.10)], but not in the older adults [OR=1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (2.41%, 5.80%) in older adults. Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.

AB - Background: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults 45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity/oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI=9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking=5.3% (11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR=2.27 (95% CI=1.26, 4.10)], but not in the older adults [OR=1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (2.41%, 5.80%) in older adults. Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.

KW - Adult

KW - Alcohol drinking

KW - Diet

KW - Head and neck neoplasms

KW - Smoking

UR - http://www.scopus.com/inward/record.url?scp=84924584545&partnerID=8YFLogxK

U2 - 10.1093/ije/dyu255

DO - 10.1093/ije/dyu255

M3 - Article

C2 - 25613428

AN - SCOPUS:84924584545

SN - 0300-5771

VL - 44

SP - 169

EP - 185

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 1

ER -

Risk factors for head and neck cancer in young adults: A pooled analysis in the INHANCE consortium

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Keywords

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