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Int J Epidemiol. 2016 Jun;45(3):835-45. doi: 10.1093/ije/dyv146. Epub 2015 Jul 30.

Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis.

Author information

1
International Agency for Research on Cancer, Lyon, France, Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France.
2
International Agency for Research on Cancer, Lyon, France.
3
Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
4
Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany.
5
Instituto do Câncer do Estado de Sao Paulo (ICESP), Sao Paulo, Brazil.
6
Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy, L'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
7
Head and Neck Surgery Department, Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
8
University of Padua, Padua, Italy.
9
Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
10
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
11
Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
12
International Prevention Research Institute, Lyon, France.
13
Aviano Cancer Centre, Aviano, Italy.
14
Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
15
Regional Authority of Public Health, Banska Bystrica, Slovakia.
16
Institute of Oncology and Radiobiology, La Havana, Cuba, Instituto do Câncer do Estado de Sao Paulo (ICESP), Sao Paulo, Brazil.
17
Division of Epidemiology, New York University School Of Medicine, New York, NY, USA.
18
Trinity College School of Dental Science, Dublin, Ireland.
19
Institute of Hygiene and Epidemiology, Prague, Czech Republic.
20
Brown University, Providence, RI, USA.
21
Cancer Registry of Norway, Oslo, Norway.
22
Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.
23
University of Athens School of Medicine, Athens, Greece.
24
Istituto Di Ricovero e Cura a Carattere Scientific IRCCS, Milan, Italy.
25
Washington State University College of Pharmacy, Spokane, WA, USA.
26
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
27
M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Cancer Epidemiology and Prevention, Warsaw, Poland.
28
University of Aberdeen Dental School, Aberdeen, UK.
29
National Institute of Public Health, Bucharest, Romania.
30
Boston University School of Public Health, Boston, MA, USA.
31
Universidade Federal de Pelotas, Pelotas, Brazil.
32
University of Turin, Turin, Italy.
33
Departments of Epidemiology, Environmental Health Sciences, and Urology, Schools of Public Health and Medicine, and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
34
Penn State College of Medicine, Hershey, PA, USA.
35
UNC School of Public Health, Chapel Hill, NC, USA.
36
National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
37
University of Heidelberg, Heidelberg, Germany.
38
National Institute of Environmental Health, Budapest, Hungary.
39
Cancer Research Centre, Moscow, Russia.
40
College of Public Health, University of Iowa, Iowa City, IA, USA.
41
UT-M.D. Anderson Cancer Center, Houston, TX, USA.
42
Institute of Occupational Medicine, Lodz, Poland.
43
University of Newcastle, Newcastle, UK.
44
Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina.
45
Universidade de Sao Paulo, Sao Paulo, Brazil.
46
UCLA School of Public Health, Los Angeles, CA, USA.
47
Croatian National Cancer Registry, Zagreb, Croatia.
48
Tisch Cancer Institute and Institute of Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
49
Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA and University of Utah School of Medicine, Salt Lake City, UT, USA.
50
University of Utah School of Medicine, Salt Lake City, UT, USA amy.lee@utah.edu.

Abstract

BACKGROUND:

Cigarette smoking is a major risk factor for head and neck cancer (HNC). To our knowledge, low cigarette smoking (<10 cigarettes per day) has not been extensively investigated in fine categories or among never alcohol drinkers.

METHODS:

We conducted a pooled analysis of individual participant data from 23 independent case-control studies including 19 660 HNC cases and 25 566 controls. After exclusion of subjects using other tobacco products including cigars, pipes, snuffed or chewed tobacco and straw cigarettes (tobacco product used in Brazil), as well as subjects smoking more than 10 cigarettes per day, 4093 HNC cases and 13 416 controls were included in the analysis. The lifetime average frequency of cigarette consumption was categorized as follows: never cigarette users, >0-3, >3-5, >5-10 cigarettes per day.

RESULTS:

Smoking >0-3 cigarettes per day was associated with a 50% increased risk of HNC in the study population [odds ratio (OR) = 1.52, 95% confidence interval (CI): (1.21, 1.90). Smoking >3-5 cigarettes per day was associated in each subgroup from OR = 2.01 (95% CI: 1.22, 3.31) among never alcohol drinkers to OR = 2.74 (95% CI: 2.01, 3.74) among women and in each cancer site, particularly laryngeal cancer (OR = 3.48, 95% CI: 2.40, 5.05). However, the observed increased risk of HNC for low smoking frequency was not found among smokers with smoking duration shorter than 20 years.

CONCLUSION:

Our results suggest a public health message that low frequency of cigarette consumption contributes to the development of HNC. However, smoking duration seems to play at least an equal or a stronger role in the development of HNC.

KEYWORDS:

Head and neck cancer; low frequency cigarette smoking; pooled analysis; risk factors

PMID:
26228584
PMCID:
PMC5005938
DOI:
10.1093/ije/dyv146
[Indexed for MEDLINE]
Free PMC Article

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