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Cancer Epidemiol. 2019 Apr;59:173-177. doi: 10.1016/j.canep.2019.01.020. Epub 2019 Feb 19.

Involuntary smoking and the risk of head and neck cancer in an East Asian population.

Author information

1
Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States. Electronic address: mia.hashibe@utah.edu.
2
Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
3
Genomics Research Center, Academia Sinica, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
4
Genomics Research Center, Academia Sinica, Taipei, Taiwan.
5
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
6
Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China.
7
Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
8
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
9
Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China.
10
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
11
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
12
Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China.
13
Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China.
14
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States.
15
Department of Epidemiology, and Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles, CA, United States.
16
National Office of Cancer Prevention & Control Cancer Institute & Hospital, and Chinese Academy of Medical Sciences, Beijing, China.
17
Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States.

Abstract

BACKGROUND:

Although tobacco involuntary smoking is an established risk factor for lung cancer, the association with head and neck cancer (HNC) is not established. We aimed to investigate this potential association in an East Asian population.

METHODS:

We conducted a multicenter case-control study in East Asia including eight centers. We restricted our analysis to never tobacco smokers (303 cases and 459 controls) and to never tobacco smokers/never alcohol drinkers (243 cases and 403 controls).

RESULTS:

Among never tobacco smokers, involuntary smoking was associated with a 1.47-fold increase in risk of HNC (95%CI = 1.02, 2.13) and a 1.8-fold increase in the risk of oral cavity cancer (95%CI = 1.14, 2.92). Among never tobacco smokers who were also never alcohol drinkers, increased risks were detected for more than 3 h per day of involuntary smoking exposure and for 15 or more years of exposure. A dose-response relation was suggested for frequency of exposure (p for trend = 0.014) and for years of exposure (p for trend = 0.010) for oral cavity cancer. We did not detect strong increases in the risk of the other HNC subsites.

CONCLUSIONS:

Our study supports the association between involuntary smoking and the risk of HNC. The association may be stronger for oral cavity cancer than for other HNC subsites.

KEYWORDS:

Head and neck cancer; Involuntary smoking; Never alcohol drinkers; Never tobacco smokers

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