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Active and Involuntary Tobacco Smoking and Upper Aerodigestive Tract Cancer Risks in a Multicenter Case-Control Study

Lookup NU author(s): Dr Ray Lowry


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Introduction: Several important issues for the established association between tobacco smoking and upper aerodigestive tract (UADT) cancer risks include the associations with smoking by cancer subsite, by type of tobacco, and among never alcohol drinkers and the associations with involuntary smoking among nonsmokers. Our aim was to examine these specific issues in a large-scale case-control study in Europe. Methods: Analysis was done on 2,103 UADT squamous cell carcinoma cases and 2,221 controls in the Alcohol-Related Cancers and Genetic Susceptibility in Europe project, a multicenter case-control study in 10 European countries. Unconditional logistic regression was done to obtain odds ratios (OR) and 95% confidence intervals (95% CI). Results: Compared with never tobacco smoking, current smoking was associated with UADT cancer risks (OR, 6.72; 95% CI, 5.45-8.30 for overall; OR, 5.83; 95% Cl, 4.50-7.54 for oral cavity and oropharynx; OR, 12.19; 95% CI, 8.29-17.92 for hypopharynx and larynx; and OR, 4.17; 95% CI, 2.45-7.10 for esophagus). Among never drinkers, dose-response relationships with tobacco smoking pack-years were observed for hypopharyngeal and laryngeal cancers (P-trend = 0.010) but not for oral cavity and oropharyngeal cancers (P-trend = 0.282). Among never smokers, ever exposure to involuntary smoking was associated with an increased risk of UADT cancers (OR, 1.60; 95% CI, 1.04-2.46). Conclusion: Our results corroborate that tobacco smoking may play a stronger role in the development of hypopharyngeal and laryngeal cancers than that of oral cavity and oropharyngeal cancers among never drinkers and that involuntary smoking is an important risk factor for UADT cancers. Public health interventions to reduce involuntary smoking exposure could help reduce UADT cancer incidence. (Cancer Epidemiol Biomarkers Prev 2009;18(12):3353-61)

Publication metadata

Author(s): Lee YCA, Marron M, Benhamou S, Bouchardy C, Ahrens W, Pohlabeln H, Lagiou P, Trichopoulos D, Agudo A, Castellsague X, Bencko V, Holcatova I, Kjaerheim K, Merletti F, Richiardi L, Macfarlane GJ, Macfarlane TV, Talamini R, Barzan L, Canova C, Simonato L, Conway DI, McKinney PA, Lowry RJ, Sneddon L, Znaor A, Healy CM, McCartan BE, Brennan P, Hashibe M

Publication type: Article

Publication status: Published

Journal: Cancer Epidemiology, Biomarkers and Prevention

Year: 2009

Volume: 18

Issue: 12

Pages: 3353-3361

ISSN (print): 1055-9965

ISSN (electronic): 1538-7755

Publisher: American Association for Cancer Research


DOI: 10.1158/1055-9965.EPI-09-0910


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