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

Lookup NU author(s): Professor Peter Thomson

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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.


Publication metadata

Author(s): 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, La Vecchia C, 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, Dal Maso L, 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, Wuensch V

Publication type: Article

Publication status: Published

Journal: International Journal of Epidemiology

Year: 2015

Volume: 44

Issue: 1

Pages: 169-185

Print publication date: 01/02/2015

Online publication date: 22/01/2015

Acceptance date: 01/12/2014

ISSN (print): 0300-5771

ISSN (electronic): 1464-3685

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1093/ije/dyu255

DOI: 10.1093/ije/dyu255


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Funding

Funder referenceFunder name
Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center
Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina
International Union Against Cancer (UICC)
Italian Association for Research on Cancer (AIRC)
Italian Ministry of Research
US multicentre study: the Intramural Program of the NCI, NIH, United States
Yamagiwa-Yoshida Memorial International Cancer Study Grant
IMIM (Barcelona)
Italian League Against Cancer
National Institutes of Health (NCI) US
NIDCR intramural programmes
Swiss League against Cancer
US National Institutes of Health
Veterans Affairs Merit Review Funds
World Cancer Research Fund
01/01768-2Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP)
01GB9702/3German Ministry of Education and Research
04/12054-9Sao Paulo study: Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP)
10/51168-0Sao Paulo study: Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP)
10068AIRC (Italian Agency for Research on Cancer)
17015052Ministry of Education, Science, Sports, Culture and Technology of Japan
88D28Gustave-Roussy Institute
AKT 617Swiss Cancer Research
BAE 01/5013IARC multicentre study: Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government
FOR381.88Fribourg League against Cancer
FIS 97/0024IARC multicentre study: Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government
FIS 97/0662IARC multicentre study: Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government
IC18-CT97-0222European Commission
KFS1069-09-2000Swiss League against Cancer
H20-002Ministry of Health, Labour and Welfare of Japan
IC15-CT98-0332European Commission INCO-COPERNICUS Program
K07CA104231NIH
KFS-700Swiss Research against Cancer/Oncosuisse
NIDCR R01DE11979NIH
NIDCR R01DE13110NIH
NIH FIRCA TW01500NIH
OCS-1633Swiss Research against Cancer/Oncosuisse
P01CA068384 K07CA104231National Institutes of Health (NIH) US
QLK1-CT-2001-00182European Community
R01CA100264NIH
R01CA51845NIH
R01CA61188NIH
R01DA11386NIH
R01DE13158NIH
R21ES011667NIH
P01CA068384NIH
P30ES010126National Institute of Environmental Health Sciences
P50CA90388NIH
T32CA09142NIH
R01CA048996NIH
R01CA078609National Institutes of Health (NIH) US
R01CA100679National Institutes of Health (NIH) US
R01CA30022NIH
R01DE012609NIH
R01ES11740NIH
R03CA113157National Cancer Institute
R03CA77954NIH
R03DE016611National Institute of Dental and Craniofacial Health
U01CA96134NIH

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