Interaction between tobacco and alcohol use and the risk of head and neck cancer

Pooled analysis in the international head and neck cancer Epidemiology consortium

Mia Hashibe, Paul Brennan, Shu Chun Chuang, Stefania Boccia, Xavier Castellsague, Chu Chen, Maria Paula Curado, Luigino Dal Maso, Alexander W. Daudt, Eleonora Fabianova, Leticia Fernandez, Victor Wünsch-Filho, Silvia Franceschi, Richard B. Hayes, Rolando Herrero, Karl Kelsey, Sergio Koifman, Carlo La Vecchia, Philip Lazarus, Fabio Levi & 23 others Juan J. Lence, Dana Mates, Elena Matos, Ana Menezes, Michael D. McClean, Joshua Muscat, Jose Eluf-Neto, Andrew F. Olshan, Mark Purdue, Peter Rudnai, Stephen M. Schwartz, Elaine Smith, Erich M. Sturgis, Neonilia Szeszenia-Dabrowska, Renato Talamini, Qingyi Wei, Deborah M. Winn, Oxana Shangina, Agnieszka Pilarska, Zuo Feng Zhang, Gilles Ferro, Julien Berthiller, Paolo Boffetta

Research output: Contribution to journalArticle

507 Citations (Scopus)

Abstract

Background: The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear because studies have used various methods to quantify the excess head and neck cancer burden. Methods: We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). Results: A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ = 2.15; 95% confidence interval, 1.53-3.04). The PAR for tobacco or alcohol was 72% (95% confidence interval, 61-79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due to tobacco alone, and 35% was due to tobacco and alcohol combined. The total PAR differed by subsite (64% for oral cavity cancer, 72% for pharyngeal cancer, 89% for laryngeal cancer), by sex (74% for men, 57% for women), by age (33% for cases <45 years, 73% for cases >60 years), and by region (84% in Europe, 51% in North America, 83% in Latin America). Conclusions: Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer and for head and neck cancer among women and among young-onset cases.

Original languageEnglish (US)
Pages (from-to)541-550
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2009

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Tobacco Use
Head and Neck Neoplasms
Epidemiology
Alcohols
Tobacco
Mouth Neoplasms
Mouth
Pharyngeal Neoplasms
Confidence Intervals
Population
Laryngeal Neoplasms
Latin America
North America
Case-Control Studies

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

Hashibe, Mia ; Brennan, Paul ; Chuang, Shu Chun ; Boccia, Stefania ; Castellsague, Xavier ; Chen, Chu ; Curado, Maria Paula ; Maso, Luigino Dal ; Daudt, Alexander W. ; Fabianova, Eleonora ; Fernandez, Leticia ; Wünsch-Filho, Victor ; Franceschi, Silvia ; Hayes, Richard B. ; Herrero, Rolando ; Kelsey, Karl ; Koifman, Sergio ; Vecchia, Carlo La ; Lazarus, Philip ; Levi, Fabio ; Lence, Juan J. ; Mates, Dana ; Matos, Elena ; Menezes, Ana ; McClean, Michael D. ; Muscat, Joshua ; Eluf-Neto, Jose ; Olshan, Andrew F. ; Purdue, Mark ; Rudnai, Peter ; Schwartz, Stephen M. ; Smith, Elaine ; Sturgis, Erich M. ; Szeszenia-Dabrowska, Neonilia ; Talamini, Renato ; Wei, Qingyi ; Winn, Deborah M. ; Shangina, Oxana ; Pilarska, Agnieszka ; Zhang, Zuo Feng ; Ferro, Gilles ; Berthiller, Julien ; Boffetta, Paolo. / Interaction between tobacco and alcohol use and the risk of head and neck cancer : Pooled analysis in the international head and neck cancer Epidemiology consortium. In: Cancer Epidemiology Biomarkers and Prevention. 2009 ; Vol. 18, No. 2. pp. 541-550.
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title = "Interaction between tobacco and alcohol use and the risk of head and neck cancer: Pooled analysis in the international head and neck cancer Epidemiology consortium",
abstract = "Background: The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear because studies have used various methods to quantify the excess head and neck cancer burden. Methods: We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). Results: A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ = 2.15; 95{\%} confidence interval, 1.53-3.04). The PAR for tobacco or alcohol was 72{\%} (95{\%} confidence interval, 61-79{\%}) for head and neck cancer, of which 4{\%} was due to alcohol alone, 33{\%} was due to tobacco alone, and 35{\%} was due to tobacco and alcohol combined. The total PAR differed by subsite (64{\%} for oral cavity cancer, 72{\%} for pharyngeal cancer, 89{\%} for laryngeal cancer), by sex (74{\%} for men, 57{\%} for women), by age (33{\%} for cases <45 years, 73{\%} for cases >60 years), and by region (84{\%} in Europe, 51{\%} in North America, 83{\%} in Latin America). Conclusions: Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer and for head and neck cancer among women and among young-onset cases.",
author = "Mia Hashibe and Paul Brennan and Chuang, {Shu Chun} and Stefania Boccia and Xavier Castellsague and Chu Chen and Curado, {Maria Paula} and Maso, {Luigino Dal} and Daudt, {Alexander W.} and Eleonora Fabianova and Leticia Fernandez and Victor W{\"u}nsch-Filho and Silvia Franceschi and Hayes, {Richard B.} and Rolando Herrero and Karl Kelsey and Sergio Koifman and Vecchia, {Carlo La} and Philip Lazarus and Fabio Levi and Lence, {Juan J.} and Dana Mates and Elena Matos and Ana Menezes and McClean, {Michael D.} and Joshua Muscat and Jose Eluf-Neto and Olshan, {Andrew F.} and Mark Purdue and Peter Rudnai and Schwartz, {Stephen M.} and Elaine Smith and Sturgis, {Erich M.} and Neonilia Szeszenia-Dabrowska and Renato Talamini and Qingyi Wei and Winn, {Deborah M.} and Oxana Shangina and Agnieszka Pilarska and Zhang, {Zuo Feng} and Gilles Ferro and Julien Berthiller and Paolo Boffetta",
year = "2009",
month = "2",
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doi = "10.1158/1055-9965.EPI-08-0347",
language = "English (US)",
volume = "18",
pages = "541--550",
journal = "Cancer Epidemiology Biomarkers and Prevention",
issn = "1055-9965",
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Hashibe, M, Brennan, P, Chuang, SC, Boccia, S, Castellsague, X, Chen, C, Curado, MP, Maso, LD, Daudt, AW, Fabianova, E, Fernandez, L, Wünsch-Filho, V, Franceschi, S, Hayes, RB, Herrero, R, Kelsey, K, Koifman, S, Vecchia, CL, Lazarus, P, Levi, F, Lence, JJ, Mates, D, Matos, E, Menezes, A, McClean, MD, Muscat, J, Eluf-Neto, J, Olshan, AF, Purdue, M, Rudnai, P, Schwartz, SM, Smith, E, Sturgis, EM, Szeszenia-Dabrowska, N, Talamini, R, Wei, Q, Winn, DM, Shangina, O, Pilarska, A, Zhang, ZF, Ferro, G, Berthiller, J & Boffetta, P 2009, 'Interaction between tobacco and alcohol use and the risk of head and neck cancer: Pooled analysis in the international head and neck cancer Epidemiology consortium', Cancer Epidemiology Biomarkers and Prevention, vol. 18, no. 2, pp. 541-550. https://doi.org/10.1158/1055-9965.EPI-08-0347

Interaction between tobacco and alcohol use and the risk of head and neck cancer : Pooled analysis in the international head and neck cancer Epidemiology consortium. / Hashibe, Mia; Brennan, Paul; Chuang, Shu Chun; Boccia, Stefania; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Maso, Luigino Dal; Daudt, Alexander W.; Fabianova, Eleonora; Fernandez, Leticia; Wünsch-Filho, Victor; Franceschi, Silvia; Hayes, Richard B.; Herrero, Rolando; Kelsey, Karl; Koifman, Sergio; Vecchia, Carlo La; Lazarus, Philip; Levi, Fabio; Lence, Juan J.; Mates, Dana; Matos, Elena; Menezes, Ana; McClean, Michael D.; Muscat, Joshua; Eluf-Neto, Jose; Olshan, Andrew F.; Purdue, Mark; Rudnai, Peter; Schwartz, Stephen M.; Smith, Elaine; Sturgis, Erich M.; Szeszenia-Dabrowska, Neonilia; Talamini, Renato; Wei, Qingyi; Winn, Deborah M.; Shangina, Oxana; Pilarska, Agnieszka; Zhang, Zuo Feng; Ferro, Gilles; Berthiller, Julien; Boffetta, Paolo.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 18, No. 2, 01.02.2009, p. 541-550.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Interaction between tobacco and alcohol use and the risk of head and neck cancer

T2 - Pooled analysis in the international head and neck cancer Epidemiology consortium

AU - Hashibe, Mia

AU - Brennan, Paul

AU - Chuang, Shu Chun

AU - Boccia, Stefania

AU - Castellsague, Xavier

AU - Chen, Chu

AU - Curado, Maria Paula

AU - Maso, Luigino Dal

AU - Daudt, Alexander W.

AU - Fabianova, Eleonora

AU - Fernandez, Leticia

AU - Wünsch-Filho, Victor

AU - Franceschi, Silvia

AU - Hayes, Richard B.

AU - Herrero, Rolando

AU - Kelsey, Karl

AU - Koifman, Sergio

AU - Vecchia, Carlo La

AU - Lazarus, Philip

AU - Levi, Fabio

AU - Lence, Juan J.

AU - Mates, Dana

AU - Matos, Elena

AU - Menezes, Ana

AU - McClean, Michael D.

AU - Muscat, Joshua

AU - Eluf-Neto, Jose

AU - Olshan, Andrew F.

AU - Purdue, Mark

AU - Rudnai, Peter

AU - Schwartz, Stephen M.

AU - Smith, Elaine

AU - Sturgis, Erich M.

AU - Szeszenia-Dabrowska, Neonilia

AU - Talamini, Renato

AU - Wei, Qingyi

AU - Winn, Deborah M.

AU - Shangina, Oxana

AU - Pilarska, Agnieszka

AU - Zhang, Zuo Feng

AU - Ferro, Gilles

AU - Berthiller, Julien

AU - Boffetta, Paolo

PY - 2009/2/1

Y1 - 2009/2/1

N2 - Background: The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear because studies have used various methods to quantify the excess head and neck cancer burden. Methods: We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). Results: A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ = 2.15; 95% confidence interval, 1.53-3.04). The PAR for tobacco or alcohol was 72% (95% confidence interval, 61-79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due to tobacco alone, and 35% was due to tobacco and alcohol combined. The total PAR differed by subsite (64% for oral cavity cancer, 72% for pharyngeal cancer, 89% for laryngeal cancer), by sex (74% for men, 57% for women), by age (33% for cases <45 years, 73% for cases >60 years), and by region (84% in Europe, 51% in North America, 83% in Latin America). Conclusions: Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer and for head and neck cancer among women and among young-onset cases.

AB - Background: The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear because studies have used various methods to quantify the excess head and neck cancer burden. Methods: We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). Results: A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ = 2.15; 95% confidence interval, 1.53-3.04). The PAR for tobacco or alcohol was 72% (95% confidence interval, 61-79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due to tobacco alone, and 35% was due to tobacco and alcohol combined. The total PAR differed by subsite (64% for oral cavity cancer, 72% for pharyngeal cancer, 89% for laryngeal cancer), by sex (74% for men, 57% for women), by age (33% for cases <45 years, 73% for cases >60 years), and by region (84% in Europe, 51% in North America, 83% in Latin America). Conclusions: Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer and for head and neck cancer among women and among young-onset cases.

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U2 - 10.1158/1055-9965.EPI-08-0347

DO - 10.1158/1055-9965.EPI-08-0347

M3 - Article

VL - 18

SP - 541

EP - 550

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

SN - 1055-9965

IS - 2

ER -