Smokeless tobacco use and the risk of head and neck cancer

Pooled analysis of US studies in the inhance consortium

Annah B. Wyss, Mia Hashibe, Yuan Chin Amy Lee, Shu Chun Chuang, Joshua Muscat, Chu Chen, Stephen M. Schwartz, Elaine Smith, Zuo Feng Zhang, Hal Morgenstern, Qingyi Wei, Guojun Li, Karl T. Kelsey, Michael McClean, Deborah M. Winn, Stimson Schantz, Guo Pei Yu, Maura L. Gillison, Jose P. Zevallos, Paolo Boffetta & 1 others Andrew F. Olshan

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.

Original languageEnglish (US)
Pages (from-to)703-716
Number of pages14
JournalAmerican journal of epidemiology
Volume184
Issue number10
DOIs
StatePublished - Jan 1 2016

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Smokeless Tobacco
Tobacco Use
Head and Neck Neoplasms
Mouth Neoplasms
Tobacco Products
Odds Ratio
Confidence Intervals
Mouth
Smoking
Pharyngeal Neoplasms
Laryngeal Neoplasms
Case-Control Studies
Epidemiology
Logistic Models

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Wyss, Annah B. ; Hashibe, Mia ; Lee, Yuan Chin Amy ; Chuang, Shu Chun ; Muscat, Joshua ; Chen, Chu ; Schwartz, Stephen M. ; Smith, Elaine ; Zhang, Zuo Feng ; Morgenstern, Hal ; Wei, Qingyi ; Li, Guojun ; Kelsey, Karl T. ; McClean, Michael ; Winn, Deborah M. ; Schantz, Stimson ; Yu, Guo Pei ; Gillison, Maura L. ; Zevallos, Jose P. ; Boffetta, Paolo ; Olshan, Andrew F. / Smokeless tobacco use and the risk of head and neck cancer : Pooled analysis of US studies in the inhance consortium. In: American journal of epidemiology. 2016 ; Vol. 184, No. 10. pp. 703-716.
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abstract = "Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95{\%} confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95{\%} confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95{\%} CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95{\%} CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95{\%} CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.",
author = "Wyss, {Annah B.} and Mia Hashibe and Lee, {Yuan Chin Amy} and Chuang, {Shu Chun} and Joshua Muscat and Chu Chen and Schwartz, {Stephen M.} and Elaine Smith and Zhang, {Zuo Feng} and Hal Morgenstern and Qingyi Wei and Guojun Li and Kelsey, {Karl T.} and Michael McClean and Winn, {Deborah M.} and Stimson Schantz and Yu, {Guo Pei} and Gillison, {Maura L.} and Zevallos, {Jose P.} and Paolo Boffetta and Olshan, {Andrew F.}",
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Wyss, AB, Hashibe, M, Lee, YCA, Chuang, SC, Muscat, J, Chen, C, Schwartz, SM, Smith, E, Zhang, ZF, Morgenstern, H, Wei, Q, Li, G, Kelsey, KT, McClean, M, Winn, DM, Schantz, S, Yu, GP, Gillison, ML, Zevallos, JP, Boffetta, P & Olshan, AF 2016, 'Smokeless tobacco use and the risk of head and neck cancer: Pooled analysis of US studies in the inhance consortium', American journal of epidemiology, vol. 184, no. 10, pp. 703-716. https://doi.org/10.1093/aje/kww075

Smokeless tobacco use and the risk of head and neck cancer : Pooled analysis of US studies in the inhance consortium. / Wyss, Annah B.; Hashibe, Mia; Lee, Yuan Chin Amy; Chuang, Shu Chun; Muscat, Joshua; Chen, Chu; Schwartz, Stephen M.; Smith, Elaine; Zhang, Zuo Feng; Morgenstern, Hal; Wei, Qingyi; Li, Guojun; Kelsey, Karl T.; McClean, Michael; Winn, Deborah M.; Schantz, Stimson; Yu, Guo Pei; Gillison, Maura L.; Zevallos, Jose P.; Boffetta, Paolo; Olshan, Andrew F.

In: American journal of epidemiology, Vol. 184, No. 10, 01.01.2016, p. 703-716.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Smokeless tobacco use and the risk of head and neck cancer

T2 - Pooled analysis of US studies in the inhance consortium

AU - Wyss, Annah B.

AU - Hashibe, Mia

AU - Lee, Yuan Chin Amy

AU - Chuang, Shu Chun

AU - Muscat, Joshua

AU - Chen, Chu

AU - Schwartz, Stephen M.

AU - Smith, Elaine

AU - Zhang, Zuo Feng

AU - Morgenstern, Hal

AU - Wei, Qingyi

AU - Li, Guojun

AU - Kelsey, Karl T.

AU - McClean, Michael

AU - Winn, Deborah M.

AU - Schantz, Stimson

AU - Yu, Guo Pei

AU - Gillison, Maura L.

AU - Zevallos, Jose P.

AU - Boffetta, Paolo

AU - Olshan, Andrew F.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.

AB - Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.

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DO - 10.1093/aje/kww075

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