Chun-Pin Chang1, Shen-Chih Chang2, Shu-Chun Chuang3, Julien Berthiller4, Gilles Ferro5, Keitaro Matsuo6, Victor Wünsch-Filho7, Tatiana N Toporcov7, Marcos Brasilino de Carvalho8, Carlo La Vecchia9, Andrew F Olshan10, Jose P Zevallos11, Diego Serraino12, Joshua Muscat13, Erich M Sturgis14, Guojun Li14, Hal Morgenstern15, Fabio Levi16, Luigino Dal Maso12, Elaine Smith17, Karl Kelsey18, Michael McClean18, Thomas L Vaughan19, Philip Lazarus20, Heribert Ramroth21, Chu Chen19, Stephen M Schwartz19, Deborah M Winn22, Cristina Bosetti23, Valeria Edefonti9, Werner Garavello24, Eva Negri25, Richard B Hayes26, Mark P Purdue22, Stefania Boccia27, Gabriella Cadoni28, Oxana Shangina29, Rosalina Koifman30, Maria Paula Curado31, Marta Vilensky32, Beata Swiatkowska33, Rolando Herrero5, Silvia Franceschi34, Simone Benhamou35, Leticia Fernandez36, Ana M B Menezes37, Alexander W Daudt38, Dana Mates39, Stimson Schantz40, Guo-Pei Yu41, Jolanta Lissowska42, Hermann Brenner43, Eleonora Fabianova44, Peter Rudnai45, Paul Brennan5, Paolo Boffetta46, Zuo-Feng Zhang47, Mia Hashibe1, Yuan-Chin Amy Lee48. 1. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States. 2. International Agency for Research on Cancer, Lyon, France; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States. 3. Institute of Population Health Sciences, National Health Research Institutes, Taiwan. 4. International Agency for Research on Cancer, Lyon, France; Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France. 5. International Agency for Research on Cancer, Lyon, France. 6. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 7. Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil. 8. Department of Head and Neck, Heliopolis Hospital, São Paulo, Brazil. 9. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 10. Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, United States. 11. Division of Head and Neck Surgical Oncology, Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, United States. 12. Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy. 13. Penn State College of Medicine, Hershey, PA, United States. 14. University of Texas M. D. Anderson Cancer Center, Houston, TX, United States. 15. Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States. 16. Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland. 17. College of Public Health, University of Iowa, Iowa City, IA, United States. 18. Brown University, Providence, RI, United States. 19. Fred Hutchinson Cancer Research Center, Seattle, WA, United States. 20. Washington State University College of Pharmacy, Spokane, WA, United States. 21. University of Heidelberg, Heidelberg, Germany. 22. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States. 23. Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. 24. Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. 25. Department of Biomedical and Clinical Sciences, University of Milan, Italy. 26. Division of Epidemiology, New York University School of Medicine, New York, United States. 27. Institute of Public Health, Section of Hygiene, Universita Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy. 28. Department of Head and Neck Surgery, Institute of Clinical Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy; Istituto di Clinica Otorinolaringoiatrica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy. 29. Cancer Research Centre, Moscow, Russia. 30. Escola Nacional de Suade Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. 31. ACCAMARGO Cancer Center, São Paulo, Brazil. 32. Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina. 33. Nofer Institute of Occupational Medicine, Lodz, Poland. 34. Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy. 35. National Institute of Health and Medical Research, Inserm U1018, Villejuif, France. 36. Institute of Oncology and Radiobiology, Havana, Cuba. 37. Universidade Federal de Pelotas, Pelotas, Brazil. 38. Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. 39. National Institute of Public Health, Bucharest, Romania. 40. New York Eye and Ear Infirmary, New York, NY, United States. 41. Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, NY, United States. 42. The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland. 43. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany. 44. Regional Authority of Public Health in Banska Bystrica, Slovakia. 45. National Institute of Environmental Health, Budapest, Hungary. 46. The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 47. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States. 48. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States. Electronic address: amy.lee@utah.edu.
Abstract
BACKGROUND: Tobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk. METHODS: We analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models. RESULTS: Without adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR<10 years vs. ≥30 years: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR<10 years vs. ≥30 years: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed. CONCLUSIONS: Results from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.
BACKGROUND:Tobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk. METHODS: We analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models. RESULTS: Without adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR<10 years vs. ≥30 years: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR<10 years vs. ≥30 years: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed. CONCLUSIONS: Results from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.
Authors: Rafael Ferreira E Costa; Marina Luiza Baião Leão; Maria Sissa Pereira Sant'Ana; Ricardo Alves Mesquita; Ricardo Santiago Gomez; Alan Roger Santos-Silva; Syed Ali Khurram; Artysha Tailor; Ciska-Mari Schouwstra; Liam Robinson; Willie F P van Heerden; Ramiro Alejandro Tomasi; Romina Gorrino; Ruth Salomé Ferreyra de Prato; Adalberto Mosqueda Taylor; José Manuel Aguirre Urizar; Irene Lafuente Ibañez de Mendoza; Raghu Radhakrishnan; Chetana Chandrashekar; Siu-Wai Choi; Peter Thomson; Hélder Antônio Rebelo Pontes; Felipe Paiva Fonseca Journal: Head Neck Pathol Date: 2022-03-22
Authors: À Roselló; R Albuquerque; X Roselló-Llabrés; A Marí-Roig; A Estrugo-Devesa; J López-López Journal: Med Oral Patol Oral Cir Bucal Date: 2020-09-01
Authors: Chun-Pin Chang; Bhola Siwakoti; Amir Sapkota; Dej K Gautam; Yuan-Chin Amy Lee; Marcus Monroe; Mia Hashibe Journal: Int J Cancer Date: 2019-12-27 Impact factor: 7.396
Authors: Francesca Bravi; Yuan-Chin Amy Lee; Mia Hashibe; Paolo Boffetta; David I Conway; Monica Ferraroni; Carlo La Vecchia; Valeria Edefonti Journal: Oral Dis Date: 2020-07-16 Impact factor: 3.511