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

Tatiana Natasha Toporcov; Ariana Znaor; Zuo-Feng Zhang; Guo-Pei Yu; Deborah M Winn; Qingyi Wei; Marta Vilensky; Thomas Vaughan; Peter Thomson; Renato Talamini; Neonila Szeszenia-Dabrowska; Erich M Sturgis; Elaine Smith; Oxana Shangina; Stephen M Schwartz; Stimson Schantz; Peter Rudnai; Lorenzo Richiardi; Heribert Ramroth; Mark P Purdue; Andrew F Olshan; José Eluf-Neto; Joshua Muscat; Raquel Ajub Moyses; Hal Morgenstern; Ana Menezes; Michael McClean; Keitaro Matsuo; Dana Mates; Tatiana V Macfarlane; Jolanta Lissowska; Fabio Levi; Philip Lazarus; Carlo La Vecchia; Pagona Lagiou; Sergio Koifman; Kristina Kjaerheim; Karl Kelsey; Ivana Holcatova; Rolando Herrero; Claire Healy; Richard B Hayes; Silvia Franceschi; Leticia Fernandez; Eleonora Fabianova; Alexander W Daudt; Otávio Alberto Curioni; Luigino Dal Maso; Maria Paula Curado; David I Conway; Chu Chen; Xavier Castellsague; Cristina Canova; Gabriella Cadoni; Paul Brennan; Stefania Boccia; José Leopoldo Ferreira Antunes; Wolfgang Ahrens; Antonio Agudo; Paolo Boffetta; Mia Hashibe; Yuan-Chin Amy Lee; Victor Wünsch Filho

doi:10.1093/ije/dyu255

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

Int J Epidemiol. 2015 Feb;44(1):169-85. doi: 10.1093/ije/dyu255. Epub 2015 Jan 22.

Authors

Tatiana Natasha Toporcov¹, Ariana Znaor¹, Zuo-Feng Zhang¹, Guo-Pei Yu¹, Deborah M Winn¹, Qingyi Wei¹, Marta Vilensky¹, Thomas Vaughan¹, Peter Thomson¹, Renato Talamini¹, Neonila Szeszenia-Dabrowska¹, Erich M Sturgis¹, Elaine Smith¹, Oxana Shangina¹, Stephen M Schwartz¹, Stimson Schantz¹, Peter Rudnai¹, Lorenzo Richiardi¹, Heribert Ramroth¹, Mark P Purdue¹, Andrew F Olshan¹, José Eluf-Neto¹, Joshua Muscat¹, Raquel Ajub Moyses¹, Hal Morgenstern¹, Ana Menezes¹, Michael McClean¹, Keitaro Matsuo¹, Dana Mates¹, Tatiana V Macfarlane¹, Jolanta Lissowska¹, Fabio Levi¹, Philip Lazarus¹, Carlo La Vecchia¹, Pagona Lagiou¹, Sergio Koifman¹, Kristina Kjaerheim¹, Karl Kelsey¹, Ivana Holcatova¹, Rolando Herrero¹, Claire Healy¹, Richard B Hayes¹, Silvia Franceschi¹, Leticia Fernandez¹, Eleonora Fabianova¹, Alexander W Daudt¹, Otávio Alberto Curioni¹, Luigino Dal Maso¹, Maria Paula Curado¹, David I Conway¹, Chu Chen¹, Xavier Castellsague¹, Cristina Canova¹, Gabriella Cadoni¹, Paul Brennan¹, Stefania Boccia¹, José Leopoldo Ferreira Antunes¹, Wolfgang Ahrens¹, Antonio Agudo¹, Paolo Boffetta¹, Mia Hashibe¹, Yuan-Chin Amy Lee¹, Victor Wünsch Filho¹

Affiliation

¹ Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil, Croatian National Cancer Registry, Zagreb, Croatia, UCLA School of Public Health, Los Angeles, CA, USA, Medical Informatics Center, Peking University, Beijing, China, and New York Medical College, Valhalla, NY, USA, National Cancer Institute, Bethesda, MD, USA, UT-MD Anderson Cancer Center, Houston, TX, USA, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, School of Dental Sciences, University of Newcastle, Newcastle, UK, Aviano Cancer Centre, Aviano, Italy, Institute of Occupational Medicine, Lodz, Poland, College of Public Health, University of Iowa, Iowa City, IA, USA, Cancer Research Centre, Moscow, Russia, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York Eye and Ear Infirmary, New York, NY, USA, National Institute of Environmental Health, Budapest, Hungary, Department of Medical Science, Cancer Epidemiology Unit, University of Turin, Turin, Italy, Institute of Public Health, University of Heidelberg, Heidelberg, Germany, University of North Carolina School of Public Health, Chapel Hill, NC, USA, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, Penn State College of Medicine, Hershey, PA, USA, Cirurgia de Cabeça e Pescoço (LIM 28), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Comprehensive Cancer Center, University of Michigan Ann Arbor, Ann Arbor, MI, USA, Universidade Federal de Pelotas, Pelotas, Brazil, Boston University School of Public Health, Boston, MA, USA, Aichi Cancer Center Research Institute, Nagoya, Japan, Institute of Public Health, Bucharest, Romania, University of Aberdeen Dental School, Aberdeen, UK, The M Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Cancer Epidemiology and Pre

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', 17700 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.

Keywords: Head and neck neoplasms; adult; alcohol drinking; diet; smoking.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Age Factors
Alcohol Drinking / epidemiology*
Case-Control Studies
Female
Genetic Predisposition to Disease
Head and Neck Neoplasms / epidemiology*
Head and Neck Neoplasms / genetics
Humans
Incidence
Male
Middle Aged
Odds Ratio
Registries
Risk Factors
Sex Factors
Smoking / epidemiology*

Abstract

Publication types

MeSH terms

Grants and funding