Active and involuntary tobacco smoking and upper aerodigestive tract cancer risks in a multicenter case-control study.
BACKGROUND
Several important issues for the established association between tobacco smoking and upper aerodigestive tract (UADT) cancer risks include the associations with smoking by cancer subsite, by type of tobacco, and among never alcohol drinkers and the associations with involuntary smoking among nonsmokers. Our aim was to examine these specific issues in a large-scale case-control study in Europe.


METHODS
Analysis was done on 2,103 UADT squamous cell carcinoma cases and 2,221 controls in the Alcohol-Related Cancers and Genetic Susceptibility in Europe project, a multicenter case-control study in 10 European countries. Unconditional logistic regression was done to obtain odds ratios (OR) and 95% confidence intervals (95% CI).


RESULTS
Compared with never tobacco smoking, current smoking was associated with UADT cancer risks (OR, 6.72; 95% CI, 5.45-8.30 for overall; OR, 5.83; 95% CI, 4.50-7.54 for oral cavity and oropharynx; OR, 12.19; 95% CI, 8.29-17.92 for hypopharynx and larynx; and OR, 4.17; 95% CI, 2.45-7.10 for esophagus). Among never drinkers, dose-response relationships with tobacco smoking pack-years were observed for hypopharyngeal and laryngeal cancers (P(trend) = 0.010) but not for oral cavity and oropharyngeal cancers (P(trend) = 0.282). Among never smokers, ever exposure to involuntary smoking was associated with an increased risk of UADT cancers (OR, 1.60; 95% CI, 1.04-2.46).


CONCLUSIONS
Our results corroborate that tobacco smoking may play a stronger role in the development of hypopharyngeal and laryngeal cancers than that of oral cavity and oropharyngeal cancers among never drinkers and that involuntary smoking is an important risk factor for UADT cancers. Public health interventions to reduce involuntary smoking exposure could help reduce UADT cancer incidence.
Lee
Yuan-Chin Amy
YC
IARC, Lyon, France.
Marron
Manuela
M
Benhamou
Simone
S
Bouchardy
Christine
C
Ahrens
Wolfgang
W
Pohlabeln
Hermann
H
Lagiou
Pagona
P
Trichopoulos
Dimitrios
D
Agudo
Antonio
A
Castellsague
Xavier
X
Bencko
Vladimir
V
Holcatova
Ivana
I
Kjaerheim
Kristina
K
Merletti
Franco
F
Richiardi
Lorenzo
L
Macfarlane
Gary J
GJ
Macfarlane
Tatiana V
TV
Talamini
Renato
R
Barzan
Luigi
L
Canova
Cristina
C
Simonato
Lorenzo
L
Conway
David I
DI
McKinney
Patricia A
PA
Lowry
Raymond J
RJ
Sneddon
Linda
L
Znaor
Ariana
A
Healy
Claire M
CM
McCartan
Bernard E
BE
Brennan
Paul
P
Hashibe
Mia
M
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects*