title: Active and involuntary tobacco smoking and upper aerodigestive tract cancer risks in a multicenter case-control study.
abstract: 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.
authors: IARC, Lyon, France.
authors: Yuan-Chin Amy
authors: YC
authors: Lee
authors: Manuela
authors: M
authors: Marron
authors: Simone
authors: S
authors: Benhamou
authors: Christine
authors: C
authors: Bouchardy
authors: Wolfgang
authors: W
authors: Ahrens
authors: Hermann
authors: H
authors: Pohlabeln
authors: Pagona
authors: P
authors: Lagiou
authors: Dimitrios
authors: D
authors: Trichopoulos
authors: Antonio
authors: A
authors: Agudo
authors: Xavier
authors: X
authors: Castellsague
authors: Vladimir
authors: V
authors: Bencko
authors: Ivana
authors: I
authors: Holcatova
authors: Kristina
authors: K
authors: Kjaerheim
authors: Franco
authors: F
authors: Merletti
authors: Lorenzo
authors: L
authors: Richiardi
authors: Gary J
authors: GJ
authors: Macfarlane
authors: Tatiana V
authors: TV
authors: Macfarlane
authors: Renato
authors: R
authors: Talamini
authors: Luigi
authors: L
authors: Barzan
authors: Cristina
authors: C
authors: Canova
authors: Lorenzo
authors: L
authors: Simonato
authors: David I
authors: DI
authors: Conway
authors: Patricia A
authors: PA
authors: McKinney
authors: Raymond J
authors: RJ
authors: Lowry
authors: Linda
authors: L
authors: Sneddon
authors: Ariana
authors: A
authors: Znaor
authors: Claire M
authors: CM
authors: Healy
authors: Bernard E
authors: BE
authors: McCartan
authors: Paul
authors: P
authors: Brennan
authors: Mia
authors: M
authors: Hashibe
mesh_terms: 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*