title: Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium.
abstract: BACKGROUND
  Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV).
  
  
  METHODS
  We undertook a pooled analysis of four population-based and four hospital-based case-control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral-anal contact. Findings were stratified by sex and disease subsite.
  
  
  RESULTS
  Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09, 2.33) and with an earlier age at sexual debut (OR = 2.36, 95% CI 1.37, 5.05). Cancer of the base of the tongue was associated with ever having oral sex among women (OR = 4.32, 95% CI 1.06, 17.6), having two sexual partners in comparison with only one (OR = 2.02, 95% CI 1.19, 3.46) and, among men, with a history of same-sex sexual contact (OR = 8.89, 95% CI 2.14, 36.8).
  
  
  CONCLUSIONS
  Sexual behaviours are associated with cancer risk at the head and neck cancer subsites that have previously been associated with HPV infection.
authors.affiliation: Lifestyle, Environment, and Cancer Group, International Agency for Research on Cancer, Lyon, France.
authors.forename: Julia E
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authors.initials: MD
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authors.lastname: Wünsch-Filho
authors.forename: Leticia
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authors.lastname: Fernández
authors.forename: Alexander W
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authors.lastname: Daudt
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Curado
authors.forename: Chu
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authors.lastname: Chen
authors.forename: Xavier
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authors.lastname: Castellsagué
authors.forename: Gilles
authors.initials: G
authors.lastname: Ferro
authors.forename: Paul
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authors.forename: Paolo
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mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000453:epidemiology*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors