Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium.
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.
Heck
Julia E
JE
Lifestyle, Environment, and Cancer Group, International Agency for Research on Cancer, Lyon, France.
Berthiller
Julien
J
Vaccarella
Salvatore
S
Winn
Deborah M
DM
Smith
Elaine M
EM
Shan'gina
Oxana
O
Schwartz
Stephen M
SM
Purdue
Mark P
MP
Pilarska
Agnieszka
A
Eluf-Neto
Jose
J
Menezes
Ana
A
McClean
Michael D
MD
Matos
Elena
E
Koifman
Sergio
S
Kelsey
Karl T
KT
Herrero
Rolando
R
Hayes
Richard B
RB
Franceschi
Silvia
S
Wünsch-Filho
Victor
V
Fernández
Leticia
L
Daudt
Alexander W
AW
Curado
Maria Paula
MP
Chen
Chu
C
Castellsagué
Xavier
X
Ferro
Gilles
G
Brennan
Paul
P
Boffetta
Paolo
P
Hashibe
Mia
M
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