Body mass index, cigarette smoking, and alcohol consumption and cancers of the oral cavity, pharynx, and larynx: modeling odds ratios in pooled case-control data.
Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height(2) (m(2))). Using data from the International Head and Neck Cancer Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of < or =10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis. Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers. Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer (P < 0.01), while smoking odds ratios were greater for laryngeal cancer (P < 0.01). Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cancer (P < 0.01), while BMI did not modify smoking and drinking odds ratios for laryngeal cancer. The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer.
Lubin
Jay H
JH
Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Rockville, MD 20852, USA. lubinj@mail.nih.gov
Gaudet
Mia M
MM
Olshan
Andrew F
AF
Kelsey
Karl
K
Boffetta
Paolo
P
Brennan
Paul
P
Castellsague
Xavier
X
Chen
Chu
C
Curado
Maria Paula
MP
Dal Maso
Luigino
L
Daudt
Alexander W
AW
Fabianova
Eleonora
E
Fernandez
Leticia
L
Wünsch-Filho
Victor
V
Franceschi
Silvia
S
Herrero
Rolando
R
Koifman
Sergio
S
La Vecchia
Carlo
C
Lazarus
Philip
P
Levi
Fabio
F
Lissowska
Jolanta
J
Mates
Ioan Nicolae
IN
Matos
Elena
E
McClean
Michael
M
Menezes
Ana
A
Morgenstern
Hal
H
Muscat
Joshua
J
Eluf Neto
Jose
J
Purdue
Mark P
MP
Rudnai
Peter
P
Schwartz
Stephen M
SM
Shangina
Oxana
O
Sturgis
Erich M
EM
Szeszenia-Dabrowska
Neonilia
N
Talamini
Renato
R
Wei
Qingyi
Q
Winn
Deborah
D
Zhang
Zuo-Feng
ZF
Hashibe
Mia
M
Hayes
Richard B
RB
D000428:Alcohol Drinking / Q000009:adverse effects*; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology*; D009062:Mouth Neoplasms / Q000209:etiology*; D016017:Odds Ratio; D010610:Pharyngeal Neoplasms / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*