The aetiology of upper aerodigestive tract cancers among young adults in Europe: the ARCAGE study.
BACKGROUND
The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption.


OBJECTIVE
To determine the contribution of lifestyle factors to the etiology of UADT cancers occurring in those aged less than 50 years.


METHODS
A case-control study was conducted in 10 European countries. Cases were cancers of the oral cavity and pharynx, larynx and esophagus, and hospital or population controls were age and sex matched.


RESULTS
There were 356 cases younger than 50 years and 419 controls. Risk was strongly related to current smoking [odds ratio (OR) 5.5 95%; confidence interval (CI) (3.3, 9.2)], and risk increased with number of pack-years smoked. Risk was also related to alcohol consumption for both current (OR 1.8; 0.97, 3.3) and past (OR 3.4; 1.6, 7.4) drinkers, and risk increased with number of drink-years. Persons frequently consuming fruits and vegetables were at significantly reduced risk.


CONCLUSIONS
Risk factors already identified as being important for UADT cancers in adults are also important influences on risk in younger adults. The implication of these results is that the public health message in preventing UADT cancers remains the same to young and old alike.
Macfarlane
Tatiana V
TV
School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK. Tatiana.Macfarlane@abdn.ac.uk.
Macfarlane
Gary J
GJ
Oliver
Richard J
RJ
Benhamou
Simone
S
Bouchardy
Christine
C
Ahrens
Wolfgang
W
Pohlabeln
Hermann
H
Lagiou
Pagona
P
Lagiou
Areti
A
Castellsague
Xavier
X
Agudo
Antonio
A
Merletti
Franco
F
Richiardi
Lorenzo
L
Kjaerheim
Kristina
K
Slamova
Alena
A
Schejbalova
Miriam
M
Canova
Cristina
C
Simonato
Lorenzo
L
Talamini
Renato
R
Barzan
Luigi
L
Conway
David I
DI
McKinney
Patricia A
PA
Znaor
Ariana
A
Lowry
Raymond J
RJ
Thomson
Peter
P
Healy
Claire M
CM
McCartan
Bernard E
BE
Marron
Manuela
M
Hashibe
Mia
M
Brennan
Paul
P
D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology*; 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*; D015337:Multicenter Studies as Topic; D010610:Pharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D055815:Young Adult