title: An examination of male and female odds ratios by BMI, cigarette smoking, and alcohol consumption for cancers of the oral cavity, pharynx, and larynx in pooled data from 15 case-control studies.
abstract: BACKGROUND
  Greater tobacco smoking and alcohol consumption and lower body mass index (BMI) increase odds ratios (OR) for oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancers; however, there are no comprehensive sex-specific comparisons of ORs for these factors.
  
  
  METHODS
  We analyzed 2,441 oral cavity (925 women and 1,516 men), 2,297 oropharynx (564 women and 1,733 men), 508 hypopharynx (96 women and 412 men), and 1,740 larynx (237 women and 1,503 men) cases from the INHANCE consortium of 15 head and neck cancer case-control studies. Controls numbered from 7,604 to 13,829 subjects, depending on analysis. Analyses fitted linear-exponential excess ORs models.
  
  
  RESULTS
  ORs were increased in underweight (< 18.5 BMI) relative to normal weight (18.5-24.9) and reduced in overweight and obese categories (≥ 25 BMI) for all sites and were homogeneous by sex. ORs by smoking and drinking in women compared with men were significantly greater for oropharyngeal cancer (p < 0.01 for both factors), suggestive for hypopharyngeal cancer (p = 0.05 and p = 0.06, respectively), but homogeneous for oral cavity (p = 0.56 and p = 0.64) and laryngeal (p = 0.18 and p = 0.72) cancers.
  
  
  CONCLUSIONS
  The extent that OR modifications of smoking and drinking by sex for oropharyngeal and, possibly, hypopharyngeal cancers represent true associations, or derive from unmeasured confounders or unobserved sex-related disease subtypes (e.g., human papillomavirus-positive oropharyngeal cancer) remains to be clarified.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rockville, MD 20852, USA. lubinj@mail.nih.gov
authors: Jay H
authors: JH
authors: Lubin
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authors: MM
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authors: Olshan
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authors: Dal Maso
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authors: Wünsch-Filho
authors: Erich M
authors: EM
authors: Sturgis
authors: Neonilia
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authors: Szeszenia-Dabrowska
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authors: Castellsague
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authors: Zhang
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authors: Smith
authors: Leticia
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authors: Fernandez
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authors: Matos
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authors: Franceschi
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authors: Fabianova
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authors: Rudnai
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authors: Koifman
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authors: Lissowska
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authors: Lazarus
authors: Deborah M
authors: DM
authors: Winn
authors: Stephen M
authors: SM
authors: Schwartz
authors: Paolo
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authors: Boffetta
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authors: Brennan
authors: Ana
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authors: Menezes
authors: Carlo
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authors: La Vecchia
authors: Michael
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authors: McClean
authors: Renato
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mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*