Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:2012:571862.
doi: 10.1155/2012/571862. Epub 2012 Jan 23.

Complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol: a case for multifactor disease

Elaine M Smith  1 , Linda M Rubenstein, Thomas H Haugen, Michael Pawlita, Lubomir P Turek
Affiliations

Complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol: a case for multifactor disease

Elaine M Smith et al. J Oncol. 2012.

Abstract

Findings are inconsistent about whether tobacco, alcohol, and human papillomavirus (HPV) are two independent HNC risk factor groups that distinguish an infection-associated cancer from a tobacco/alcohol-associated HNC. We found that cancer in the oral cavity risk was greater in HPV-E6/E7 seropositive/heavy tobacco users (adjusted OR = 3.5) than in HPV-seronegative/heavy tobacco users (adjusted OR = 1.4); and HPV-seropositive/heavy alcohol users (adjusted OR = 9.8) had greater risk than HPV-seronegative/heavy alcohol users (adjusted OR = 3.1). In contrast, the risk of oropharyngeal cancer was greater in the HPV-seronegative/heavy tobacco (adjusted OR = 11.0) than in HPV-seropositive/heavy tobacco (adjusted OR = 4.7) users and greater in HPV-seronegative/heavy alcohol users (adjusted OR = 24.3) compared to HPV-seropositive/heavy alcohol users (adjusted OR = 8.5). Disease-specific and recurrence-free adjusted survival were significantly worse in oropharyngeal HPV-seronegative cases with no survival differences by HPV status seen in oral cavity cases. The association between tobacco/alcohol, HPV, and tumor site is complex. There appear to be distinct tumor site differences in the combined exposure risks, suggesting that different molecular pathways are involved.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(a) Oral cavity disease-specific Kaplan-Meier survival curves by E6/E7 and tumor DNA status. (b) Oropharynx disease-specific Kaplan-Meier survival curves by E6/E7 and tumor DNA status.
Figure 2
Figure 2
(a) Oral cavity recurrence-free specific Kaplan-Meier survival curves by E6/E7 and tumor DNA status. (b) Oropharynx recurrence-free specific Kaplan-Meier survival curves by E6/E7 and tumor DNA status.
See this image and copyright information in PMC

References

    1. Smith EM, Rubenstein LM, Haugen TH, Hamsikova E, Turek LP. Tobacco and alcohol use increases the risk of both HPV-associated and HPV-independent head and neck cancers. Cancer Causes and Control. 2010;21(9):1369–1378. - PubMed
    1. Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systemic review. Cancer Epidemiology Biomarkers and Prevention. 2005;14(2):467–475. - PubMed
    1. Gillison ML, D’Souza G, Westra W, et al. Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. Journal of the National Cancer Institute. 2008;100(6):407–420. - PubMed
    1. Applebaum KM, Furniss CS, Zeka A, et al. Lack of association of alcohol and tobacco with HPV16-associated head and neck cancer. Journal of the National Cancer Institute. 2007;99(23):1801–1810. - PubMed
    1. Herrero R, Castellsagué X, Pawlita M, et al. Human papillomavirus and oral cancer: the international agency for research on cancer multicenter study. Journal of the National Cancer Institute. 2003;95(23):1772–1783. - PubMed

LinkOut - more resources