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. 2019 Dec:63:101615.
doi: 10.1016/j.canep.2019.101615. Epub 2019 Oct 3.

Age at start of using tobacco on the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium (INHANCE)

Chun-Pin Chang  1 , Shen-Chih Chang  2 , Shu-Chun Chuang  3 , Julien Berthiller  4 , Gilles Ferro  5 , Keitaro Matsuo  6 , Victor Wünsch-Filho  7 , Tatiana N Toporcov  7 , Marcos Brasilino de Carvalho  8 , Carlo La Vecchia  9 , Andrew F Olshan  10 , Jose P Zevallos  11 , Diego Serraino  12 , Joshua Muscat  13 , Erich M Sturgis  14 , Guojun Li  14 , Hal Morgenstern  15 , Fabio Levi  16 , Luigino Dal Maso  12 , Elaine Smith  17 , Karl Kelsey  18 , Michael McClean  18 , Thomas L Vaughan  19 , Philip Lazarus  20 , Heribert Ramroth  21 , Chu Chen  19 , Stephen M Schwartz  19 , Deborah M Winn  22 , Cristina Bosetti  23 , Valeria Edefonti  9 , Werner Garavello  24 , Eva Negri  25 , Richard B Hayes  26 , Mark P Purdue  22 , Stefania Boccia  27 , Gabriella Cadoni  28 , Oxana Shangina  29 , Rosalina Koifman  30 , Maria Paula Curado  31 , Marta Vilensky  32 , Beata Swiatkowska  33 , Rolando Herrero  5 , Silvia Franceschi  34 , Simone Benhamou  35 , Leticia Fernandez  36 , Ana M B Menezes  37 , Alexander W Daudt  38 , Dana Mates  39 , Stimson Schantz  40 , Guo-Pei Yu  41 , Jolanta Lissowska  42 , Hermann Brenner  43 , Eleonora Fabianova  44 , Peter Rudnai  45 , Paul Brennan  5 , Paolo Boffetta  46 , Zuo-Feng Zhang  47 , Mia Hashibe  1 , Yuan-Chin Amy Lee  48
Affiliations

Age at start of using tobacco on the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium (INHANCE)

Chun-Pin Chang et al. Cancer Epidemiol. 2019 Dec.

Abstract

Background: Tobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk.

Methods: We analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models.

Results: Without adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR<10 years vs. ≥30 years: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR<10 years vs. ≥30 years: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed.

Conclusions: Results from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.

Keywords: Age at start of tobacco use; Head and neck cancer; Hypopharyngeal cancer; Laryngeal cancer; Oral cancer; Oropharyngeal cancer.

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Conflict of interest statement

Conflict of interest statement

None declared.

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