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. 2020 Oct;123(9):1456-1463.
doi: 10.1038/s41416-020-01031-z. Epub 2020 Aug 24.

Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration

Gioia Di Credico  1 , Jerry Polesel  2 , Luigino Dal Maso  3 , Francesco Pauli  1 , Nicola Torelli  1 , Daniele Luce  4 , Loredana Radoï  5 , Keitaro Matsuo  6   7 , Diego Serraino  8 , Paul Brennan  9 , Ivana Holcatova  10 , Wolfgang Ahrens  11   12 , Pagona Lagiou  13 , Cristina Canova  14 , Lorenzo Richiardi  15 , Claire M Healy  16 , Kristina Kjaerheim  17 , David I Conway  18 , Gary J Macfarlane  19 , Peter Thomson  20 , Antonio Agudo  21 , Ariana Znaor  9 , Silvia Franceschi  22 , Rolando Herrero  9 , Tatiana N Toporcov  23 , Raquel A Moyses  24 , Joshua Muscat  25 , Eva Negri  26 , Marta Vilensky  27 , Leticia Fernandez  28 , Maria Paula Curado  29 , Ana Menezes  30 , Alexander W Daudt  31 , Rosalina Koifman  32 , Victor Wunsch-Filho  23 , Andrew F Olshan  33 , Jose P Zevallos  34 , Erich M Sturgis  35 , Guojun Li  35 , Fabio Levi  36 , Zuo-Feng Zhang  37 , Hal Morgenstern  38 , Elaine Smith  39 , Philip Lazarus  40 , Carlo La Vecchia  41 , Werner Garavello  42 , Chu Chen  43 , Stephen M Schwartz  43 , Tongzhang Zheng  44 , Thomas L Vaughan  43 , Karl Kelsey  45 , Michael McClean  46 , Simone Benhamou  47 , Richard B Hayes  48 , Mark P Purdue  49 , Maura Gillison  50 , Stimson Schantz  51 , Guo-Pei Yu  52 , Shu-Chun Chuang  53 , Paolo Boffetta  54   55 , Mia Hashibe  56 , Amy Lee Yuan-Chin  56 , Valeria Edefonti  41
Affiliations

Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration

Gioia Di Credico et al. Br J Cancer. 2020 Oct.

Abstract

Background: Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk.

Methods: Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking.

Results: For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx).

Conclusions: Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Cancer risk for the joint exposure to drinking intensity and duration (3D representation).
Bivariate spline model’s estimates of odds ratios of oral cavity (a), oropharyngeal (b), hypopharyngeal (c), and laryngeal (d) cancers in current drinkers for the joint effect of intensity and duration of alcohol consumption. On the grid, black thicker lines represent knot locations, at 5 drinks/day for oral cavity, at 4 drinks/day for hypopharyngeal cancer and at 28 years for oropharyngeal cancer.
Fig. 2
Fig. 2. Cancer risk for the joint exposure to drinking intensity and duration (2D representation).
Bivariate spline model’s estimates of odds ratios of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers in current drinkers for alcohol intensity and fixed levels of alcohol duration (a–d) and for duration and fixed levels of intensity (e–h).
See this image and copyright information in PMC

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