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Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: Results from the Netherlands Cohort Study

Author: Maasland, D.H.E. · Brandt, P.A. van den · Kremer, S.H.A. · Goldbohm, R.A. · Schouten, L.J.
Source:BMC Cancer, 1, 14
Identifier: 503248
doi: doi:10.1186/1471-2407-14-187
Article number: 187
Keywords: Health · Alcohol consumption · Cigarette smoking · Cohort studies · Etiology · Head-neck cancer · Head-neck cancer subtypes · Alcohol · Adult · Cancer incidence · Cancer risk · Cohort analysis · Controlled study · Drinking behavior · Female · Head and neck cancer · Human · Major clinical study · Male · Netherlands · Prospective study · Questionnaire · Risk factor · Smoking · Healthy for Life · Healthy Living · Behavioural Changes · LS - Life Style · ELSS - Earth, Life and Social Sciences


Background: Prospective data on alcohol consumption, cigarette smoking and risk of head-neck cancer (HNC) subtypes, i.e. oral cavity cancer (OCC), oro-/hypopharyngeal cancer (OHPC), and laryngeal cancer (LC), are limited. We investigated these associations within the second largest prospective study on this topic so far, the Netherlands Cohort Study. Methods: 120,852 participants completed a questionnaire on diet and other cancer risk factors in 1986. After 17.3 years of follow-up, 395 HNC (110 OCC, 83 OHPC, and 199 LC) cases and 4288 subcohort members were available for case-cohort analysis using Cox proportional hazards models. Results: For total HNC, the multivariable adjusted incidence rate ratio (RR) was 2.74 (95% confidence interval (CI) 1.85-4.06) for those drinking ≥30 g ethanol/day compared with abstainers; in subtypes, RRs were 6.39 for OCC, 3.52 for OHPC, and 1.54 for LC. Compared with never cigarette smokers, current cigarette smokers had a RR of 4.49 (95%CI 3.11-6.48) for HNC overall, and 2.11 for OCC, 8.53 for OHPC, and 8.07 for LC. A significant, positive, multiplicative interaction between categories of alcohol consumption and cigarette smoking was found for HNC overall (P interaction 0.03). Conclusions: Alcohol consumption and cigarette smoking were independently associated with risk of HNC overall, with a positive, multiplicative interaction. The strength of these associations differed among HNC-subtypes: OCC was most strongly associated with alcohol consumption but most weakly with cigarette smoking, whereas LC was not statistically significantly associated with alcohol consumption. © 2014 Maasland et al.; licensee BioMed Central Ltd. Chemicals/CAS: alcohol, 64-17-5