Citation
Toporcov, Tatiana N.; Znaor, Ariana; Zhang, Zuo-Feng; Yu, Guo-Pei; Winn, Deborah M.; Wei, Qingyi; Vilensky, Marta; Vaughan, Thomas L.; Thomson, Peter; & Talamini, Renato, et al. (2015). Risk Factors for Head and Neck Cancer in Young Adults: A Pooled Analysis in the INHANCE Consortium. International Journal of Epidemiology, 44(1), 169-185. PMCID: PMC4339764Abstract
Background: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients.Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults ≤45 years old (‘young adults’, 2010 cases and 4042 controls) and >45 years old (‘older adults’, 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity / oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI = 9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking = 5.3% (−11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR = 2.27 (95% CI = 1.26, 4.10)], but not in the older adults [OR = 1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (−2.41%, 5.80%) in older adults.
Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.
URL
http://dx.doi.org/10.1093/ije/dyu255Reference Type
Journal ArticleYear Published
2015Journal Title
International Journal of EpidemiologyAuthor(s)
Toporcov, Tatiana N.Znaor, Ariana
Zhang, Zuo-Feng
Yu, Guo-Pei
Winn, Deborah M.
Wei, Qingyi
Vilensky, Marta
Vaughan, Thomas L.
Thomson, Peter
Talamini, Renato
Szeszenia-Dabrowska, Neonila
Sturgis, Erich M.
Smith, Elaine
Shangina, Oxana
Schwartz, Stephen M.
Schantz, Stimson
Rudnai, Peter
Richiardi, Lorenzo
Ramroth, Heribert
Purdue, Mark P.
Olshan, Andrew F.
Eluf-Neto, José
Muscat, Joshua E.
Moyses, Raquel A.
Morgenstern, Hal
Menezes, Ana M.
McClean, Michael D.
Matsuo, Keitaro
Mates, Dana
Macfarlane, Tatiana V.
Lissowska, Jolanta
Levi, Fabio
Lazarus, Philip
Vecchia, Carlo La
Lagiou, Pagona
Koifman, Sergio
Kjaerheim, Kristina
Kelsey, Karl T.
Holcatova, Ivana
Herrero, Rolando
Healy, Claire M.
Hayes, Richard B.
Franceschi, Silvia
Fernandez, Leticia
Fabianova, Eleonora
Daudt, Alexander W.
Curioni, Otávio Alberto
Maso, Luigino Dal
Curado, Maria Paula
Conway, David I.
Chen, Chu
Castellsague, Xavier
Canova, Cristina
Cadoni, Gabriella
Brennan, Paul
Boccia, Stefania
Antunes, José Leopoldo Ferreira
Ahrens, Wolfgang
Agudo, Antonio
Boffetta, Paolo
Hashibe, Mia
Lee, Yuan-Chin Amy
Filho, Victor Wünsch