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Hashibe M, Brennan P, Benhamou S, Castellsague X, Chen C, Curado MP, et al. 2007. Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium

Gene-Environment Epidemiology Group, International Agency for Research on Cancer, 150 cours Albert Thomas, 69008 Lyon, France.
CancerSpectrum Knowledge Environment (Impact Factor: 15.16). 06/2007; 99(10):777-89. DOI: 10.1093/jnci/djk179
Source: PubMed

ABSTRACT At least 75% of head and neck cancers are attributable to a combination of cigarette smoking and alcohol drinking. A precise understanding of the independent association of each of these factors in the absence of the other with the risk of head and neck cancer is needed to elucidate mechanisms of head and neck carcinogenesis and to assess the efficacy of interventions aimed at controlling either risk factor.
We examined the extent to which head and neck cancer is associated with cigarette smoking among never drinkers and with alcohol drinking among never users of tobacco. We pooled individual-level data from 15 case-control studies that included 10,244 head and neck cancer case subjects and 15,227 control subjects, of whom 1072 case subjects and 5775 control subjects were never users of tobacco and 1598 case subjects and 4051 control subjects were never drinkers of alcohol. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. All statistical tests were two-sided.
Among never drinkers, cigarette smoking was associated with an increased risk of head and neck cancer (OR for ever versus never smoking = 2.13, 95% CI = 1.52 to 2.98), and there were clear dose-response relationships for the frequency, duration, and number of pack-years of cigarette smoking. Approximately 24% (95% CI = 16% to 31%) of head and neck cancer cases among nondrinkers in this study would have been prevented if these individuals had not smoked cigarettes. Among never users of tobacco, alcohol consumption was associated with an increased risk of head and neck cancer only when alcohol was consumed at high frequency (OR for three or more drinks per day versus never drinking = 2.04, 95% CI = 1.29 to 3.21). The association with high-frequency alcohol intake was limited to cancers of the oropharynx/hypopharynx and larynx.
Our results represent the most precise estimates available of the independent association of each of the two main risk factors of head and neck cancer, and they exemplify the strengths of large-scale consortia in cancer epidemiology.

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    • "This project takes advantage of the experience gained by several principal investigators participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium (Hashibe et al., 2007; Conway et al., 2009), and other similar ones (Kamper-Jorgensen et al., 2013; Bosetti et al., 2013b). "
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    ABSTRACT: Gastric cancer affects about one million people per year worldwide, being the second leading cause of cancer mortality. The study of its etiology remains therefore a global issue as it may allow the identification of major targets, besides eradication of Helicobacter pylori infection, for primary prevention. It has however received little attention, given its comparatively low incidence in most high-income countries. We introduce a consortium of epidemiological investigations named the 'Stomach cancer Pooling (StoP) Project'. Twenty-two studies agreed to participate, for a total of over 9000 cases and 23 000 controls. Twenty studies have already shared the original data set. Of the patients, 40% are from Asia, 43% from Europe, and 17% from North America; 34% are women and 66% men; the median age is 61 years; 56% are from population-based case-control studies, 41% from hospital-based ones, and 3% from nested case-control studies derived from cohort investigations. Biological samples are available from 12 studies. The aim of the StoP Project is to analyze the role of lifestyle and genetic determinants in the etiology of gastric cancer through pooled analyses of individual-level data. The uniquely large data set will allow us to define and quantify the main effects of each risk factor of interest, including a number of infrequent habits, and to adequately address associations in subgroups of the population, as well as interaction within and between environmental and genetic factors. Further, we will carry out separate analyses according to different histotypes and subsites of gastric cancer, to identify potential different risk patterns and etiological characteristics.
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    • "These findings are mirrored in the differences in prognosis and recurrence rates of different subclasses of squamous cell carcinoma (Chung et al., 2004). HNSCC is considered an environmental tumor mostly attributable to tobacco use, alcohol consumption, and infection with human papilloma virus (HPV) (Hashibe et al., 2007). There is a growing proportion of cases in younger low-risk patients with a poor prognosis and a distinctive clinical and histopathological pattern (Chung et al., 2004; Dahlstrom et al., 2008), which suggests a role for genetic factors contributing to carcinogenesis of these tumors (Liang et al., 2008). "
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    • "The tumour is often locally advanced (stage IV) with significant lymph node involvement at the time of diagnosis [3]. An environmentally caused cancer, with tobacco use and alcohol consumption being the main causative factors [4], HNSCC has been recently linked to infection with human papillomavirus (HPV). HPV-induced HNSCCs are generally limited to the oropharynx and are most frequently seen in non-smoker, non-drinker individuals [5] [6] [7]. "
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