@article{3164901, title = "Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium", author = "Toporcov, Tatiana Natasha and Znaor, Ariana and Zhang, Zuo-Feng and Yu, and Guo-Pei and Winn, Deborah M. and Wei, Qingyi and Vilensky, Marta and and Vaughan, Thomas and Thomson, Peter and Talamini, Renato and and Szeszenia-Dabrowska, Neonila and Sturgis, Erich M. and Smith, Elaine and and Shangina, Oxana and Schwartz, Stephen M. and Schantz, Stimson and and Rudnai, Peter and Richiardi, Lorenzo and Ramroth, Heribert and Purdue, and Mark P. and Olshan, Andrew F. and Eluf-Neto, Jose and Muscat, Joshua and and Moyses, Raquel Ajub and Morgenstern, Hal and Menezes, Ana and McClean, and Michael and Matsuo, Keitaro and Mates, Dana and Macfarlane, Tatiana V. and and Lissowska, Jolanta and Levi, Fabio and Lazarus, Philip and La and Vecchia, Carlo and Lagiou, Pagona and Koifman, Sergio and Kjaerheim, and Kristina and Kelsey, Karl and Holcatova, Ivana and Herrero, Rolando and and Healy, Claire and Hayes, Richard B. and Franceschi, Silvia and and Fernandez, Leticia and Fabianova, Eleonora and Daudt, Alexander W. and and Curioni, Otavio Alberto and Dal Maso, Luigino and Curado, Maria Paula and and Conway, David I. and Chen, Chu and Castellsague, Xavier and Canova, and Cristina and Cadoni, Gabriella and Brennan, Paul and Boccia, Stefania and and Antunes, Jose Leopoldo Ferreira and Ahrens, Wolfgang and Agudo, and Antonio and Boffetta, Paolo and Hashibe, Mia and Lee, Yuan-Chin Amy and and Wuensch Filho, Victor", journal = "International Journal of Epidemiology", year = "2015", volume = "44", number = "1", pages = "169-185", publisher = "Oxford University Press", issn = "0300-5771, 1464-3685", doi = "10.1093/ije/dyu255", keywords = "Head and neck neoplasms; adult; smoking; alcohol drinking; diet", abstract = "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." }