TY - JOUR
TI - Active and Involuntary Tobacco Smoking and Upper Aerodigestive Tract
Cancer Risks in a Multicenter Case-Control Study
AU - Lee, Yuan-Chin Amy
AU - Marron, Manuela
AU - Benhamou, Simone and
AU - Bouchardy, Christine
AU - Ahrens, Wolfgang
AU - Pohlabeln, Hermann and
AU - Lagiou, Pagona
AU - Trichopoulos, Dimitrios
AU - Agudo, Antonio and
AU - Castellsague, Xavier
AU - Bencko, Vladimir
AU - Holcatova, Ivana and
AU - Kjaerheim, Kristina
AU - Merletti, Franco
AU - Richiardi, Lorenzo and
AU - Macfarlane, Gary J.
AU - Macfarlane, Tatiana V.
AU - Talamini, Renato and
AU - Barzan, Luigi
AU - Canova, Cristina
AU - Simonato, Lorenzo
AU - Conway,
AU - David I.
AU - McKinney, Patricia A.
AU - Lowry, Raymond J.
AU - Sneddon,
AU - Linda
AU - Znaor, Ariana
AU - Healy, Claire M.
AU - McCartan, Bernard E.
AU - and Brennan, Paul
AU - Hashibe, Mia
JO - Cancer Epidemiology, Biomarkers & Prevention
PY - 2009
VL - 18
TODO - 12, SI
SP - 3353-3361
PB - AMER ASSOC CANCER RESEARCH
SN - 1055-9965, 1538-7755
TODO - 10.1158/1055-9965.EPI-09-0910
TODO - null
TODO - Introduction: Several important issues for the established association
between tobacco smoking and upper aerodigestive tract (UADT) cancer
risks include the associations with smoking by cancer subsite, by type
of tobacco, and among never alcohol drinkers and the associations with
involuntary smoking among nonsmokers. Our aim was to examine these
specific issues in a large-scale case-control study in Europe.
Methods: Analysis was done on 2,103 UADT squamous cell carcinoma cases
and 2,221 controls in the Alcohol-Related Cancers and Genetic
Susceptibility in Europe project, a multicenter case-control study in 10
European countries. Unconditional logistic regression was done to obtain
odds ratios (OR) and 95% confidence intervals (95% CI).
Results: Compared with never tobacco smoking, current smoking was
associated with UADT cancer risks (OR, 6.72; 95% CI, 5.45-8.30 for
overall; OR, 5.83; 95% Cl, 4.50-7.54 for oral cavity and oropharynx;
OR, 12.19; 95% CI, 8.29-17.92 for hypopharynx and larynx; and OR, 4.17;
95% CI, 2.45-7.10 for esophagus). Among never drinkers, dose-response
relationships with tobacco smoking pack-years were observed for
hypopharyngeal and laryngeal cancers (P-trend = 0.010) but not for oral
cavity and oropharyngeal cancers (P-trend = 0.282). Among never smokers,
ever exposure to involuntary smoking was associated with an increased
risk of UADT cancers (OR, 1.60; 95% CI, 1.04-2.46).
Conclusion: Our results corroborate that tobacco smoking may play a
stronger role in the development of hypopharyngeal and laryngeal cancers
than that of oral cavity and oropharyngeal cancers among never drinkers
and that involuntary smoking is an important risk factor for UADT
cancers. Public health interventions to reduce involuntary smoking
exposure could help reduce UADT cancer incidence. (Cancer Epidemiol
Biomarkers Prev 2009;18(12):3353-61)
ER -