TY - JOUR
TI - Combined effects of smoking and HPV16 in oropharyngeal cancer
AU - Anantharaman, Devasena
AU - Muller, David C.
AU - Lagiou, Pagona and
AU - Ahrens, Wolfgang
AU - Holcatova, Ivana
AU - Merletti, Franco and
AU - Kjaerheim, Kristina
AU - Polesel, Jerry
AU - Simonato, Lorenzo
AU - Canova,
AU - Cristina
AU - Castellsague, Xavier
AU - Macfarlane, Tatiana V.
AU - Znaor,
AU - Ariana
AU - Thomson, Peter
AU - Robinson, Max
AU - Conway, David I. and
AU - Healy, Claire M.
AU - Tjonneland, Anne
AU - Westin, Ulla
AU - Ekstrom,
AU - Johanna
AU - Chang-Claude, Jenny
AU - Kaaks, Rudolf
AU - Overvad, Kim and
AU - Drogan, Dagmar
AU - Hallmans, Goran
AU - Laurell, Goran and
AU - Bueno-de-Mesquita, H. B.
AU - Peeters, Petra H.
AU - Agudo, Antonio and
AU - Larranaga, Nerea
AU - Travis, Ruth C.
AU - Palli, Domenico
AU - Barricarte,
AU - Aurelio
AU - Trichopoulou, Antonia
AU - George, Saitakis
AU - Trichopoulos,
AU - Dimitrios
AU - Ramon Quiros, J.
AU - Grioni, Sara
AU - Sacerdote, Carlotta
AU - and Navarro, Carmen
AU - Sanchez, Maria-Jose
AU - Tumino, Rosario and
AU - Severi, Gianluca
AU - Boutron-Ruault, Marie-Christine and
AU - Clavel-Chapelon, Francoise
AU - Panico, Salvatore
AU - Weiderpass,
AU - Elisabete
AU - Lund, Eiliv
AU - Gram, Inger T.
AU - Riboli, Elio and
AU - Pawlita, Michael
AU - Waterboer, Tim
AU - Kreimer, Aimee R.
AU - Johansson,
AU - Mattias
AU - Brennan, Paul
JO - International Journal of Epidemiology
PY - 2016
VL - 45
TODO - 3
SP - 752-761
PB - Oxford University Press
SN - 0300-5771, 1464-3685
TODO - 10.1093/ije/dyw069
TODO - Human papillomavirus; tobacco smoking; interaction; head and neck cancer
risk; oropharynx cancer
TODO - Background: Although smoking and HPV infection are recognized as
important risk factors for oropharyngeal cancer, how their joint
exposure impacts on oropharyngeal cancer risk is unclear. Specifically,
whether smoking confers any additional risk to HPV-positive
oropharyngeal cancer is not understood.
Methods: Using HPV serology as a marker of HPV-related cancer, we
examined the interaction between smoking and HPV16 in 459 oropharyngeal
(and 1445 oral cavity and laryngeal) cancer patients and 3024 control
participants from two large European multicentre studies. Odds ratios
and credible intervals [CrI], adjusted for potential confounders, were
estimated using Bayesian logistic regression.
Results: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29])
and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were
independently associated with oropharyngeal cancer. The joint
association of smoking and HPV seropositivity was consistent with that
expected on the additive scale (synergy index [CrI]: 1.32 [0.51,
3.45]), suggesting they act as independent risk factors for
oropharyngeal cancer.
Conclusions: Smoking was consistently associated with increase in
oropharyngeal cancer risk in models stratified by HPV16 seropositivity.
In addition, we report that the prevalence of oropharyngeal cancer
increases with smoking for both HPV16-positive and HPV16-negative
persons. The impact of smoking on HPV16-positive oropharyngeal cancer
highlights the continued need for smoking cessation programmes for
primary prevention of head and neck cancer.
ER -