Περίληψη:
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.
Συγγραφείς:
Toporcov, Tatiana Natasha
Znaor, Ariana
Zhang, Zuo-Feng
Yu,
Guo-Pei
Winn, Deborah M.
Wei, Qingyi
Vilensky, Marta and
Vaughan, Thomas
Thomson, Peter
Talamini, Renato and
Szeszenia-Dabrowska, Neonila
Sturgis, Erich M.
Smith, Elaine and
Shangina, Oxana
Schwartz, Stephen M.
Schantz, Stimson and
Rudnai, Peter
Richiardi, Lorenzo
Ramroth, Heribert
Purdue,
Mark P.
Olshan, Andrew F.
Eluf-Neto, Jose
Muscat, Joshua and
Moyses, Raquel Ajub
Morgenstern, Hal
Menezes, Ana
McClean,
Michael
Matsuo, Keitaro
Mates, Dana
Macfarlane, Tatiana V.
and Lissowska, Jolanta
Levi, Fabio
Lazarus, Philip
La
Vecchia, Carlo
Lagiou, Pagona
Koifman, Sergio
Kjaerheim,
Kristina
Kelsey, Karl
Holcatova, Ivana
Herrero, Rolando and
Healy, Claire
Hayes, Richard B.
Franceschi, Silvia and
Fernandez, Leticia
Fabianova, Eleonora
Daudt, Alexander W. and
Curioni, Otavio Alberto
Dal Maso, Luigino
Curado, Maria Paula
and Conway, David I.
Chen, Chu
Castellsague, Xavier
Canova,
Cristina
Cadoni, Gabriella
Brennan, Paul
Boccia, Stefania
and Antunes, Jose Leopoldo Ferreira
Ahrens, Wolfgang
Agudo,
Antonio
Boffetta, Paolo
Hashibe, Mia
Lee, Yuan-Chin Amy and
Wuensch Filho, Victor
