Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium.
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Toporcov Tatiana Natasha, Znaor Ariana, Zhang Zuo-Feng, Yu Guo-Pei, Winn Deborah M, Wei Qingyi, Vilensky Marta, Vaughan Thomas, Thomson Peter, Talamini Renato, Szeszenia-Dabrowska Neonila, Sturgis Erich M, Smith Elaine, Shangina Oxana, Schwartz Stephen M, Schantz Stimson, Rudnai Peter, Richiardi Lorenzo, Ramroth Heribert, Purdue Mark P, Olshan Andrew F, Eluf-Neto José, Muscat Joshua, Moyses Raquel Ajub, Morgenstern Hal, Menezes Ana, McClean Michael, Matsuo Keitaro, Mates Dana, Macfarlane Tatiana V, Lissowska Jolanta, Levi Fabio, Lazarus Philip, La Vecchia Carlo, Lagiou Pagona, Koifman Sergio, Kjaerheim Kristina, Kelsey Karl, Holcatova Ivana, Herrero Rolando, Healy Claire, Hayes Richard B, Franceschi Silvia, Fernandez Leticia, Fabianova Eleonora, Daudt Alexander W, Curioni Otávio Alberto, Maso Luigino Dal, Curado Maria Paula, Conway David I, Chen Chu, Castellsague Xavier, Canova Cristina, Cadoni Gabriella, Brennan Paul, Boccia Stefania, Antunes José Leopoldo Ferreira, Ahrens Wolfgang, Agudo Antonio, Boffetta Paolo, Hashibe Mia, Lee Yuan-Chin Amy, Filho Victor Wünsch
Аннотация
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', 17700 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.