Br J Cancer. 2020 Aug 24.
doi: 10.1038/s41416-020-01031-z. Online ahead of print.
Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration
Gioia Di Credico 1 , Jerry Polesel 2 , Luigino Dal Maso 3 , Francesco Pauli 1 , Nicola Torelli 1 , Daniele Luce 4 , Loredana Radoï 5 , Keitaro Matsuo 6 7 , Diego Serraino 8 , Paul Brennan 9 , Ivana Holcatova 10 , Wolfgang Ahrens 11 12 , Pagona Lagiou 13 , Cristina Canova 14 , Lorenzo Richiardi 15 , Claire M Healy 16 , Kristina Kjaerheim 17 , David I Conway 18 , Gary J Macfarlane 19 , Peter Thomson 20 , Antonio Agudo 21 , Ariana Znaor 9 , Silvia Franceschi 22 , Rolando Herrero 9 , Tatiana N Toporcov 23 , Raquel A Moyses 24 , Joshua Muscat 25 , Eva Negri 26 , Marta Vilensky 27 , Leticia Fernandez 28 , Maria Paula Curado 29 , Ana Menezes 30 , Alexander W Daudt 31 , Rosalina Koifman 32 , Victor Wunsch-Filho 23 , Andrew F Olshan 33 , Jose P Zevallos 34 , Erich M Sturgis 35 , Guojun Li 35 , Fabio Levi 36 , Zuo-Feng Zhang 37 , Hal Morgenstern 38 , Elaine Smith 39 , Philip Lazarus 40 , Carlo La Vecchia 41 , Werner Garavello 42 , Chu Chen 43 , Stephen M Schwartz 43 , Tongzhang Zheng 44 , Thomas L Vaughan 43 , Karl Kelsey 45 , Michael McClean 46 , Simone Benhamou 47 , Richard B Hayes 48 , Mark P Purdue 49 , Maura Gillison 50 , Stimson Schantz 51 , Guo-Pei Yu 52 , Shu-Chun Chuang 53 , Paolo Boffetta 54 55 , Mia Hashibe 56 , Amy Lee Yuan-Chin 56 , Valeria Edefonti 41
PMID: 32830199 DOI: 10.1038/s41416-020-01031-z
Background: Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk.
Methods: Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk =10 drinks/day for =54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking.
Results: For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx).
Conclusions: Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.