Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.
Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.
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DOI：
10.1158/1055-9965.epi-08-0347
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发表时间：
2009-02
期刊：
影响因子：
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通讯作者：
Boffetta P
中科院分区：
文献类型：
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作者：
Hashibe M;Brennan P;Chuang SC;Boccia S;Castellsague X;Chen C;Curado MP;Dal Maso L;Daudt AW;Fabianova E;Fernandez L;Wünsch-Filho V;Franceschi S;Hayes RB;Herrero R;Kelsey K;Koifman S;La Vecchia C;Lazarus P;Levi F;Lence JJ;Mates D;Matos E;Menezes A;McClean MD;Muscat J;Eluf-Neto J;Olshan AF;Purdue M;Rudnai P;Schwartz SM;Smith E;Sturgis EM;Szeszenia-Dabrowska N;Talamini R;Wei Q;Winn DM;Shangina O;Pilarska A;Zhang ZF;Ferro G;Berthiller J;Boffetta P
烟草和酒精使用之间的相互作用对头颈癌风险的影响程度尚不清楚，因为研究使用了各种方法来量化头颈癌的过度负担。我们分析了参加国际头颈癌流行病学（INHANCE）联盟的17项欧洲和美国病例对照研究（11,221例和16,168例对照）的个人水平汇总数据。我们估计了相乘的相互作用参数（ψ）和总体归因风险（PAR）。曾经吸烟和饮酒对头颈癌风险的联合效应大于乘数效应（ψ=2.15, 95%CI= 1.53-3.04）。烟草或酒精对头颈癌的PAR为72% (95%CI= 61%-79%)，其中4%是由于酒精单独引起的，33%是由于烟草单独引起的，35%是由于烟草和酒精联合引起的。总PAR因亚位点（口腔癌64%，咽癌72%，喉癌89%）、性别（男性74%，女性57%）、年龄（45岁以下病例33%，60岁以下病例73%）和地区（欧洲84%，北美51%，拉丁美洲83%）而异。我们的研究结果证实，吸烟和饮酒对头颈癌风险的共同影响大于乘数。然而，头颈癌的很大一部分不能归因于吸烟或饮酒，特别是口腔癌、妇女头颈癌和年轻发病病例。
The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear, since studies have used various methods to quantify the excess head and neck cancer burden. We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ=2.15, 95%CI=1.53–3.04). The PAR for tobacco or alcohol was 72% (95%CI=61%–79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due tobacco alone and 35% was due to tobacco and alcohol combined. The total PAR differed by subsite (64% for oral cavity cancer, 72% for pharyngeal cancer, 89% for laryngeal cancer), by sex (74% for men, 57% for women) by age (33% for cases <45 years, 73% for cases >60 years) and by region (84% in Europe, 51% in North America, 83% in Latin America). Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer, for head and neck cancer among women and among young onset cases.