BACKGROUND: Cigarette smoking is a major risk factor for head and neck cancer (HNC). To our knowledge, low cigarette smoking (<10 cigarettes per day) has not been extensively investigated in fine categories or among never alcohol drinkers. METHODS: We conducted a pooled analysis of individual participant data from 23 independent case-control studies including 19 660 HNC cases and 25 566 controls. After exclusion of subjects using other tobacco products including cigars, pipes, snuffed or chewed tobacco and straw cigarettes (tobacco product used in Brazil), as well as subjects smoking more than 10 cigarettes per day, 4093 HNC cases and 13 416 controls were included in the analysis. The lifetime average frequency of cigarette consumption was categorized as follows: never cigarette users, >0-3, >3-5, >5-10 cigarettes per day. RESULTS: Smoking >0-3 cigarettes per day was associated with a 50% increased risk of HNC in the study population [odds ratio (OR) = 1.52, 95% confidence interval (CI): (1.21, 1.90). Smoking >3-5 cigarettes per day was associated in each subgroup from OR = 2.01 (95% CI: 1.22, 3.31) among never alcohol drinkers to OR = 2.74 (95% CI: 2.01, 3.74) among women and in each cancer site, particularly laryngeal cancer (OR = 3.48, 95% CI: 2.40, 5.05). However, the observed increased risk of HNC for low smoking frequency was not found among smokers with smoking duration shorter than 20 years. CONCLUSION: Our results suggest a public health message that low frequency of cigarette consumption contributes to the development of HNC. However, smoking duration seems to play at least an equal or a stronger role in the development of HNC.

Aviano Cancer Centre Aviano Italy

Boston University School of Public Health Boston MA USA

Bremen Institute for Prevention Research and Social Medicine Bremen Germany

Brown University Providence RI USA

Cancer Registry of Norway Oslo Norway

Cancer Research Centre Moscow Russia

Catalan Institute of Oncology Barcelona Spain

Catalan Institute of Oncology L'Hospitalet de Llobregat Barcelona Spain

College of Public Health University of Iowa Iowa City IA USA

Croatian National Cancer Registry Zagreb Croatia

Dental School College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK

Departments of Epidemiology Environmental Health Sciences and Urology Schools of Public Health and Medicine and Comprehensive Cancer Center University of Michigan Ann Arbor MI USA

Division of Epidemiology New York University School Of Medicine New York NY USA

Escola Nacional de Saude Publica Fundacao Oswaldo Cruz Rio de Janeiro Brazil

Fred Hutchinson Cancer Research Center Seattle WA USA

Head and Neck Surgery Department Institute of Otorhinolaryngology Università Cattolica del Sacro Cuore Rome Italy

Hospital de Clinicas de Porto Alegre Porto Alegre Brazil

Huntsman Cancer Institute University of Utah School of Medicine Salt Lake City UT USA and University of Utah School of Medicine Salt Lake City UT USA

Institute of Hygiene and Epidemiology Prague Czech Republic

Institute of Occupational Medicine Lodz Poland

Institute of Oncology and Radiobiology La Havana Cuba Instituto do Câncer do Estado de Sao Paulo Sao Paulo Brazil

Institute of Oncology Angel H Roffo University of Buenos Aires Buenos Aires Argentina

Institute of Public Health Section of Hygiene Università Cattolica del Sacro Cuore Rome Italy L'Istituto di Ricovero e Cura a Carattere Scientifico Rome Italy

Institute of Social and Preventive Medicine Lausanne Switzerland

Instituto do Câncer do Estado de Sao Paulo Sao Paulo Brazil

International Agency for Research on Cancer Lyon France

International Agency for Research on Cancer Lyon France Pôle Information Médicale Evaluation Recherche Hospices Civils de Lyon France

International Prevention Research Institute Lyon France

Istituto Di Ricovero e Cura a Carattere Scientific IRCCS Milan Italy

M Skasodowska Curie Memorial Cancer Center and Institute of Oncology Department of Cancer Epidemiology and Prevention Warsaw Poland

National Cancer Institute National Institutes of Health Bethesda MD USA

National Institute of Environmental Health Budapest Hungary

National Institute of Public Health Bucharest Romania

Penn State College of Medicine Hershey PA USA

Regional Authority of Public Health Banska Bystrica Slovakia

Tisch Cancer Institute and Institute of Translational Epidemiology Icahn School of Medicine at Mount Sinai New York NY USA

Trinity College School of Dental Science Dublin Ireland

UCLA School of Public Health Los Angeles CA USA

UNC School of Public Health Chapel Hill NC USA

Universidade de Sao Paulo Sao Paulo Brazil

Universidade Federal de Pelotas Pelotas Brazil

University of Aberdeen Dental School Aberdeen UK

University of Athens School of Medicine Athens Greece

University of Heidelberg Heidelberg Germany

University of Newcastle Newcastle UK

University of Padua Padua Italy

University of Turin Turin Italy

University of Utah School of Medicine Salt Lake City UT USA

UT M D Anderson Cancer Center Houston TX USA

Washington State University College of Pharmacy Spokane WA USA

Zobrazit více v PubMed

Lubin JH, Alavanja MC, Caporaso N, et al. . Cigarette smoking and cancer risk: modeling total exposure and intensity . Am J Epidemiol 2007. ; 166:479 – 89 . PubMed

Wyss A, Hashibe M, Chuang SC, et al. . Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled . Am J Epidemiol 2013. ; 178:679 – 90 . PubMed PMC

Polesel J, Talamini R, La Vecchia C, et al. . Tobacco smoking and the risk of upper aero-digestive tract cancers: A reanalysis of case-control studies using spline models . Int J Cancer 2008. ; 122:2398 – 402 . PubMed

Tuyns AJ, Esteve J, Raymond L, et al. . Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC international case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Calvados (France) . Int J Cancer 1988. ; 41:483 – 91 . PubMed

McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF, Jr . Smoking and cancer mortality among U.S. veterans: a 26-year follow-up . Int J Cancer 1995. ; 60:190 – 93 . PubMed

Conway DI, Hashibe M, Boffetta P, et al. . Enhancing epidemiologic research on head and neck cancer: INHANCE –The international head and neck cancer epidemiology consortium . Oral Oncol 2009. ; 45:743 – 46 . PubMed

Hashibe M, Brennan P, Benhamou S, et al. . Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium . J Natl Cancer Inst 2007. ; 99:777 – 89 . PubMed

Hashibe M, Brennan P, Chuang S-C, et al. . 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 . Cancer Epidemiol Biomarkers Prev 2009. ; 18:541 – 50 . PubMed PMC

DerSimonian R, Laird N . Meta-analysis in clinical trials . Control Clin Trials 1986. ; 7:177 – 88 . PubMed

Greenland S, Finkle WD . A critical look at methods for handling missing covariates in epidemiologic regression analyses . Am J Epidemiol 1995. ; 142:1255 – 64 . PubMed

Rudin D . Multiple Imputation for Nonresponse in Surveys . New York, NY: : John Wiley; , 1987. .

IARC working group on the Evaluation of Carcinogenic Risks to Humans . Tobacco Smoke and Involuntary Smoking . Lyon, France: : IARC Press; , 2004. . PubMed PMC

D’Avanzo B, La Vecchia C, Talamini R, Franceschi S . Anthropometric measures and risk of cancers of the upper digestive and respiratory tract . Nutr Cancer 1996. ; 26:219 – 27 . PubMed

Lee Y-CA, Boffetta P, Sturgis EM, et al. . Involuntary smoking and head and neck cancer risk: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium . Cancer Epidemiol Biomarkers Prev 2008. ; 17:1974 – 81 . PubMed PMC

A risk prediction model for head and neck cancers incorporating lifestyle factors, HPV serology and genetic markers

Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach