Journal
ORAL ONCOLOGY
Volume 94, Issue -, Pages 47-57Publisher
ELSEVIER
DOI: 10.1016/j.oraloncology.2019.05.006
Keywords
Bivariate spline models; Cigarette smoking duration; Cigarette smoking intensity; Head and neck cancer; INHANCE; Laryngeal cancer; Oral cavity and pharyngeal cancers
Categories
Funding
- National Institutes of Health (NIH) [P01CA068384, K07CA104231, R01CA048996, R01DE012609, TW001500, R01CA061188, R01DE013158, P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, R21ES011667, R01ES011740, R01CA100264, R01CA078609, R01CA100679, R01CA051845, R01CA030022, DE016631]
- National Cancer Institute (NCI) at the National Institutes of Health (NIH) [R03CA113157, R01CA90731-01]
- National Institute of Dental and Craniofacial Research (NIDCR) at the National Institutes of Health (NIH) [R03DE016611, R01DE011979, R01DE013110]
- Italian Association for Research on Cancer (AIRC) [10068]
- Italian League against Cancer
- Italian Ministry of Research
- Swiss Research against cancer/Oncosuisse [KFS-700, OCS-1633]
- World Cancer Research Fund
- European Commission [IC18-CT97-0222, IC15-CT98-0332]
- Veterans Affairs Merit Review Funds
- National Institute of Environmental Health Sciences (NIEHS) [P30ES010126]
- Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center
- Fondo para la Investigacion Cientifica y Tecnologica Argentina (FONCYT)
- Institut Hospital del Mar d'Investigacions Mediques (IMIM)
- Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP) [01/01768-2, GENCAPO 04/12054-9, 10/51168-0]
- Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government [FIS 97/0024, FIS 97/0662, BAE 01/5013]
- International Union Against Cancer (UICC)
- Yamagiwa-Yoshida Memorial International Cancer Study Grant
- European Community (5th Framework Programme) [QLK1-CT-2001-00182]
- Ministry of Science, Research and Arts Baden-Wurttemberg
- German Ministry of Education and Research [01 GB9702/3]
- Ministry of Education, Science, Sports, Culture and Technology of Japan [17015052]
- Third-Term Comprehensive 10-Year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan [H20-002]
- Johns Hopkins Richard Gelb Cancer Prevention Award
- Italian Foundation for Cancer Research (FIRC)
- Italian Ministry of Education PRIN 2009 Program [X8YCBN]
- Universita degli Studi di Milano 'Young Investigator Grant Program 2017'
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Objectives: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. Materials and Methods: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. Results: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) > 5 was reached after 30 years in current smokers of similar to 20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs > 20 were found for current smokers of >= 20 cigarettes/day for >= 30 years. In former smokers who quit >= 10 years ago, the ORs were approximately halved for OCP cancers, and similar to 1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. Conclusion: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.
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