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.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear because studies have used various methods to quantify the excess head and neck cancer burden. METHODS: 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 consortium. We estimated the multiplicative interaction parameter (psi) and population attributable risks (PAR). RESULTS: A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (psi = 2.15; 95% confidence interval, 1.53-3.04). The PAR for tobacco or alcohol was 72% (95% confidence interval, 61-79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due to 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). CONCLUSIONS: 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 and for head and neck cancer among women and among young-onset cases.

Full Text

Duke Authors

Cited Authors

  • Hashibe, M; Brennan, P; Chuang, S-C; 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, Z-F; Ferro, G; Berthiller, J; Boffetta, P

Published Date

  • February 2009

Published In

Volume / Issue

  • 18 / 2

Start / End Page

  • 541 - 550

PubMed ID

  • 19190158

Pubmed Central ID

  • PMC3051410

International Standard Serial Number (ISSN)

  • 1055-9965

Digital Object Identifier (DOI)

  • 10.1158/1055-9965.EPI-08-0347


  • eng

Conference Location

  • United States