Consistent but indirect evidence has implicated genetic factors in smoking behavior1,2. We report meta-analyses of several smoking phenotypes within cohorts of the Tobacco and Genetics Consortium (n = 74,053). We also partnered with the European Network of Genetic and Genomic Epidemiology (ENGAGE) and Oxford-GlaxoSmithKline (Ox-GSK) consortia to follow up the 15 most significant regions (n > 140,000). We identified three loci associated with number of cigarettes smoked per day. The strongest association was a synonymous 15q25 SNP in the nicotinic receptor gene CHRNA3 (rs1051730[A], β = 1.03, standard error (s.e.) = 0.053, P = 2.8 × 10−73). Two 10q25 SNPs (rs1329650[G], β = 0.367, s.e. = 0.059, P = 5.7 × 10−10; and rs1028936[A], β = 0.446, s.e. = 0.074, P = 1.3 × 10−9) and one 9q13 SNP in EGLN2 (rs3733829[G], β = 0.333, s.e. = 0.058, P = 1.0 × 10−8) also exceeded genome-wide significance for cigarettes per day. For smoking initiation, eight SNPs exceeded genome-wide significance, with the strongest association at a nonsynonymous SNP in BDNF on chromosome 11 (rs6265[C], odds ratio (OR) = 1.06, 95% confidence interval (Cl) 1.04–1.08, P = 1.8 × 10−8). One SNP located near DBH on chromosome 9 (rs3025343[G], OR = 1.12, 95% Cl 1.08–1.18, P = 3.6 × 10−8) was significantly associated with smoking cessation.

Sentinel node biopsy is a reliable and reproducible means of staging the clinically N0 neck for patients with cT1/T2 HNSCC. It can be used as the sole staging tool for the majority of these patients, but cannot currently be recommended for patients with tumors in the floor of the mouth.

Alcohol is an important risk factor for upper aerodigestive cancers and is principally metabolized by alcohol dehydrogenase (ADH) enzymes. We have investigated six ADH genetic variants in over 3,800 aerodigestive cancer cases and 5,200 controls from three individual studies. Gene variants rs1229984 (ADH1B) and rs1573496 (ADH7) were significantly protective against aerodigestive cancer in each individual study and overall (P ¼ 10 À10 and 10 À9 , respectively). These effects became more apparent with increasing alcohol consumption (P for trend ¼ 0.0002 and 0.065, respectively). Both gene effects were independent of each other, implying that multiple ADH genes may be involved in upper aerodigestive cancer etiology.The alcohol dehydrogenase (ADH) pathway includes seven distinct ADH genes, a key candidate gene group for aerodigestive cancers 1-3 .Studies of aerodigestive cancer in populations of European origin have focused on ADH1C with little evidence of any effect 4 . We previously reported an association for ADH1B R48H (rs1229984) in a central European (CE) population 5 and now consider the effect of this and five other ADH variants in an expanded study comprising 809 aerodigestive cancer cases and 2,586 controls from the CE study as well as a further 3,067 aerodigestive cancer cases and 2,692 controls from two other studies in Europe (ARCAGE study) and Latin America (LA study) (total of 3,876 cases and 5,278 controls). All three studies were coordinated by the International Agency for Research on Cancer (IARC) and followed a similar protocol (Supplementary Methods online). Of the 3,876 cases, 1,790 were cancers of the oral cavity or pharynx, 1,659 were cancers of the hypopharynx or larynx and 427 were cancers of the esophagus (Supplementary Table 1 online). Cases with a histology other than squamous cell were excluded.The HapMap Consortium has genotyped 163 SNPs in the vicinity of the ADH gene cluster with a minor allele frequency (MAF) of 4% or more in the CEPH Utah (CEU) population 6 . Inspection of the linkage disequilibrium (LD) pattern across this region indicates that ADH1A, ADH1B, ADH1C, ADH4, ADH5 and ADH6 are relatively highly correlated, whereas ADH7 showed little correlation with the remaining six ( Supplementary Fig. 1a online). From all verified missense SNPs in the seven ADH genes found in both the NCBI SNP and SNP500 databases 7 , we selected eight that had a MAF 4 4% in the CEU population. Three missense SNPs in ADH4 (rs1126671, rs1126673 and rs1042364) were in strong LD, and thus were genotyped by the highly correlated tagging SNP rs1984362 (r 2 4 0.89). In total, we genotyped six genetic variants (five missense SNPs and one tagging SNP) in all three studies (Table 1 and Supplementary Table 2 online).In the pooled analysis on all 3,876 cases and 5,278 controls, four variants reported a significant association (Supplementary Table 3 online). The most prominent was with rs1229984 (in ADH1B; OR for codominant model ¼ 0.59 (95% CI ¼ 0.50-0.69); P under codominant model ¼ 8 Â 10 À10 ). This variant w...

Larynx preservation, progression-free interval, and overall survival were similar in both arms, as were acute and late toxic effects.