Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis

Berthiller, Julien; Straif, Kurt; Agudo, Antonio; Ahrens, Wolfgang; Santos, Alexandre Bezerra dos; Boccia, Stefania; Cadoni, Gabriella; Canova, Cristina; Castellsagué, Xavier; Chen, Chu; Conway, David I.; Curado, María Paula; Maso, Luigino Dal; Daudt, Alexander W.; Fabiánovà, Eleonóra; Fernández, Leticia; Franceschi, Silvia; Fukuyama, Érica Erina; Hayes, Richard B.; Healy, Claire M.; Herrero, Rolando; Holcátová, Ivana; Kelsey, Karl T.; Kjærheim, Kristina; Koifman, Sérgio; Λάγιου, Παγώνα; Vecchia, Carlo La; Lazarus, Philip; Levi, Fabio; Lissowska, Jolanta; Macfarlane, Tatiana V.; Mateș, Dana; McClean, Michael D.; Menezes, Ana; Merletti, Franco; Morgenstern, Hal; Muscat, Joshua E.; Olshan, Andrew F.; Purdue, Mark P.; Ramroth, Heribert; Rudnai, Péter; Schwartz, Stephen M.; Serraino, Diego; Shangina, Oxana; Smith, Elaine; Sturgis, Erich M.; Szeszenia-Da̧browska, Neonila; Thomson, Peter; Vaughan, Thomas L.; Vilensky, Marta; Wei, Qingyi; Winn, Deborah M.; Wünsch-Filho, Victor; Zhang, Zuo‐Feng; Znaor, Ariana; Ferro, Gilles; Brennan, Paul; Boffetta, Paolo; Hashibe, Mia; Lee, Yuan Chin Amy

doi:10.1093/ije/dyv146

Cited by 47 publications

(49 citation statements)

References 13 publications

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“…Nevertheless, analogous findings to those in our study were observed in a recent case-control consortium study of head and neck cancer. 16 In this case-control study, participants who had averaged smoking of fewer than 0 to 3, more than 3 to 5, and more than 5 to 10 CPD over their lifetime had higher odds of head and neck cancer compared with never smokers.…”

Section: Discussionmentioning

confidence: 85%

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

et al. 2017

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IMPORTANCE A growing proportion of US smokers now smoke fewer than 10 cigarettes per day (CPD), and that proportion will likely rise in the future. The health effects of smoking only a few CPD over one's lifetime are less understood than are the effects of heavier smoking, although many smokers believe that their level is modest.OBJECTIVE To evaluate the associations of long-term smoking of fewer than 1 or 1 to 10 CPD (low intensity) with all-cause and cause-specific mortality compared with never smoking cigarettes.DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of 290 215 adults in the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study who were aged 59 to 82 years in calendar years 2004-2005 (baseline). Data were gathered with a questionnaire assessing lifetime cigarette smoking history. Hazard ratios (HRs) and 95% CIs were determined for all-cause mortality and cause-specific mortality through the end of 2011. Hazard ratios and 95% CIs were estimated using Cox proportional hazards regression models using age as the underlying time metric and adjusted for sex, race/ethnicity, educational level, physical activity, and alcohol intake. Data analysis was conducted from December 15, 2015, to September 30, 2016.EXPOSURES Current and historical smoking intensity during 9 previous age periods (from <15 years to Ն70 years) over the lifetime assessed on the 2004-2005 questionnaire.MAIN OUTCOMES AND MEASURES All-cause and cause-specific mortality among current, former, and never smokers. RESULTSOf the 290 215 cohort participants who completed the 2004-2005 questionnaire, 168 140 were men (57.9%); the mean (SD) age was 71 (5.3) years (range, 59-82 years). Most people who smoked fewer than 1 or 1 to 10 CPD at baseline reported smoking substantially higher numbers of CPD earlier in their lives. Nevertheless, 159 (9.1%) and 1493 (22.5%) of these individuals reported consistently smoking fewer than 1 or 1 to 10 CPD in each age period that they smoked, respectively. Relative to never smokers, consistent smokers of fewer than 1 CPD (HR, 1.64; 95% CI, 1.07-2.51) and 1 to 10 CPD (HR, 1.87; 95% CI, 1.64-2.13) had a higher all-cause mortality risk. Associations were similar in women and men for all-cause mortality and were observed across a range of smoking-related causes of death, with an especially strong association with lung cancer (HR, 9.12; 95% CI, and HR, 11.61; 95% CI, for <1 and 1-10 CPD, respectively). Former smokers who had consistently smoked fewer than 1 or 1 to 10 CPD had progressively lower risks with younger age at cessation. For example, the HRs for consistent smokers of fewer than 1 and 1 to 10 CPD who quit at 50 years or older were 1.44 (95% CI, 1.12-1.85) and 1.42 (95% CI, 1.27-1.59), respectively. CONCLUSIONS AND RELEVANCEThis study provides evidence that individuals who smoke fewer than 1 or 1 to 10 CPD over their lifetime have higher mortality risks than never smokers and would benefit from cessation. These results provide further...

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Section: Discussionmentioning

confidence: 85%

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

et al. 2017

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“…However, it is possible that differences between HPV positive and HPV negative HNSCCs may be undervalued due to the lack of data regarding cumulative doses of tobacco and alcohol exposure, as also reported elsewhere [Gillison et al, ]. It has been reported that both tobacco doses and smoking duration are linked to the development of HNSCC [Berthiller et al, ].…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal and laryngeal but not oral cancers are strongly associated with high‐risk human papillomavirus in 172 Greek patients

Tsimplaki

Argyri

Sakellaridis

et al. 2016

Journal of Medical Virology

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A strong and consistent association has been reported between human papillomavirus (HPV) infection and oropharyngeal cancer, whereas a similar link has not yet been clarified in oral and laryngeal cancer. The purpose of this study was to investigate the association between HPV infection and head and neck squamous cell carcinoma (HNSCC) in Greek patients. Cytological or tissue specimens from 172 cases patients with HNSCC and cytological specimens from 91 control subjects were analyzed for HPV DNA detection and genotyping using a microarray-based assay. Multivariate logistic regression was used to estimate odds ratios (ORs) for the association between the presence of HPV infection and HNSCC for each of the tumor site, after adjustment for potential confounders. The adjusted ORs for positivity to high-risk HPV infection for oropharyngeal and laryngeal cancer were 20.3 (95% CI: 1.7-250.1) and 22.8 (95% CI: 2.5-206.2), respectively. High-risk HPV infection was not significantly associated with oral cancer. HPV infection was independently associated with poorly differentiated tumors (OR = 2.8; 95% CI: 1.1-7.5). Our results suggest a strong association of high-risk HPV infection with oropharyngeal and laryngeal cancer. J. Med. Virol. 89:170-176, 2017. © 2016 Wiley Periodicals, Inc.

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“…Just a few studies to date have examined associations of low‐intensity smoking with cancer. Results from these studies are generally consistent with our findings, observing higher risk of cancers, such as lung and head and neck cancers, among those who smoked 1–10 CPD . Data on disease risks among nondaily smokers are even more limited.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have directly examined the health effects of long‐term low‐intensity smoking. Several studies have shown an increased risk of tobacco‐related cancer, but these studies have largely been unable to distinguish those who smoked at low‐intensity over their lifetime from those who smoked much more earlier in life …”

mentioning

confidence: 99%

“…an increased risk of tobacco-related cancer, but these studies 14,15 have largely been unable to distinguish those who smoked at low-intensity over their lifetime from those who smoked much more earlier in life. 16,17 We recently found strong associations between lifelong low-intensity smoking (10 CPD) and total and causespecific mortality in the National Institutes of Health (NIH)-AARP cohort.…”

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confidence: 99%

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Association between long‐term low‐intensity cigarette smoking and incidence of smoking‐related cancer in the national institutes of health‐AARP cohort

Inoue-Choi

Hartge

Liao

et al. 2017

Intl Journal of Cancer

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An increasing proportion of US smokers smoke ≤10 cigarettes per day (CPD) or do not smoke every day, yet the health effects of low-intensity smoking are poorly understood. We identified lifelong smokers of <1 or 1-10 CPD and evaluated risk of incident cancer among 238,525 cancer-free adults, aged 59-82, in the NIH-AARP Diet and Health Study. A questionnaire administered in 2004-2005 assessed CPD during nine age-periods (<15 to ≥70). We estimated hazard ratios (HR) and 95% confidence intervals (CI) using multivariable-adjusted Cox proportional hazards regression with age as the underlying time metric. Of the 18,233 current smokers, (7.6%), 137 and 1,243 reported consistently smoking <1 CPD and 1-10 CPD, respectively. Relative to never smokers, current smokers who reported consistently smoking 1-10 CPD over their lifetime were 2.34 (95% CI = 1.86-2.93) times more likely to develop smoking-related cancer. Current lifetime smokers of <1 CPD were 1.89 (95% CI = 0.90-3.96) times more likely to develop tobacco-related cancer, although the association did not reach statistical significance. Associations were observed for lifelong smoking of ≤10 CPD with lung cancer (HR = 9.65, 95% CI = 6.93-13.43); bladder cancer (HR = 2.22, 95% CI = 1.22-4.05); and pancreatic cancer (HR = 2.03, 95%CI: 1.05-3.95). Among lifelong ≤10 CPD smokers, former smokers had lower risks of smoking-related cancer with longer time since cessation and longer smoking duration. Lifelong <1 and 1-10 CPD smokers are at increased risk of incident cancer relative to never smokers and would benefit from cessation, providing further evidence that even low-levels of cigarette smoking cause cancer.

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Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis

Abstract: 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.

Cited by 47 publications

References 13 publications

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

Oropharyngeal and laryngeal but not oral cancers are strongly associated with high‐risk human papillomavirus in 172 Greek patients

Association between long‐term low‐intensity cigarette smoking and incidence of smoking‐related cancer in the national institutes of health‐AARP cohort

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