Tobacco smoking, alcohol drinking, betel quid chewing, and the risk of head and neck cancer in an East Asian population
Corresponding Author
Yuan-Chin Amy Lee PhD
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Correspondence
Yuan-Chin Amy Lee, Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, 375 Chipeta Way, Salt Lake City, UT 84108.
Email: [email protected]
Search for more papers by this authorShuang Li BS
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorYuji Chen BS
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorQian Li PhD
Departments of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorChien-Jen Chen ScD
Genomics Research Center, Academia Sinica, Taipei, Taiwan
Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorWan-Lun Hsu PhD
Genomics Research Center, Academia Sinica, Taipei, Taiwan
Search for more papers by this authorPei-Jen Lou MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCairong Zhu PhD
Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China
Search for more papers by this authorJian Pan MD
Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China
Search for more papers by this authorHongbing Shen MD, PhD
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
Search for more papers by this authorHongxia Ma MD, PhD
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
Search for more papers by this authorLin Cai MD, PhD
Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China
Search for more papers by this authorBaochang He PhD
Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China
Search for more papers by this authorYu Wang MD
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Search for more papers by this authorXiaoyan Zhou MD
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
Search for more papers by this authorQinghai Ji MD
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Search for more papers by this authorBaosen Zhou MD, PhD
Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
Search for more papers by this authorWei Wu PhD
Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
Search for more papers by this authorJie Ma MD
Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China
Search for more papers by this authorPaolo Boffetta MD
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
Search for more papers by this authorZuo-Feng Zhang MD, PhD
Department of Epidemiology, and Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles, California
Search for more papers by this authorMin Dai PhD
National Office of Cancer Prevention and Control Cancer Institute and Hospital, and Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorMia Hashibe PhD
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorCorresponding Author
Yuan-Chin Amy Lee PhD
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Correspondence
Yuan-Chin Amy Lee, Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, 375 Chipeta Way, Salt Lake City, UT 84108.
Email: [email protected]
Search for more papers by this authorShuang Li BS
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorYuji Chen BS
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorQian Li PhD
Departments of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorChien-Jen Chen ScD
Genomics Research Center, Academia Sinica, Taipei, Taiwan
Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorWan-Lun Hsu PhD
Genomics Research Center, Academia Sinica, Taipei, Taiwan
Search for more papers by this authorPei-Jen Lou MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCairong Zhu PhD
Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China
Search for more papers by this authorJian Pan MD
Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China
Search for more papers by this authorHongbing Shen MD, PhD
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
Search for more papers by this authorHongxia Ma MD, PhD
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
Search for more papers by this authorLin Cai MD, PhD
Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China
Search for more papers by this authorBaochang He PhD
Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China
Search for more papers by this authorYu Wang MD
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Search for more papers by this authorXiaoyan Zhou MD
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
Search for more papers by this authorQinghai Ji MD
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Search for more papers by this authorBaosen Zhou MD, PhD
Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
Search for more papers by this authorWei Wu PhD
Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
Search for more papers by this authorJie Ma MD
Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China
Search for more papers by this authorPaolo Boffetta MD
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
Search for more papers by this authorZuo-Feng Zhang MD, PhD
Department of Epidemiology, and Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles, California
Search for more papers by this authorMin Dai PhD
National Office of Cancer Prevention and Control Cancer Institute and Hospital, and Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorMia Hashibe PhD
Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorAbstract
Background
The smoking prevalence among men in China is high, but the head and neck cancer incidence rates are low. This study's purpose was to investigate the impact of tobacco, betel quid, and alcohol on head and neck cancer risk in East Asia.
Methods
A multicenter case-control study (921 patients with head and neck cancer and 806 controls) in East Asia was conducted. The odds ratio (OR) and 95% confidence interval (CI) were estimated using logistic regression.
Results
Head and neck cancer risks were elevated for tobacco (OR = 1.58), betel quid (OR = 8.23), and alcohol (OR = 2.29). The total attributable risk of tobacco and/or alcohol was 47.2%. Tobacco/alcohol appeared to account for a small proportion of head and neck cancer among women (attributable risk of 2.2%). Betel quid chewing alone accounted for 28.7% of head and neck cancer.
Conclusions
Betel quid chewing is the strongest risk factor for oral cavity cancer in this Chinese population. Alcohol may play a larger role for head and neck cancer in this population than in European or U.S. populations.
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