Tobacco smoking, alcohol drinking, betel quid chewing, and the risk of head and neck cancer in an East Asian population

Yuan-Chin Amy Lee; Shuang Li; Yuji Chen; Qian Li; Chien-Jen Chen; Wan-Lun Hsu; Pei-Jen Lou; Cairong Zhu; Jian Pan; Hongbing Shen; Hongxia Ma; Lin Cai; Baochang He; Yu Wang; Xiaoyan Zhou; Qinghai Ji; Baosen Zhou; Wei Wu; Jie Ma; Paolo Boffetta; Zuo-Feng Zhang; Min Dai; Mia Hashibe

doi:10.1002/hed.25383

Tobacco smoking, alcohol drinking, betel quid chewing, and the risk of head and neck cancer in an East Asian population

Head Neck. 2019 Jan;41(1):92-102. doi: 10.1002/hed.25383. Epub 2018 Dec 15.

Authors

Yuan-Chin Amy Lee¹, Shuang Li¹, Yuji Chen¹, Qian Li², Chien-Jen Chen^{3

4}, Wan-Lun Hsu³, Pei-Jen Lou⁵, Cairong Zhu⁶, Jian Pan⁷, Hongbing Shen⁸, Hongxia Ma⁸, Lin Cai⁹, Baochang He⁹, Yu Wang^{10

11}, Xiaoyan Zhou^{11

12}, Qinghai Ji^{10

11}, Baosen Zhou¹³, Wei Wu¹³, Jie Ma¹⁴, Paolo Boffetta¹⁵, Zuo-Feng Zhang¹⁶, Min Dai¹⁷, Mia Hashibe¹

Affiliations

¹ Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah.
² Departments of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
³ Genomics Research Center, Academia Sinica, Taipei, Taiwan.
⁴ Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
⁶ Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China.
⁷ Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
⁸ 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.
⁹ Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China.
¹⁰ Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
¹¹ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
¹² Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
¹³ Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China.
¹⁴ Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China.
¹⁵ Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
¹⁶ Department of Epidemiology, and Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles, California.
¹⁷ National Office of Cancer Prevention and Control Cancer Institute and Hospital, and Chinese Academy of Medical Sciences, Beijing, China.

PMID: 30552826
DOI: 10.1002/hed.25383

Abstract

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.

Keywords: alcohol drinking; attributable fraction, head and neck cancer risk; betel quid chewing; tobacco smoking.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Alcohol Drinking / adverse effects*
Alcohol Drinking / epidemiology
Areca / adverse effects*
Asia, Eastern / epidemiology
Asian People
Case-Control Studies
Female
Head and Neck Neoplasms / epidemiology*
Humans
Male
Middle Aged
Risk Factors
Tobacco Smoking / adverse effects*
Tobacco Smoking / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding