Alcohol Drinking in Never Users of Tobacco, Cigarette Smoking in Never Drinkers, and the Risk of Head and Neck Cancer: Pooled Analysis in the International Head and Neck Cancer Epidemiology ConsortiumJNCI Journal of the National Cancer Institute 2007 99(10):777-789
At least 75% of head and neck cancers are attributable to a combination of cigarette smoking and alcohol drinking. A precise understanding of the independent association of each of these factors in the absence of the other with the risk of head and neck cancer is needed to elucidate mechanisms of head and neck carcinogenesis and to assess the efficacy of interventions aimed at controlling either risk factor.
We examined the extent to which head and neck cancer is associated with cigarette smoking among never drinkers and with alcohol drinking among never users of tobacco.
Among never drinkers, cigarette smoking was associated with an increased risk of head and neck cancer and there were clear dose–response relationships for the frequency, duration, and number of pack-years of cigarette smoking.
Approximately 24% of head and neck cancer cases among nondrinkers in this study would have been prevented if these individuals had not smoked cigarettes.
Among never users of tobacco, alcohol consumption was associated with an increased risk of head and neck cancer only when alcohol was consumed at high frequency. The association with high-frequency alcohol intake was limited to cancers of the oropharynx/hypopharynx and larynx.
Our results represent the most precise estimates available of the independent association of each of the two main risk factors of head and neck cancer, and they exemplify the strengths of large-scale consortia in cancer epidemiology.
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