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Bernier MO, Baysson H, Pearce MS, Moissonnier M, Cardis E, Hauptmann M, Struelens L, Dabin J, Johansen C, Journy N, Laurier D, Blettner M, Le Cornet L, Pokora R, Gradowska P, Meulepas JM, Kjaerheim K, Istad T, Olerud H, Sovik A, Bosch de Basea M, Thierry-Chef I, Kaijser M, Nordenskjöld A, Berrington de Gonzalez A, Harbron RW, Kesminiene A. Cohort Profile: the EPI-CT study: a European pooled epidemiological study to quantify the risk of radiation-induced cancer from paediatric CT. Int J Epidemiol 2019; 48:379-381g. [PMID: 30388267 PMCID: PMC6469297 DOI: 10.1093/ije/dyy231] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 01/13/2023] Open
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Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Cancer incidence and mortality among firefighters. Int J Cancer 2019; 145:2639-2646. [PMID: 30737784 DOI: 10.1002/ijc.32199] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/07/2022]
Abstract
Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle-Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta-analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non-Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in-depth exposure assessments are indicated.
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Kjaerheim K, Haldorsen T, Lynge E, Martinsen JI, Pukkala E, Weiderpass E, Grimsrud TK. Variation in Nordic Work-Related Cancer Risks after Adjustment for Alcohol and Tobacco. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2760. [PMID: 30563223 PMCID: PMC6313809 DOI: 10.3390/ijerph15122760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 01/15/2023]
Abstract
Background: Alcohol and tobacco strongly increases the risk of cancers of the tongue, mouth, pharynx, larynx, and oesophagus, and are also established risk factors for cancer of the liver, colon, and rectum. It is well documented that these habits are unequally distributed among occupational groups. Most occupational cohort studies lack information on these potentially important confounders, and may therefore be prone to bias. Aim: The aim of the study is to present Nordic standardized incidence ratios (SIRs) for alcohol and tobacco related cancer by occupation, after adjustment for alcohol and tobacco, and to compare to the unadjusted SIRs. Material and Methods: The study is based on the Nordic Occupational Cancer (NOCCA) database. We used confirmatory factor analysis models for simultaneous analysis of the cancer sites related to alcohol and tobacco, to obtain factors that allow for computation of adjusted expected numbers from the reference rates. We then calculated adjusted SIRs for the relevant cancer sites for each occupation. Results: For some occupations and cancers, the changes of risk estimates were striking, from significantly high to significantly low and vice versa. Among Nordic farmers, unadjusted SIRs for cancer of the mouth and oesophagus were 0.56 (95% confidence interval (CI) 0.51⁻0.61) and 0.67 (CI 0.63⁻0.70), respectively. After adjustment, estimates changed to 1.10 (CI 1.01⁻1.21) and 1.16 (CI 1.10⁻1.22). Unadjusted SIR for pharynx cancer among wood workers was 0.83 (CI 0.75⁻0.91), adjusted SIR was 1.14 (CI 1.03⁻1.25). For larynx cancer, results in the opposite direction were seen: unadjusted SIR for economically inactive was 1.38 (CI 1.31⁻1.46) while the adjusted SIR was 0.91 (CI 0.86⁻0.96). Conclusions: Adjustment for the latent indicators of alcohol and tobacco consumption changed risk estimates for several occupations, gave a less confounded description of risk, and may guide in the identification of true risk factors.
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Michalek IM, Martinsen JI, Weiderpass E, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Pukkala E. Occupation and risk of cancer of the renal pelvis in Nordic countries. BJU Int 2018; 123:233-238. [DOI: 10.1111/bju.14533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Katuwal S, Martinsen JI, Kjaerheim K, Sparen P, Tryggvadottir L, Lynge E, Weiderpass E, Pukkala E. Occupational variation in the risk of female breast cancer in the Nordic countries. Cancer Causes Control 2018; 29:1027-1038. [DOI: 10.1007/s10552-018-1076-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/23/2018] [Indexed: 12/31/2022]
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Talibov M, Sormunen J, Hansen J, Kjaerheim K, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Benzene exposure at workplace and risk of colorectal cancer in four Nordic countries. Cancer Epidemiol 2018; 55:156-161. [PMID: 29980027 DOI: 10.1016/j.canep.2018.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this case-control study was to assess the effect of occupational benzene exposure on the risk of colorectal cancer, including its subtypes. METHODS The study included 181,709 colon cancer and 109,227 rectal cancer cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway and Sweden. Cases were identified from the Nordic Occupational Cancer Study (NOCCA) cohort. Five controls per case were selected from the same cohort, matched for country, birth year, and sex. Occupational benzene exposure for each study participant was estimated by linking their job titles to country specific job-exposure matrices. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by using conditional logistic regression models. The results were adjusted for physical strain at work, formaldehyde, ionizing radiation and wood dust. RESULTS Increased risk was observed for all colorectal cancer (OR = 1.12, 95% CI 1.05-1.18) for the high decile of cumulative benzene exposure, indicating a statistically significant dose-response relationship. This excess risk was mainly seen in ascending colon (OR = 1.27, 95% CI 1.13-1.43), and transversal colon (OR = 1.21, 95% CI 1.01-1.41). The ORs in the highest exposure category were markedly higher in women than in men in all subsites of colon and rectum. CONCLUSION This study showed an association between workplace benzene exposure and colorectal cancer. The risk was restricted to ascending and transversal colon, and was the strongest among women.
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Abrahão R, Anantharaman D, Gaborieau V, Abedi-Ardekani B, Lagiou P, Lagiou A, Ahrens W, Holcatova I, Betka J, Merletti F, Richiardi L, Kjaerheim K, Serraino D, Polesel J, Simonato L, Alemany L, Agudo Trigueros A, Macfarlane TV, Macfarlane GJ, Znaor A, Robinson M, Canova C, Conway DI, Wright S, Healy CM, Toner M, Cadoni G, Boccia S, Gheit T, Tommasino M, Scelo G, Brennan P. The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe: The ARCAGE study. Int J Cancer 2018; 143:32-44. [PMID: 29405297 DOI: 10.1002/ijc.31294] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 01/23/2023]
Abstract
Head and neck cancer (HNC) is a preventable malignancy that continues to cause substantial morbidity and mortality worldwide. Using data from the ARCAGE and Rome studies, we investigated the main predictors of survival after larynx, hypopharynx and oral cavity (OC) cancers. We used the Kaplan-Meier method to estimate overall survival, and Cox proportional models to examine the relationship between survival and sociodemographic and clinical characteristics. 604 larynx, 146 hypopharynx and 460 OC cancer cases were included in this study. Over a median follow-up time of 4.6 years, nearly 50% (n = 586) of patients died. Five-year survival was 65% for larynx, 55% for OC and 35% for hypopharynx cancers. In a multivariable analysis, we observed an increased mortality risk among older (≥71 years) versus younger (≤50 years) patients with larynx/hypopharynx combined (LH) and OC cancers [HR = 1.61, 95% CI 1.09-2.38 (LH) and HR = 2.12, 95% CI 1.35-3.33 (OC)], current versus never smokers [HR = 2.67, 95% CI 1.40-5.08 (LH) and HR = 2.16, 95% CI 1.32-3.54 (OC)] and advanced versus early stage disease at diagnosis [IV versus I, HR = 2.60, 95% CI 1.78-3.79 (LH) and HR = 3.17, 95% CI 2.05-4.89 (OC)]. Survival was not associated with sex, alcohol consumption, education, oral health, p16 expression, presence of HPV infection or body mass index 2 years before cancer diagnosis. Despite advances in diagnosis and therapeutic modalities, survival after HNC remains low in Europe. In addition to the recognized prognostic effect of stage at diagnosis, smoking history and older age at diagnosis are important prognostic indicators for HNC.
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Anantharaman D, Billot A, Waterboer T, Gheit T, Abedi-Ardekani B, Lagiou P, Lagiou A, Ahrens W, Holcátová I, Merletti F, Kjaerheim K, Polesel J, Simonato L, Alemany L, Mena Cervigon M, Macfarlane TV, Znaor A, Thomson PJ, Robinson M, Canova C, Conway DI, Wright S, Healy CM, Toner ME, Pawlita M, Tommasino M, Brennan P. Predictors of oropharyngeal cancer survival in Europe. Oral Oncol 2018; 81:89-94. [PMID: 29884419 DOI: 10.1016/j.oraloncology.2018.04.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/10/2018] [Accepted: 04/22/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. MATERIALS AND METHODS We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. RESULTS Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHR = 0.51, 95% CI: 0.32-0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29-0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38-4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12-11.21). CONCLUSION This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival.
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Waszak SM, Northcott PA, Buchhalter I, Robinson GW, Sutter C, Groebner S, Grund KB, Brugières L, Jones DTW, Pajtler KW, Morrissy AS, Kool M, Sturm D, Chavez L, Ernst A, Brabetz S, Hain M, Zichner T, Segura-Wang M, Weischenfeldt J, Rausch T, Mardin BR, Zhou X, Baciu C, Lawerenz C, Chan JA, Varlet P, Guerrini-Rousseau L, Fults DW, Grajkowska W, Hauser P, Jabado N, Ra YS, Zitterbart K, Shringarpure SS, De La Vega FM, Bustamante CD, Ng HK, Perry A, MacDonald TJ, Hernáiz Driever P, Bendel AE, Bowers DC, McCowage G, Chintagumpala MM, Cohn R, Hassall T, Fleischhack G, Eggen T, Wesenberg F, Feychting M, Lannering B, Schüz J, Johansen C, Andersen TV, Röösli M, Kuehni CE, Grotzer M, Kjaerheim K, Monoranu CM, Archer TC, Duke E, Pomeroy SL, Shelagh R, Frank S, Sumerauer D, Scheurlen W, Ryzhova MV, Milde T, Kratz CP, Samuel D, Zhang J, Solomon DA, Marra M, Eils R, Bartram CR, von Hoff K, Rutkowski S, Ramaswamy V, Gilbertson RJ, Korshunov A, Taylor MD, Lichter P, Malkin D, Gajjar A, Korbel JO, Pfister SM. Spectrum and prevalence of genetic predisposition in medulloblastoma: a retrospective genetic study and prospective validation in a clinical trial cohort. Lancet Oncol 2018; 19:785-798. [PMID: 29753700 PMCID: PMC5984248 DOI: 10.1016/s1470-2045(18)30242-0] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. METHODS In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED). Whole-genome sequences and exome sequences from blood and tumour samples were analysed for rare damaging germline mutations in cancer predisposition genes. DNA methylation profiling was done to determine consensus molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGroup3), and group 4 (MBGroup4). Medulloblastoma predisposition genes were predicted on the basis of rare variant burden tests against controls without a cancer diagnosis from the Exome Aggregation Consortium (ExAC). Previously defined somatic mutational signatures were used to further classify medulloblastoma genomes into two groups, a clock-like group (signatures 1 and 5) and a homologous recombination repair deficiency-like group (signatures 3 and 8), and chromothripsis was investigated using previously established criteria. Progression-free survival and overall survival were modelled for patients with a genetic predisposition to medulloblastoma. FINDINGS We included a total of 1022 patients with medulloblastoma from the retrospective cohorts (n=673) and the four prospective studies (n=349), from whom blood samples (n=1022) and tumour samples (n=800) were analysed for germline mutations in 110 cancer predisposition genes. In our rare variant burden analysis, we compared these against 53 105 sequenced controls from ExAC and identified APC, BRCA2, PALB2, PTCH1, SUFU, and TP53 as consensus medulloblastoma predisposition genes according to our rare variant burden analysis and estimated that germline mutations accounted for 6% of medulloblastoma diagnoses in the retrospective cohort. The prevalence of genetic predispositions differed between molecular subgroups in the retrospective cohort and was highest for patients in the MBSHH subgroup (20% in the retrospective cohort). These estimates were replicated in the prospective clinical cohort (germline mutations accounted for 5% of medulloblastoma diagnoses, with the highest prevalence [14%] in the MBSHH subgroup). Patients with germline APC mutations developed MBWNT and accounted for most (five [71%] of seven) cases of MBWNT that had no somatic CTNNB1 exon 3 mutations. Patients with germline mutations in SUFU and PTCH1 mostly developed infant MBSHH. Germline TP53 mutations presented only in childhood patients in the MBSHH subgroup and explained more than half (eight [57%] of 14) of all chromothripsis events in this subgroup. Germline mutations in PALB2 and BRCA2 were observed across the MBSHH, MBGroup3, and MBGroup4 molecular subgroups and were associated with mutational signatures typical of homologous recombination repair deficiency. In patients with a genetic predisposition to medulloblastoma, 5-year progression-free survival was 52% (95% CI 40-69) and 5-year overall survival was 65% (95% CI 52-81); these survival estimates differed significantly across patients with germline mutations in different medulloblastoma predisposition genes. INTERPRETATION Genetic counselling and testing should be used as a standard-of-care procedure in patients with MBWNT and MBSHH because these patients have the highest prevalence of damaging germline mutations in known cancer predisposition genes. We propose criteria for routine genetic screening for patients with medulloblastoma based on clinical and molecular tumour characteristics. FUNDING German Cancer Aid; German Federal Ministry of Education and Research; German Childhood Cancer Foundation (Deutsche Kinderkrebsstiftung); European Research Council; National Institutes of Health; Canadian Institutes for Health Research; German Cancer Research Center; St Jude Comprehensive Cancer Center; American Lebanese Syrian Associated Charities; Swiss National Science Foundation; European Molecular Biology Organization; Cancer Research UK; Hertie Foundation; Alexander and Margaret Stewart Trust; V Foundation for Cancer Research; Sontag Foundation; Musicians Against Childhood Cancer; BC Cancer Foundation; Swedish Council for Health, Working Life and Welfare; Swedish Research Council; Swedish Cancer Society; the Swedish Radiation Protection Authority; Danish Strategic Research Council; Swiss Federal Office of Public Health; Swiss Research Foundation on Mobile Communication; Masaryk University; Ministry of Health of the Czech Republic; Research Council of Norway; Genome Canada; Genome BC; Terry Fox Research Institute; Ontario Institute for Cancer Research; Pediatric Oncology Group of Ontario; The Family of Kathleen Lorette and the Clark H Smith Brain Tumour Centre; Montreal Children's Hospital Foundation; The Hospital for Sick Children: Sonia and Arthur Labatt Brain Tumour Research Centre, Chief of Research Fund, Cancer Genetics Program, Garron Family Cancer Centre, MDT's Garron Family Endowment; BC Childhood Cancer Parents Association; Cure Search Foundation; Pediatric Brain Tumor Foundation; Brainchild; and the Government of Ontario.
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Plato N, Martinsen JI, Kjaerheim K, Kyyronen P, Sparen P, Weiderpass E. Mesothelioma in Sweden: Dose-Response Analysis for Exposure to 29 Potential Occupational Carcinogenic Agents. Saf Health Work 2018; 9:290-295. [PMID: 30370160 PMCID: PMC6129996 DOI: 10.1016/j.shaw.2018.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/10/2018] [Indexed: 11/30/2022] Open
Abstract
Background There is little information on the dose-response relationship between exposure to occupational carcinogenic agents and mesothelioma. This study aimed to investigate this association as well as the existence of agents other than asbestos that might cause mesothelioma. Methods The Swedish component of the Nordic Occupational Cancer (NOCCA) study consists of 6.78 million individuals with detailed information on occupation. Mesothelioma diagnoses recorded in 1961-2009 were identified through linkage to the Swedish Cancer Registry. We determined cumulative exposure, time of first exposure, and maximum exposure intensity by linking data on occupation to the Swedish NOCCA job-exposure matrix, which includes 29 carcinogenic agents and corresponding exposure for 283 occupations. To assess the risk of mesothelioma, we used conditional logistic regression models to estimate hazard ratios and 95% confidence intervals. Results 2,757 mesothelioma cases were identified in males, including 1,416 who were exposed to asbestos. Univariate analyses showed not only a significant excess risk for maximum exposure intensity, with a hazard ratio of 4.81 at exposure levels 1.25-2.0 fb/ml but also a clear dose-response effect for cumulative exposure with a 30-, 40-, and 50-year latency time. No convincing excess risk was revealed for any of the other carcinogenic agents included in the Swedish NOCCA job-exposure matrix. Conclusion When considering asbestos exposure, past exposure, even for short periods, might be enough to cause mesothelioma of the pleura later in life.
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Hadkhale K, Martinsen JI, Weiderpass E, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Pukkala E. 144 Smoking adjusted incidence of bladder cancer using proxy smoking from lung cancer in nordic males. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alfonso JH, Martinsen JI, Weiderpass E, Pukkala E, Lynge E, Tryggvadottir L, Sparén P, Kjaerheim K. 844 Occupation and relative risk of cutaneous melanoma: a 45-year follow-up study of 15 million people in five nordic countries. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pastorino R, Puggina A, Carreras-Torres R, Lagiou P, Holcátová I, Richiardi L, Kjaerheim K, Agudo A, Castellsagué X, Macfarlane TV, Barzan L, Canova C, Thakker NS, Conway DI, Znaor A, Healy CM, Ahrens W, Zaridze D, Szeszenia-Dabrowska N, Lissowska J, Fabianova E, Mates IN, Bencko V, Foretova L, Janout V, Brennan P, Gaborieau V, McKay JD, Boccia S. Genetic Contributions to The Association Between Adult Height and Head and Neck Cancer: A Mendelian Randomization Analysis. Sci Rep 2018; 8:4534. [PMID: 29540730 PMCID: PMC5852094 DOI: 10.1038/s41598-018-22626-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 02/19/2018] [Indexed: 01/02/2023] Open
Abstract
With the aim to dissect the effect of adult height on head and neck cancer (HNC), we use the Mendelian randomization (MR) approach to test the association between genetic instruments for height and the risk of HNC. 599 single nucleotide polymorphisms (SNPs) were identified as genetic instruments for height, accounting for 16% of the phenotypic variation. Genetic data concerning HNC cases and controls were obtained from a genome-wide association study. Summary statistics for genetic association were used in complementary MR approaches: the weighted genetic risk score (GRS) and the inverse-variance weighted (IVW). MR-Egger regression was used for sensitivity analysis and pleiotropy evaluation. From the GRS analysis, one standard deviation (SD) higher height (6.9 cm; due to genetic predisposition across 599 SNPs) raised the risk for HNC (Odds ratio (OR), 1.14; 95% Confidence Interval (95%CI), 0.99-1.32). The association analyses with potential confounders revealed that the GRS was associated with tobacco smoking (OR = 0.80, 95% CI (0.69-0.93)). MR-Egger regression did not provide evidence of overall directional pleiotropy. Our study indicates that height is potentially associated with HNC risk. However, the reported risk could be underestimated since, at the genetic level, height emerged to be inversely associated with smoking.
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Farioli A, Straif K, Brandi G, Curti S, Kjaerheim K, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Biasco G, Violante FS, Mattioli S, Pukkala E. Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case-control study in four Nordic countries. Occup Environ Med 2018; 75:191-198. [PMID: 29133597 PMCID: PMC5869450 DOI: 10.1136/oemed-2017-104603] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/01/2017] [Accepted: 09/28/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). METHODS We conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work. RESULTS We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC. CONCLUSIONS Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed.
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Siew SS, Martinsen JI, Kjaerheim K, Sparén P, Tryggvadottir L, Weiderpass E, Pukkala E. Occupational exposure to wood dust and risk of nasal and nasopharyngeal cancer: A case-control study among men in four nordic countries-With an emphasis on nasal adenocarcinoma. Int J Cancer 2017; 141:2430-2436. [PMID: 28840594 DOI: 10.1002/ijc.31015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/16/2017] [Accepted: 07/25/2017] [Indexed: 11/09/2022]
Abstract
The current study aims to provide stronger evidence to aid in our understanding of the role of cumulative occupational exposure to (softwood-dominated) mixed wood dust in aetiology of nasal cancer. We included broad exposure occurred in a range of wood-processing occupation across varied industries in four Nordic countries. A population-based case-control study was conducted on all male cases with nasal adenocarcinoma (393 cases), other types of nasal cancer (2,446) and nasopharyngeal cancer (1,747) diagnosed in Finland, Sweden, Norway and Iceland between 1961 and 2005. For each case, five male controls, who were alive at the time of diagnosis of the case (index date), were randomly selected, matched by birth-year and country. Cumulative exposures (CE)s to wood dust and formaldehyde before the index date were quantified based on a job-exposure matrix linked to occupational titles derived from population censuses. Hazard ratios (HRs) for the CE of wood dust were estimated by conditional logistic regression, adjusted for CE to formaldehyde and 95% confidence intervals (CIs) were calculated. There was an increasing risk of nasal adenocarcinoma related to wood dust exposure. The HR in the highest CE category of wood dust (≥ 28.82 mg/m3 -years) was 16.5 (95% CI 5.05-54.1). Neither nonadenocarcinoma of the nose nor nasopharyngeal cancer could be linked to wood dust exposure. CE to softwood-dominated mixed wood dusts is strongly linked with elevated risk in nasal adenocarcinoma but not with other types of nasal or nasopharyngeal cancer.
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Hadkhale K, MacLeod J, Demers PA, Martinsen JI, Weiderpass E, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Anne Harris M, Tjepkema M, Peters PA, Pukkala E. Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada. BMJ Open 2017; 7:e016538. [PMID: 28780557 PMCID: PMC5629726 DOI: 10.1136/bmjopen-2017-016538] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada. METHODS In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC. RESULTS Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort. CONCLUSION We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.
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Talibov M, Auvinen A, Weiderpass E, Hansen J, Martinsen JI, Kjaerheim K, Tryggvadottir L, Pukkala E. Occupational solvent exposure and adult chronic lymphocytic leukemia: No risk in a population-based case-control study in four Nordic countries. Int J Cancer 2017; 141:1140-1147. [PMID: 28571111 DOI: 10.1002/ijc.30814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/15/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022]
Abstract
The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.
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Tarvainen L, Suojanen J, Kyyronen P, Lindqvist C, Martinsen JI, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Occupational Risk for Oral Cancer in Nordic Countries. Anticancer Res 2017; 37:3221-3228. [PMID: 28551668 DOI: 10.21873/anticanres.11684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/17/2017] [Accepted: 04/19/2017] [Indexed: 11/10/2022]
Abstract
AIM To evaluate occupational risk for cancer of the tongue, oral cavity or pharynx after adjustment for alcohol and tobacco use. MATERIALS AND METHODS The data covered 14.9 million people and 28,623 cases of cancer of the tongue, oral cavity and pharynx in the Nordic countries 1961-2005. Alcohol consumption by occupation was estimated based on mortality from liver cirrhosis and incidence of liver cancer. Smoking by occupation was estimated based on the incidence of lung cancer. RESULTS Only few occupations had relative risks of over 1.5 for cancer of the tongue, oral cavity and pharynx. These occupations included dentists, artistic workers, hairdressers, journalists, cooks and stewards, seamen and waiters. CONCLUSION Several occupational categories, including dentists, had an increased relative risk of tongue cancer. This new finding remains to be explained but could be related to occupational chemical exposures, increased consumption of alcohol and tobacco products, or infection with human papilloma virus.
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Hadkhale K, Martinsen JI, Weiderpass E, Kjaerheim K, Sparen P, Tryggvadottir L, Lynge E, Pukkala E. Occupational exposure to solvents and bladder cancer: A population‐based case control study in Nordic countries. Int J Cancer 2017; 140:1736-1746. [DOI: 10.1002/ijc.30593] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/14/2016] [Indexed: 11/07/2022]
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Lesseur C, Diergaarde B, Olshan AF, Wünsch-Filho V, Ness AR, Liu G, Lacko M, Eluf-Neto J, Franceschi S, Lagiou P, Macfarlane GJ, Richiardi L, Boccia S, Polesel J, Kjaerheim K, Zaridze D, Johansson M, Menezes AM, Curado MP, Robinson M, Ahrens W, Canova C, Znaor A, Castellsagué X, Conway DI, Holcátová I, Mates D, Vilensky M, Healy CM, Szeszenia-Dąbrowska N, Fabiánová E, Lissowska J, Grandis JR, Weissler MC, Tajara EH, Nunes FD, de Carvalho MB, Thomas S, Hung RJ, Peters WHM, Herrero R, Cadoni G, Bueno-de-Mesquita HB, Steffen A, Agudo A, Shangina O, Xiao X, Gaborieau V, Chabrier A, Anantharaman D, Boffetta P, Amos CI, McKay JD, Brennan P. Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer. Nat Genet 2016; 48:1544-1550. [PMID: 27749845 PMCID: PMC5131845 DOI: 10.1038/ng.3685] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/01/2016] [Indexed: 02/07/2023]
Abstract
We conducted a genome-wide association study of oral cavity and pharyngeal cancer in 6,034 cases and 6,585 controls from Europe, North America and South America. We detected eight significantly associated loci (P < 5 × 10-8), seven of which are new for these cancer sites. Oral and pharyngeal cancers combined were associated with loci at 6p21.32 (rs3828805, HLA-DQB1), 10q26.13 (rs201982221, LHPP) and 11p15.4 (rs1453414, OR52N2-TRIM5). Oral cancer was associated with two new regions, 2p23.3 (rs6547741, GPN1) and 9q34.12 (rs928674, LAMC3), and with known cancer-related loci-9p21.3 (rs8181047, CDKN2B-AS1) and 5p15.33 (rs10462706, CLPTM1L). Oropharyngeal cancer associations were limited to the human leukocyte antigen (HLA) region, and classical HLA allele imputation showed a protective association with the class II haplotype HLA-DRB1*1301-HLA-DQA1*0103-HLA-DQB1*0603 (odds ratio (OR) = 0.59, P = 2.7 × 10-9). Stratified analyses on a subgroup of oropharyngeal cases with information available on human papillomavirus (HPV) status indicated that this association was considerably stronger in HPV-positive (OR = 0.23, P = 1.6 × 10-6) than in HPV-negative (OR = 0.75, P = 0.16) cancers.
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El-Zaemey S, Schinasi L, Ferro G, Baldi I, Tual S, Lebailly P, Nordby KC, Kjaerheim K, Schüz J, Monnereau A, Brouwer M, Kromhout H, Leon M, Freeman LEB. P030 Animal production and risk of lympho-hematopoietic cancers in three cohort studies of farmers within the agricoh consortium-preliminary results. Cancer 2016. [DOI: 10.1136/oemed-2016-103951.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Siew SSA, Martinsen JI, Weiderpass E, Kjaerheim K, Sparen P, Tryggvadottir L, Pukkala E. P048 Lifetime occupational exposure to wood dust and risk of nasal and nasopharyngeal cancer – a case-control study among men in four nordic countries. Cancer 2016. [DOI: 10.1136/oemed-2016-103951.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hadkhale K, Martinsen JI, Weiderpass E, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Pukkala E. P032 Occupational solvent exposure and risk of bladder cancer in the nordic countries. Cancer 2016. [DOI: 10.1136/oemed-2016-103951.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Barry KH, Martinsen JI, Alavanja MC, Andreotti G, Blair A, Hansen J, Kjaerheim K, Koutros S, Lynge E, Sparen P, Tryggvadottir L, Weiderpass E, Berndt SI, Pukkala E. Abstract 3431: Occupation and the risk of early- and later-onset prostate cancer in five Nordic countries. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-3431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The etiology of prostate cancer remains largely unknown. Cases that occur late in life may have a different etiology than early-onset cases, and their inclusion in epidemiological studies may obscure associations with early-onset prostate cancer, which is often more aggressive and clinically relevant. We evaluated occupation in relation to the risk of prostate cancer separately for early-onset and later-onset disease in a large pooled study. We used census data to code occupations among census participants in five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) from 1960-1990. We identified prostate cancer cases diagnosed from 1961-2005 by linkage to national cancer registries and calculated standardized incidence ratios (SIRs) by occupation separately for men aged 30-49 and those aged 50 or older. We also conducted separate analyses by period of cancer follow-up in two categories, 1961-1990 and 1991-2005, based on introduction of the prostate-specific antigen (PSA) screening test in the Nordic countries in 1990 or later. For early-onset prostate cancer, the highest SIRs were observed for public safety workers (e.g., firefighters) [SIR = 1.71, 95% confidence interval (CI): 1.23-2.31] and military personnel (SIR = 1.97, 95% CI: 1.31-2.85). These SIRs were significantly higher than those observed for later-onset disease (pheterogeneity = 0.005 and 0.002), with public safety workers and military personnel demonstrating SIRs of 1.10 (95% CI: 1.07-1.14) and 1.09 (95% CI: 1.05-1.13), respectively. Administrators (SIR = 1.41, 95% CI: 1.13-1.73) and technical workers (SIR = 1.18, 95% CI: 1.01-1.37) also demonstrated significantly increased risk for early-onset prostate cancer, although the SIRs did not significantly differ from those for later-onset disease (for administrators, SIR = 1.17, 95% CI: 1.15-1.19; pheterogeneity = 0.08, and for technical workers, SIR = 1.11, 95% CI: 1.09-1.12; pheterogeneity = 0.40). With the exception of public safety workers, for whom the SIR for early-onset prostate cancer was higher in the later period (for 1961-1990, SIR = 1.45, 95% CI: 0.79-2.43, and for 1991-2005, SIR = 1.87, 95% CI: 1.25-2.71), the observed associations with early-onset disease tended to be restricted to the earlier, pre-PSA period. Our results suggest that occupational exposures among public safety workers and military personnel may contribute to the risk of prostate cancer, particularly for early-onset disease.
Citation Format: Kathryn Hughes Barry, Jan Ivar Martinsen, Michael C.R. Alavanja, Gabriella Andreotti, Aaron Blair, Johnni Hansen, Kristina Kjaerheim, Stella Koutros, Elsebeth Lynge, Par Sparen, Laufey Tryggvadottir, Elisabete Weiderpass, Sonja I. Berndt, Eero Pukkala. Occupation and the risk of early- and later-onset prostate cancer in five Nordic countries. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3431.
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Berthiller J, Straif K, Agudo A, Ahrens W, Bezerra Dos Santos A, Boccia S, Cadoni G, Canova C, Castellsague X, Chen C, Conway D, Curado MP, Dal Maso L, Daudt AW, Fabianova E, Fernandez L, Franceschi S, Fukuyama EE, Hayes RB, Healy C, Herrero R, Holcatova I, Kelsey K, Kjaerheim K, Koifman S, Lagiou P, La Vecchia C, Lazarus P, Levi F, Lissowska J, Macfarlane T, Mates D, McClean M, Menezes A, Merletti F, Morgenstern H, Muscat J, Olshan AF, Purdue M, Ramroth H, Rudnai P, Schwartz SM, Serraino D, Shangina O, Smith E, Sturgis EM, Szeszenia-Dabrowska N, Thomson P, Vaughan TL, Vilensky M, Wei Q, Winn DM, Wünsch-Filho V, Zhang ZF, Znaor A, Ferro G, Brennan P, Boffetta P, Hashibe M, Lee YCA. Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis. Int J Epidemiol 2016; 45:835-45. [PMID: 26228584 PMCID: PMC5005938 DOI: 10.1093/ije/dyv146] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cigarette smoking is a major risk factor for head and neck cancer (HNC). To our knowledge, low cigarette smoking (<10 cigarettes per day) has not been extensively investigated in fine categories or among never alcohol drinkers. METHODS We conducted a pooled analysis of individual participant data from 23 independent case-control studies including 19 660 HNC cases and 25 566 controls. After exclusion of subjects using other tobacco products including cigars, pipes, snuffed or chewed tobacco and straw cigarettes (tobacco product used in Brazil), as well as subjects smoking more than 10 cigarettes per day, 4093 HNC cases and 13 416 controls were included in the analysis. The lifetime average frequency of cigarette consumption was categorized as follows: never cigarette users, >0-3, >3-5, >5-10 cigarettes per day. RESULTS Smoking >0-3 cigarettes per day was associated with a 50% increased risk of HNC in the study population [odds ratio (OR) = 1.52, 95% confidence interval (CI): (1.21, 1.90). Smoking >3-5 cigarettes per day was associated in each subgroup from OR = 2.01 (95% CI: 1.22, 3.31) among never alcohol drinkers to OR = 2.74 (95% CI: 2.01, 3.74) among women and in each cancer site, particularly laryngeal cancer (OR = 3.48, 95% CI: 2.40, 5.05). However, the observed increased risk of HNC for low smoking frequency was not found among smokers with smoking duration shorter than 20 years. CONCLUSION 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.
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