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Risk factors associated with head and neck cancer in former smokers: A Brazilian multicentric study

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Title : Risk factors associated with head and neck cancer in former smokers: A Brazilian multicentric study
Author: Luciane Campos Gislon a,b, Maria Paula Curado a, Rossana Veronica ´ Mendoza Lopez ´ c,Jos´e Carlos de Oliveira d
, Jos´e Roberto Vasconcelos de Podesta´ e, Sandra Ventorin von Zeidlerf,Paul Brennan g, Luiz Paulo Kowalski a,h,*
Publication: Cancer Epidemiology
Publisher: Elsevier Inc
Year: 2022
Language: English
Pages: 6
Format: PDF
File size: 427 KB
DOI: 10.1016/j.canep.2022.102143
CBID: CBR233

Categories: Researches, Medical Researches Tags: Epidemiology; Head and neck neoplasms; Risk factors; Smoking cessation; Tobacco smoking., Medical Researches

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Abstract

Background

Reduced tobacco consumption in the population has not been associated with reduced incidence rates of head and neck cancer in several countries.

Objective

To explore the associations between HNC and sociodemographic characteristics and lifestyle of former smokers from three Brazilian cancer centers.

Methods

A multicenter case-control study was conducted with 229 former smokers diagnosed with squamous cell carcinoma of the oral cavity, oropharynx, larynx, and 318 controls (former smokers without head and neck cancer). Bivariate and multiple logistic regression analyses were conducted to estimate odds ratios (ORs) with a 95% confidence interval (CI).

Results

11–20 years after smoking cessation showed significant impact on HNC reduction (OR 0.22, 95% CI, 0.12–0.39), which reached 82% (95% CI, 0.09–0.35) among 20 + former smokers when compared to individuals who had stopped smoking for up to 5 years. A history of high-intensity smoking (>40 pack-years) increased HNC risk by 2.09 times (95% CI 1.13–3.89) when compared to subjects who smoked up to 20 pack-years. Past alcohol consumption (OR 1.99, 95% CI, 1.06–3.82) was also associated with head and neck cancer risk in former smokers when compared to no alcohol consumption. There was a decreased head and neck cancer risk in former smokers who had high school level of education (OR 0.38, 95% CI, 0.16–0.91) compared to illiterate former smokers; and former smokers with moderate intake of vegetables (OR 0.49, 95% CI, 0.28–0.85) and fruits (OR 0.43, 95% CI, 0.25–0.73) compared to those with low intake.

Conclusion

Head and neck cancer risk in former smokers decreases after 11 years after smoking cessation, former smokers with past alcohol consumption showed an increased risk of HNC. High school level of education and moderate intake of vegetables and fruits reduced HNC risk among former smokers.

Highlights

• Early smoking cessation reduces HNC likelihood in former smokers.
• A history of high-intensity smoking increases HNC risk among former smokers.
• Former smokers with past alcohol consumption show an increased risk for HNC.
• Moderate intake of vegetables and fruits reduces HNC risk in former smokers.

1 Introduction

Head and neck cancer (HNC) represents the sixth most common cancer in the world, with an estimated 660,740 new oral cavity, larynx, and oropharynx cancers in 2020 . The main risk factors for HNC are tobacco smoking and alcohol beverage consumption , low intake of fruits and vegetables , and human papillomavirus infection (HPV) . Alcohol and tobacco may interact to increase risk-dose response gradients for HNC .

There is evidence that smoking cessation reduces the risk of head and neck cancer . Studies comparing former smokers and current smokers found an inverse association between smoking cessation and HNC . Former smokers after ≥ 10 years of cessation have been reported to have a reduced risk of HNC compared to smokers . However, there is not much information regarding the protective factors on HNC risk in former smokers .

This study aimed to explore the association between HNC and sociodemographic factors and lifestyle of former smokers from three Brazilian cancer centers.