Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration

Di Credico, Gioia, Polesel, Jerry, Dal Maso, Luigino, Pauli, Francesco, Torelli, Nicola, Luce, Daniele, Radoï, Loredana, Matsuo, Keitaro, Serraino, Diego, Brennan, Paul, Holcatova, Ivana, Ahrens, Wolfgang, Lagiou, Pagona, Canova, Cristina, Richiardi, Lorenzo, Healy, Claire M., Kjaerheim, Kristina, Conway, David I., Macfarlane, Gary J., Thomson, Peter, Agudo, Antonio, Znaor, Ariana, Franceschi, Silvia, Herrero, Rolando, Toporcov, Tatiana N., Moyses, Raquel A., Muscat, Joshua, Negri, Eva, Vilensky, Marta, Fernandez, Leticia, Curado, Maria Paula, Menezes, Ana, Daudt, Alexander W., Koifman, Rosalina, Wunsch-Filho, Victor, Olshan, Andrew F., Zevallos, Jose P., Sturgis, Erich M., Li, Guojun, Levi, Fabio, Zhang, Zuo Feng, Morgenstern, Hal, Smith, Elaine, Lazarus, Philip, La Vecchia, Carlo, Garavello, Werner, Chen, Chu, Schwartz, Stephen M., Zheng, Tongzhang, Vaughan, Thomas L., Kelsey, Karl, McClean, Michael, Benhamou, Simone, Hayes, Richard B., Purdue, Mark P., Gillison, Maura, Schantz, Stimson, Yu, Guo Pei, Chuang, Shu Chun, Boffetta, Paolo, Hashibe, Mia, Yuan-Chin, Amy Lee, and Edefonti, Valeria (2020) Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration. British Journal of Cancer, 123. pp. 1456-1463.

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Background: Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk.

Methods: Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking.

Results: For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx).

Conclusions: Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.

Item ID: 68430
Item Type: Article (Research - C1)
ISSN: 1532-1827
Copyright Information: © The Author(s), under exclusive licence to Cancer Research UK 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Date Deposited: 02 Aug 2022 03:54
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3203 Dentistry > 320305 Oral and maxillofacial surgery @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321199 Oncology and carcinogenesis not elsewhere classified @ 50%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 100%
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