joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer a bivariate spline model approach

• DOI: 10.17615/9csk-mr96
• Publication Date: 2019-07-01
• Authors: Fabio Levi; Francesco Pauli; Heribert Ramroth; Chu Chen; Ariana Znaor; Valeria Edefonti; Elaine M. Smith; Philip Lazarus; Joshua E. Muscat; Paolo Boffetta; Ana M. B. Menezes; Rolando Herrero; Leticia Fernandez; Guojun Li; Maria Paula Curado; Victor Wünsch-Filho; Ivana Holcatova; Neil D. Gross; Hermann Brenner; Tatiana Natasha T...; Thomas L. Vaughan; Shu Chun Chuang; Andrew F. Olshan; Karl T. Kelsey; Lorenzo Richiardi; Eleonora Fabianova; Paul Brennan; Alexander W. Daudt; Werner Garavello; Silvia Franceschi; Nicola Torelli; Gioia Di Credico; Gioia Di Credico; Jerry Polesel; Stimson P. Schantz; Yuan Chin Amy Lee; Gypsyamber D'Souza; Danièle Luce; Gabriella Cadoni; Gabriella Cadoni; Antonio Agudo; Lorenzo Simonato; Keitaro Matsuo; Jose P. Zevallos; Luigino Dal Maso; Oxana Shangina; Isabelle Stücker; Erich M. Sturgis; Carlo La Vecchia; Guo Pei Yu; Diego Serraino; Wolfgang Ahrens; Wolfgang Ahrens; Tongzhang Zheng; Rosalina Jorge Ko...; Peter Rudnai; Leonardo F. Boave...; Deborah M. Winn; Cristina Bosetti; Kristina Kjærheim; Eva Negri; Zuo-Feng Zhang; Stefania Boccia; Stefania Boccia; Stephen M. Schwartz; Pagona Lagiou; Beata Swiatkowska; Michael D. McClean; Claire M. Healy; Marta Vilensky; Richard B. Hayes; Jolanda Lissowska; Maura L. Gillison; Mark P. Purdue; David I. Conway; Mia Hashibe; Dana Mates; Gwenn Menvielle; Tatiana V. Macfar...; Hal Morgenstern; Peter Thomson; Kirsten B. Moysich
• Keywords: Oral cavity and pharyngeal cancers; Male; Bivariate spline model; Squamous-Cell Carcinoma; Lung-Cancer; Pooled Analysis; Genetic Susceptibility; International Head; Substance Misuse; Laryngeal cancer; Risk Factors; 80 and over; 2.2 Factors relating to the physical environment; 1306 Cancer Research; Aetiology; Head and neck cancer; Cancer; Aged, 80 and over; 3504 Oral Surgery; Middle Aged; 3. Good health; Oral-Cancer; Head and Neck Neoplasms; Bivariate spline models; Cigarette smoking duration; Cigarette smoking intensity; Head and neck cancer; Laryngeal cancer; Oral cavity and pharyngeal cancers; Public Health and Health Services; 2730 Oncology; Female; Human-Papillomavirus; Adult; INHANCE; Oncology and Carcinogenesis; Cigarette smoking duration; 610; [SDV.CAN]Life Sciences [q-bio]/Cancer; Laryngeal-Cancer; Cigarette Smoking; Alcohol-Drinking; Rare Diseases; Cigarette smoking intensity; Clinical Research; 616; Tobacco; Tobacco Smoking; Humans; Oncology & Carcinogenesis; Dental/Oral and Craniofacial Disease; Aged; Biomedical and Clinical Sciences; Tobacco Smoke and Health; Prevention; Bivariate spline models; Oncology and carcinogenesis; Bivariate spline models; Cigarette smoking duration; Cigarette smoking intensity; Head and neck cancer; INHANCE; Laryngeal cancer; Oral cavity and pharyngeal cancers; Good Health and Well Being; Dentistry; Case-Control Studies

Objectives: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. Materials and Methods: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. Results: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) >5 was reached after 30 years in current smokers of ∼20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs >20 were found for current smokers of ≥20 cigarettes/day for ≥30 years. In former smokers who quit ≥10 years ago, the ORs were approximately halved for OCP cancers, and ∼1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. Conclusion: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.