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Conway DI, Hovanec J, Ahrens W, Ross A, Holcatova I, Lagiou P, Serraino D, Canova C, Richiardi L, Healy C, Kjaerheim K, Macfarlane GJ, Thomson P, Agudo A, Znaor A, Brennan P, Luce D, Menvielle G, Stucker I, Benhamou S, Ramroth H, Boffetta P, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt A, Koifman R, Wunsch-Filho V, Yuan-Chin AL, Hashibe M, Behrens T, McMahon AD. Occupational socioeconomic risk associations for head and neck cancer in Europe and South America: individual participant data analysis of pooled case-control studies within the INHANCE Consortium. J Epidemiol Community Health 2021; 75:779-787. [PMID: 33622804 PMCID: PMC8292575 DOI: 10.1136/jech-2020-214913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/22/2020] [Accepted: 01/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association between socioeconomic disadvantage (low education and/or income) and head and neck cancer is well established, with smoking and alcohol consumption explaining up to three-quarters of the risk. We aimed to investigate the nature of and explanations for head and neck cancer risk associated with occupational socioeconomic prestige (a perceptual measure of psychosocial status), occupational socioeconomic position and manual-work experience, and to assess the potential explanatory role of occupational exposures. METHODS Pooled analysis included 5818 patients with head and neck cancer (and 7326 control participants) from five studies in Europe and South America. Lifetime job histories were coded to: (1) occupational social prestige-Treiman's Standard International Occupational Prestige Scale (SIOPS); (2) occupational socioeconomic position-International Socio-Economic Index (ISEI); and (3) manual/non-manual jobs. RESULTS For the longest held job, adjusting for smoking, alcohol and nature of occupation, increased head and neck cancer risk estimates were observed for low SIOPS OR=1.88 (95% CI: 1.64 to 2.17), low ISEI OR=1.74 (95% CI: 1.51 to 1.99) and manual occupations OR=1.49 (95% CI: 1.35 to 1.64). Following mutual adjustment by socioeconomic exposures, risk associated with low SIOPS remained OR=1.59 (95% CI: 1.30 to 1.94). CONCLUSIONS These findings indicate that low occupational socioeconomic prestige, position and manual work are associated with head and neck cancer, and such risks are only partly explained by smoking, alcohol and occupational exposures. Perceptual occupational psychosocial status (SIOPS) appears to be the strongest socioeconomic factor, relative to socioeconomic position and manual/non-manual work.
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Affiliation(s)
- David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Jan Hovanec
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Alastair Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Charles University First Faculty of Medicine, Praha, Czech Republic
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Diego Serraino
- Oncology Reference Center, Aviano, Friuli-Venezia Giulia, Italy
| | - Cristina Canova
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padova, Veneto, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, Torino, Piemonte, Italy
| | - Claire Healy
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | | | | | - Peter Thomson
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Catalunya, Spain
| | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Danièle Luce
- University of Rennes 1-Health Sciences Campus Villejean, Rennes, Bretagne, France
- Institute for Research in Health, Environment and Work, National Institute of Health and Medical Research, Rennes, Bretagne, France
- School of Advanced Studies in Public Health, Rennes, Bretagne, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Isabelle Stucker
- Paris-Sud University, Saint-Aubin, Île-de-France, France
- Environmental Epidemiology of Cancer, Centre for Research in Epidemiology and Population Health, National Institute of Health and Medical Research, Villejuif, Île-de-France, France
| | | | - Heribert Ramroth
- Institute of Public Health, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Marta Vilensky
- Institute of Oncology Angel H Roffo, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Maria Paula Curado
- Epidemiology, AC Camargo Cancer Center International Research Center, Sao Paulo, Brazil
| | - Ana Menezes
- Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alexander Daudt
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosalina Koifman
- Fundacao Oswaldo Cruz, National School of Public Health, Rio de Janeiro, Brazil
| | | | - Amy Lee Yuan-Chin
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Alex D McMahon
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Di Credico G, Edefonti V, Polesel J, Pauli F, Torelli N, Serraino D, Negri E, Luce D, Stucker I, Matsuo K, Brennan P, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt AW, Koifman R, Wunsch-Filho V, Holcatova I, Ahrens W, Lagiou P, Simonato L, Richiardi L, Healy C, Kjaerheim K, Conway DI, Macfarlane TV, Thomson P, Agudo A, Znaor A, Boaventura Rios LF, Toporcov TN, Franceschi S, Herrero R, Muscat J, Olshan AF, Zevallos JP, La Vecchia C, Winn DM, Sturgis EM, Li G, Fabianova E, Lissowska J, Mates D, Rudnai P, Shangina O, Swiatkowska B, Moysich K, Zhang ZF, Morgenstern H, Levi F, Smith E, Lazarus P, Bosetti C, Garavello W, Kelsey K, McClean M, Ramroth H, Chen C, Schwartz SM, Vaughan TL, Zheng T, Menvielle G, Boccia S, Cadoni G, Hayes RB, Purdue M, Gillison M, Schantz S, Yu GP, Brenner H, D'Souza G, Gross ND, Chuang SC, Boffetta P, Hashibe M, Lee YCA, Dal Maso L. Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach. Oral Oncol 2019; 94:47-57. [PMID: 31178212 PMCID: PMC7117823 DOI: 10.1016/j.oraloncology.2019.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/27/2019] [Accepted: 05/05/2019] [Indexed: 01/16/2023]
Abstract
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.
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Affiliation(s)
- Gioia Di Credico
- Department of Statistics, Padua University, Padua, Italy; Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Valeria Edefonti
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy.
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Francesco Pauli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Nicola Torelli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy
| | - Daniele Luce
- Université de Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Pointe-à-Pitre, France
| | - Isabelle Stucker
- Inserm, Center for Research in Epidemiology and Population Health (CESP), Cancer and Environment team, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | | | | | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Ivana Holcatova
- Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany; University of Bremen, Faculty of Mathematics and Computer Science, Bremen, Germany
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Lorenzo Simonato
- Department of Cardiovascular and Thoracic Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Claire Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
| | - Tatiana V Macfarlane
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK and School of Medicine, University of Dundee, Dundee, UK
| | | | | | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | | | - Andrew F Olshan
- University of North Carolina School of Public Health, Chapel Hill, NC, USA
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck Surgery at Washington University School of Medicine, USA
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Deborah M Winn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Guojun Li
- UT - M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - Jolanda Lissowska
- The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - Peter Rudnai
- National Institute of Environmental Health to National Public Health Institute, Budapest, Hungary
| | | | | | | | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Fabio Levi
- Institut Universitaire de Medecine Sociale et Preventive (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Philip Lazarus
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano, Bicocca, Monza, Italy
| | | | | | | | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen M Schwartz
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Thomas L Vaughan
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of Social Epidemiology, F75012 Paris, France
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gabriella Cadoni
- Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Richard B Hayes
- Division of Epidemiology, New York University School Of Medicine, New York, NY, USA
| | - Mark Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maura Gillison
- "Thoracic/Head and Neck Medical Oncology", The University of Texas MD Anderson Cancer Center, TX, USA
| | | | - Guo-Pei Yu
- Medical Informatics Center, Peking University, China
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Neil D Gross
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Khetan P, Boffetta P, Luce D, Stucker I, Curado MP, Menezes A, Wunsch-Filho V, Ahrens W, Lagiou P, Serraino D, Richiardi L, Kjaerheim K, Conway D, Thomson P, Muscat J, Mates D, Ramroth H, Menvielle G, Vaughan TL, Brenner H, Lee YCA, La Vecchia C, Hashibe M, Hashim D. Occupations and the Risk of Head and Neck Cancer: A Pooled Analysis of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. J Occup Environ Med 2019; 61:397-404. [PMID: 31268937 PMCID: PMC6613803 DOI: 10.1097/jom.0000000000001563] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the associations between head and neck cancer (HNC) risk and occupations. METHODS We harmonized data on occupations in a pooled analysis of 8839 HNC cases and 13,730 controls in International Head and Neck Cancer Epidemiology (INHANCE) consortium. Logistic regression was used to estimate odds ratios (ORs) for associations of occupations and HNC risk. Population attributable fraction (PAF) for occupations was calculated using the formula PEC × (OR - 1)/OR. RESULTS Trend of increasing HNC risk was found with increasing duration of employment for many occupations, including cooks (OR = 1.36; 95% confidence interval [CI] 1.09 to 1.68), cleaners (OR = 1.38; 95% CI 1.13 to 1.69), painters (OR = 1.82; 95% CI 1.42 to 2.35). The PAF for a priori occupations was 14.5% (95% CI 7.1% to 21.9%) for HNC. CONCLUSIONS We found associations between certain occupations and HNC risks, including for subsites, with a duration-response relationship.
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Affiliation(s)
- Prerna Khetan
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Khetan, Dr Boffetta, Dr Hashim); University of Rennes, National Institute of Health and Medical Research, School of Advanced Studies in Public Health, Institute for Health, Environment and Work Research - Research Unit UMR_S 1085, Pointe-à-Pitre, France (Dr Luce); Cancer and Environment Team, National Institute of Health and Medical Research U1018, Paris-Sud University, Paris-Saclay University, Villejuif, France (Dr Stucker); Cancer and Environment team (CESP), (Inserm) National Institute of Health and Medical Research U1018, Paris-Sud University, Paris-Saclay University, Villejuif, France (Dr Stucker); Federal University of Pelotas, Pelotas (Dr Menezes); University of Sao Paulo, Sao Paulo, Brazil (Dr Wunsch-Filho); Leibniz Institute for Prevention Research and Epidemiology, Bremen Institute for Prevention Research and Social Medicine , Bremen, Germany (Dr Ahrens); School of Medicine, National and Kapodistrian University of Athens, Greece (Dr Lagiou); Oncological Reference Center, Institute of Scientific Characterization and Hospitalization, Aviano, Italy (Dr Serraino); Department of Medical Sciences, University of Turin, Turin (Dr Richiardi); Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway (Dr Kjaerheim); School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK (Dr Conway); University of Hong Kong, Hong Kong, China (Dr Thomson); Penn State College of Medicine, Hershey, Pennsylvania (Dr Muscat); National Institute of Public Health, Bucharest, Romania (Dr Mates); University of Heidelberg (Dr Ramroth); National Institute of Health and Medical Research, Sorbonne University, Pierre Louis Institute of Epidemiology and Public Health, Paris, France (Dr Menvielle); Fred Hutchinson Cancer Research Center, Seattle, Washington (Dr Vaughan); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (Dr Brenner); Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany (Dr Brenner); German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany Hermann Brenner (Dr Brenner); Division of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah (Dr Lee, Dr Hashibe); Department of Clinical Sciences and Community Health, University of Milan, Milan (Dr La Vecchia), Italy
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4
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Brenner DR, Fehringer G, Zhang ZF, Lee YCA, Meyers T, Matsuo K, Ito H, Vineis P, Stucker I, Boffetta P, Brennan P, Christiani DC, Diao N, Hong YC, Landi MT, Morgenstern H, Schwartz AG, Rennert G, Saliba W, McLaughlin JR, Harris CC, Orlow I, Barros Dios JM, Ruano Raviña A, Siemiatycki J, Koushik A, Cote M, Lazarus P, Fernandez-Tardon G, Tardon A, Le Marchand L, Brenner H, Saum KU, Duell EJ, Andrew AS, Consonni D, Olsson A, Hung RJ, Straif K. Alcohol consumption and lung cancer risk: A pooled analysis from the International Lung Cancer Consortium and the SYNERGY study. Cancer Epidemiol 2019; 58:25-32. [PMID: 30445228 PMCID: PMC6662590 DOI: 10.1016/j.canep.2018.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is inadequate evidence to determine whether there is an effect of alcohol consumption on lung cancer risk. We conducted a pooled analysis of data from the International Lung Cancer Consortium and the SYNERGY study to investigate this possible association by type of beverage with adjustment for other potential confounders. METHODS Twenty one case-control studies and one cohort study with alcohol-intake data obtained from questionnaires were included in this pooled analysis (19,149 cases and 362,340 controls). Adjusted odds ratios (OR) or hazard ratios (HR) with corresponding 95% confidence intervals (CI) were estimated for each measure of alcohol consumption. Effect estimates were combined using random or fixed-effects models where appropriate. Associations were examined for overall lung cancer and by histological type. RESULTS We observed an inverse association between overall risk of lung cancer and consumption of alcoholic beverages compared to non-drinkers, but the association was not monotonic. The lowest risk was observed for persons who consumed 10-19.9 g/day ethanol (OR vs. non-drinkers = 0.78; 95% CI: 0.67, 0.91), where 1 drink is approximately 12-15 g. This J-shaped association was most prominent for squamous cell carcinoma (SCC). The association with all lung cancer varied little by type of alcoholic beverage, but there were notable differences for SCC. We observed an association with beer intake (OR for ≥20 g/day vs nondrinker = 1.42; 95% CI: 1.06, 1.90). CONCLUSIONS Whether the non-monotonic associations we observed or the positive association between beer drinking and squamous cell carcinoma reflect real effects await future analyses and insights about possible biological mechanisms.
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Affiliation(s)
- Darren R Brenner
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Gord Fehringer
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA
| | - Yuan-Chin Amy Lee
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, and Huntsman Cancer Institute, Salt Lake City, USA
| | - Travis Meyers
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, and Huntsman Cancer Institute, Salt Lake City, USA
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan
| | - Hidemi Ito
- Division of Cancer Information and Contorl, Aichi Cancer Centre Research Institute, Japan
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Isabelle Stucker
- Department of Environmental Epidemiology, INSERM U170, Villejuif, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - David C Christiani
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Nancy Diao
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Maria T Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH after National Cancer Institute, Bethesda, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, USA
| | - Ann G Schwartz
- Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | | | - Curtis C Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Juan M Barros Dios
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano Raviña
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER de Epidemiology y Salud Publica, Madrid, Spain
| | - Jack Siemiatycki
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anita Koushik
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Michele Cote
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, USA
| | | | - Adonina Tardon
- University Institute of Oncology (IUOPA), University of Oviedo, and CIBERESP, Spain
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncoly (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Angeline S Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United Kingdom
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Ann Olsson
- Environment and Radiation Section, International Agency for Research on Cancer, Lyon, France; Institute of Environmental Medicine, Stockholm, Sweden
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Kurt Straif
- IARC Monographs Section, International Agency for Research on Cancer, Lyon, France.
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5
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Fehringer G, Brenner DR, Zhang ZF, Lee YCA, Matsuo K, Ito H, Lan Q, Vineis P, Johansson M, Overvad K, Riboli E, Trichopoulou A, Sacerdote C, Stucker I, Boffetta P, Brennan P, Christiani DC, Hong YC, Landi MT, Morgenstern H, Schwartz AG, Wenzlaff AS, Rennert G, McLaughlin JR, Harris CC, Olivo-Marston S, Orlow I, Park BJ, Zauderer M, Barros Dios JM, Raviña AR, Siemiatycki J, Koushik A, Lazarus P, Fernández-Somoano A, Tardon A, Le Marchand L, Brenner H, Saum KU, Duell EJ, Andrew AS, Szeszenia-Dabrowska N, Lissowska J, Zaridze D, Rudnai P, Fabianova E, Mates D, Foretova L, Janout V, Bencko V, Holcatova I, Pesatori AC, Consonni D, Olsson A, Straif K, Hung RJ. Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study. Int J Cancer 2017; 140:1976-1984. [PMID: 28120396 PMCID: PMC5356930 DOI: 10.1002/ijc.30618] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 12/22/2022]
Abstract
It is not clear whether alcohol consumption is associated with lung cancer risk. The relationship is likely confounded by smoking, complicating the interpretation of previous studies. We examined the association of alcohol consumption and lung cancer risk in a large pooled international sample, minimizing potential confounding of tobacco consumption by restricting analyses to never smokers. Our study included 22 case-control and cohort studies with a total of 2548 never-smoking lung cancer patients and 9362 never-smoking controls from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. Alcohol consumption was categorized into amounts consumed (grams per day) and also modelled as a continuous variable using restricted cubic splines for potential non-linearity. Analyses by histologic sub-type were included. Associations by type of alcohol consumed (wine, beer and liquor) were also investigated. Alcohol consumption was inversely associated with lung cancer risk with evidence most strongly supporting lower risk for light and moderate drinkers relative to non-drinkers (>0-4.9 g per day: OR = 0.80, 95% CI = 0.70-0.90; 5-9.9 g per day: OR = 0.82, 95% CI = 0.69-0.99; 10-19.9 g per day: OR = 0.79, 95% CI = 0.65-0.96). Inverse associations were found for consumption of wine and liquor, but not beer. The results indicate that alcohol consumption is inversely associated with lung cancer risk, particularly among subjects with low to moderate consumption levels, and among wine and liquor drinkers, but not beer drinkers. Although our results should have no relevant bias from the confounding effect of smoking we cannot preclude that confounding by other factors contributed to the observed associations. Confounding in relation to the non-drinker reference category may be of particular importance.
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Affiliation(s)
- Gordon Fehringer
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Darren R. Brenner
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- International Agency for Research on Cancer, Lyon, France
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA
| | - Yuan-Chin Amy Lee
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, USA
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - Paolo Vineis
- Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College, London, UK
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Piedmont Children Cancer Registry, Città della Salute e della Scienza di Torino Hospital and CPO Piemonte, Turin, Italy
| | - Isabelle Stucker
- Department of Environmental Epidemiology, INSERM U170, Villejuif, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - David. C. Christiani
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, USA
| | - Ann G. Schwartz
- Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | | | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | | | - Curtis C. Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | | | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bernard J. Park
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Marjorie Zauderer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
- Weill Cornell Medical College, Cornell University, New York, USA
| | - Juan M. Barros Dios
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Alberto Ruano Raviña
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Jack Siemiatycki
- University of Montreal Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada
| | - Anita Koushik
- University of Montreal Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, USA
| | | | - Adonina Tardon
- IUOPA, University Institute of Oncology, University of Oviedo, and CIBERESP, Spain
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric J. Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Angeline S. Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, USA
| | | | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Cancer Center Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland
| | - David Zaridze
- Institute of Carcinogenesis, Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | - Eleonora Fabianova
- Specialized Institute of Hygiene and Epidemiology, Banská Bystrica, Slovakia
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | | | - Vladimir Bencko
- Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Milan, Italy
| | - Ann Olsson
- International Agency for Research on Cancer, Lyon, France
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kurt Straif
- International Agency for Research on Cancer, Lyon, France
| | - Rayjean J. Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
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Huang R, Wei Y, Hung RJ, Liu G, Su L, Zhang R, Zong X, Zhang ZF, Morgenstern H, Brüske I, Heinrich J, Hong YC, Kim JH, Cote M, Wenzlaff A, Schwartz AG, Stucker I, Mclaughlin J, Marcus MW, Davies MPA, Liloglou T, Field JK, Matsuo K, Barnett M, Thornquist M, Goodman G, Wang Y, Chen S, Yang P, Duell EJ, Andrew AS, Lazarus P, Muscat J, Woll P, Horsman J, Teare MD, Flugelman A, Rennert G, Zhang Y, Brenner H, Stegmaier C, van der Heijden EHFM, Aben K, Kiemeney L, Barros-Dios J, Pérez-Ríos M, Ruano-Ravina A, Caporaso NE, Bertazzi PA, Landi MT, Dai J, Hongbing Shen H, Fernandez-Tardon G, Rodriguez-Suarez M, Tardon A, Christiani DC. Associated Links Among Smoking, Chronic Obstructive Pulmonary Disease, and Small Cell Lung Cancer: A Pooled Analysis in the International Lung Cancer Consortium. EBioMedicine 2016; 2:1677-85. [PMID: 26870794 PMCID: PMC4740296 DOI: 10.1016/j.ebiom.2015.09.031] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 01/17/2023] Open
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7
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Gao C, Patel CJ, Michailidou K, Peters U, Gong J, Schildkraut J, Schumacher FR, Zheng W, Boffetta P, Stucker I, Willett W, Gruber S, Easton DF, Hunter DJ, Sellers TA, Haiman C, Henderson BE, Hung RJ, Amos C, Pierce BL, Lindström S, Kraft P. Mendelian randomization study of adiposity-related traits and risk of breast, ovarian, prostate, lung and colorectal cancer. Int J Epidemiol 2016; 45:896-908. [PMID: 27427428 PMCID: PMC6372135 DOI: 10.1093/ije/dyw129] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Adiposity traits have been associated with risk of many cancers in observational studies, but whether these associations are causal is unclear. Mendelian randomization (MR) uses genetic predictors of risk factors as instrumental variables to eliminate reverse causation and reduce confounding bias. We performed MR analyses to assess the possible causal relationship of birthweight, childhood and adult body mass index (BMI), and waist-hip ratio (WHR) on the risks of breast, ovarian, prostate, colorectal and lung cancers. METHODS We tested the association between genetic risk scores and each trait using summary statistics from published genome-wide association studies (GWAS) and from 51 537 cancer cases and 61 600 controls in the Genetic Associations and Mechanisms in Oncology (GAME-ON) Consortium. RESULTS We found an inverse association between the genetic score for childhood BMI and risk of breast cancer [odds ratio (OR) = 0.71 per standard deviation (s.d.) increase in childhood BMI; 95% confidence interval (CI): 0.60, 0.80; P = 6.5 × 10(-5)). We also found the genetic score for adult BMI to be inversely associated with breast cancer risk (OR = 0.66 per s.d. increase in BMI; 95% CI: 0.57, 0.77; P = 2.5 × 10(-7)), and positively associated with ovarian cancer (OR = 1.35; 95% CI: 1.05, 1.72; P = 0.017), lung cancer (OR = 1.27; 95% CI: 1.09, 1.49; P = 2.9 × 10(-3)) and colorectal cancer (OR = 1.39; 95% CI: 1.06, 1.82, P = 0.016). The inverse association between genetically predicted adult BMI and breast cancer risk remained even after adjusting for directional pleiotropy via MR-Egger regression. CONCLUSIONS Findings from this study provide additional understandings of the complex relationship between adiposity and cancer risks. Our results for breast and lung cancer are particularly interesting, given previous reports of effect heterogeneity by menopausal status and smoking status.
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Affiliation(s)
- Chi Gao
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Electron Microscopy/Molecular Pathology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus and
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jian Gong
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Joellen Schildkraut
- Cancer Prevention, Detection & Control Research Program, Duke Cancer Institute, Durham, NC, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Fredrick R Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Wei Zheng
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | - Paolo Boffetta
- Tisch Cancer institute and Institute for Transitional Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Isabelle Stucker
- Centre for Research in Epidemiology and Population Health, INSERM, Villejuif, France
| | - Walter Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephen Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Thomas A Sellers
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
| | - Christopher Amos
- Center for Genomic Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Brandon L Pierce
- Department of Public Health Studies, University of Chicago, Chicago, IL, USA
| | - Sara Lindström
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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8
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Fehringer G, Brenner D, Zhang ZF, Lee YCA, Matsuo K, Stucker I, Vineis P, Boffetta P, Brennan P, Landi MT, Morgenstern H, Harris CC, Lan Q, Hong YC, Siemiatycki J, McLaughlin JR, Lazarus P, Muscat J, Schwartz AG, Dios JMB, Raviña AR, Rennert G, Christiani DC, Tardon A, Marchand LL, Orlow I, Duell EJ, Andrew AS, Brenner H, Consonni D, Olsson A, Straif K, Hung RJ. Abstract 1274: Alcohol and lung cancer risk: a pooled analysis using International Lung Cancer Consortium studies. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Alcohol consumption is known to be associated with risk of developing several cancers. It is unclear, however, whether alcohol consumption is a risk factor for lung cancer. The relationship between lung cancer and alcohol consumption is likely to be confounded by smoking. To minimize potential confounding by tobacco consumption, we conducted a pooled analysis to examine the association of alcohol consumption with lung cancer risk in a large sample of never-smokers.
Methods: We pooled data from 22 case-control and cohort studies from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. We examined the association of average lifetime alcohol consumption (expressed as average grams per day intake) with lung cancer risk in never smokers using logistic regression to model categories of alcohol consumption (0<5g per day, 5<10g per day, 10<20g per day, 20<30g per day, 30<45g per day, 45+ g per day). To investigate the shape of the dose response relationship, we applied restricted cubic spline models to examine the association for lung cancer risk overall and by histological subtype. Additional analyses examined wine, beer and liquor consumption in relation to risk, with mutual adjustment for each alcoholic beverage. All analyses were adjusted for age, sex, education, ethnicity and study.
Results: A total of 2548 never-smoking cases and 9362 never-smoking controls were included in the analysis. The results showed lower risk among consumers of alcohol with strongest evidence found for moderate drinkers relative to non-drinkers with ORs of 0.80 (95% CI 0.70-0.90) and 0.82 (95% CI 0.69-0.99) for <5grams and 5-10 grams of alcohol per day respectively. Non-linear restricted cubic splines showed reduced lung cancer risk among moderate drinkers relative to non-drinkers with risk increasing towards the null as consumption increased. Similar results were seen for adenocarcinoma and squamous cell carcinoma. Associations with lung cancer differed for wine and beer consumption. Reduced risk was observed for wine drinking particularly at low levels of drinking, OR of 0.80 (95% CI=0.69-0.94) for <5g per day. Risk for beer consumption increased from close to null among occasional drinkers to 1.54 (95% CI 0.90-2.65) among consumers of 20-30g of alcohol per day (test for trend P=0.09).
Conclusions: These results indicate an inverse association between moderate drinking and lung cancer risk relative to never drinkers. However, the inverse association was restricted to wine consumption, not consumption of beer. Lifestyle differences between consumers of beer and wine may play a role in differing patterns of risk found by alcohol type.
Citation Format: Gordon Fehringer, Darren Brenner, Zuo-Feng Zhang, Yuan-Chin Amy Lee, Keitaro Matsuo, Isabelle Stucker, Paolo Vineis, Paolo Boffetta, Paul Brennan, Maria T. Landi, Hal Morgenstern, Curtis C. Harris, Qing Lan, Yun-Chul Hong, Jack Siemiatycki, John R. McLaughlin, Philip Lazarus, Joshua Muscat, Ann G. Schwartz, Juan M. Barros Dios, Alberto R. Raviña, Gad Rennert, David C. Christiani, Adonina Tardon, Loic Le Marchand, Irene Orlow, Eric J. Duell, Angeline S. Andrew, Hermann Brenner, Dario Consonni, Ann Olsson, Kurt Straif, Rayjean J. Hung. Alcohol and lung cancer risk: a pooled analysis using International Lung Cancer Consortium studies. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1274. doi:10.1158/1538-7445.AM2014-1274
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Affiliation(s)
- Gordon Fehringer
- 1Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | - Darren Brenner
- 2International Agency for Research on Cancer (IARC), Lyon, France
| | - Zuo-Feng Zhang
- 3University of California, Los Angeles (UCLA), Los Angeles, CA
| | | | - Keitaro Matsuo
- 5Kyushu University Faculty of Medical Sciences, Kyushu, Japan
| | | | - Paolo Vineis
- 7Imperial College London, London, United Kingdom
| | | | - Paul Brennan
- 2International Agency for Research on Cancer (IARC), Lyon, France
| | | | | | | | - Qing Lan
- 9National Cancer Institute, Bethesda, MD
| | - Yun-Chul Hong
- 11Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jack Siemiatycki
- 12University of Montreal Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Quebec, Canada
| | | | - Philip Lazarus
- 14Penn State University College of Medicine, Hershey, PA
| | - Joshua Muscat
- 14Penn State University College of Medicine, Hershey, PA
| | | | | | - Alberto R. Raviña
- 16University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gad Rennert
- 17Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | | | - Adonina Tardon
- 19University Institute of Oncology, University of Oviedo, Oviedo, Spain
| | | | - Irene Orlow
- 21Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Eric J. Duell
- 22Catalan Institute of Oncology (ICO), Barcelona, Spain
| | | | | | - Dario Consonni
- 25Fondazione IRCCS Ca' Granda–Ospedale Maggiore Policlinico, Milan, Italy
| | - Ann Olsson
- 2International Agency for Research on Cancer (IARC), Lyon, France
| | - Kurt Straif
- 2International Agency for Research on Cancer (IARC), Lyon, France
| | - Rayjean J. Hung
- 1Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
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Conway DI, Brenner DR, McMahon AD, Macpherson LMD, Agudo A, Ahrens W, Bosetti C, Brenner H, Castellsague X, Chen C, Curado MP, Curioni OA, Dal Maso L, Daudt AW, de Gois Filho JF, D'Souza G, Edefonti V, Fabianova E, Fernandez L, Franceschi S, Gillison M, Hayes RB, Healy CM, Herrero R, Holcatova I, Jayaprakash V, Kelsey K, Kjaerheim K, Koifman S, La Vecchia C, Lagiou P, Lazarus P, Levi F, Lissowska J, Luce D, Macfarlane TV, Mates D, Matos E, McClean M, Menezes AM, Menvielle G, Merletti F, Morgenstern H, Moysich K, Müller H, Muscat J, Olshan AF, Purdue MP, Ramroth H, Richiardi L, Rudnai P, Schantz S, Schwartz SM, Shangina O, Simonato L, Smith E, Stucker I, Sturgis EM, Szeszenia-Dabrowska N, Talamini R, Thomson P, Vaughan TL, Wei Q, Winn DM, Wunsch-Filho V, Yu GP, Zhang ZF, Zheng T, Znaor A, Boffetta P, Chuang SC, Ghodrat M, Amy Lee YC, Hashibe M, Brennan P. Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. Int J Cancer 2014; 136:1125-39. [PMID: 24996155 DOI: 10.1002/ijc.29063] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 02/21/2014] [Accepted: 03/20/2014] [Indexed: 12/21/2022]
Abstract
Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 - 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 - 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.
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Affiliation(s)
- David I Conway
- Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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10
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Leoncini E, Ricciardi W, Cadoni G, Arzani D, Petrelli L, Paludetti G, Brennan P, Luce D, Stucker I, Matsuo K, Talamini R, La Vecchia C, Olshan AF, Winn DM, Herrero R, Franceschi S, Castellsague X, Muscat J, Morgenstern H, Zhang ZF, Levi F, Dal Maso L, Kelsey K, McClean M, Vaughan TL, Lazarus P, Purdue MP, Hayes RB, Chen C, Schwartz SM, Shangina O, Koifman S, Ahrens W, Matos E, Lagiou P, Lissowska J, Szeszenia-Dabrowska N, Fernandez L, Menezes A, Agudo A, Daudt AW, Richiardi L, Kjaerheim K, Mates D, Betka J, Yu GP, Schantz S, Simonato L, Brenner H, Conway DI, Macfarlane TV, Thomson P, Fabianova E, Znaor A, Rudnai P, Healy C, Boffetta P, Chuang SC, Lee YCA, Hashibe M, Boccia S. Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium. Eur J Epidemiol 2013; 29:35-48. [PMID: 24271556 DOI: 10.1007/s10654-013-9863-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 11/04/2013] [Indexed: 01/17/2023]
Abstract
Several epidemiological studies have shown a positive association between adult height and cancer incidence. The only study conducted among women on mouth and pharynx cancer risk, however, reported an inverse association. This study aims to investigate the association between height and the risk of head and neck cancer (HNC) within a large international consortium of HNC. We analyzed pooled individual-level data from 24 case-control studies participating in the International Head and Neck Cancer Epidemiology Consortium. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated separately for men and women for associations between height and HNC risk. Educational level, tobacco smoking, and alcohol consumption were included in all regression models. Stratified analyses by HNC subsites were performed. This project included 17,666 cases and 28,198 controls. We found an inverse association between height and HNC (adjusted OR per 10 cm height = 0.91, 95% CI 0.86-0.95 for men; adjusted OR = 0.86, 95% CI 0.79-0.93 for women). In men, the estimated OR did vary by educational level, smoking status, geographic area, and control source. No differences by subsites were detected. Adult height is inversely associated with HNC risk. As height can be considered a marker of childhood illness and low energy intake, the inverse association is consistent with prior studies showing that HNC occur more frequently among deprived individuals. Further studies designed to elucidate the mechanism of such association would be warranted.
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Affiliation(s)
- Emanuele Leoncini
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Pesatori AC, Carugno M, Consonni D, Hung RJ, Papadoupolos A, Landi MT, Brenner H, Müller H, Harris CC, Duell EJ, Andrew AS, McLaughlin JR, Schwartz AG, Wenzlaff AS, Stucker I. Hormone use and risk for lung cancer: a pooled analysis from the International Lung Cancer Consortium (ILCCO). Br J Cancer 2013; 109:1954-64. [PMID: 24002594 PMCID: PMC3790162 DOI: 10.1038/bjc.2013.506] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/17/2013] [Accepted: 08/04/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The association between oral contraceptive (OC) use, hormone replacement therapy (HRT) and lung cancer risk in women is still debated. METHODS We performed a pooled analysis of six case-control studies (1961 cases and 2609 controls) contributing to the International Lung Cancer Consortium. Potential associations were investigated with multivariable unconditional logistic regression and meta-analytic models. Multinomial logistic regressions were performed to investigate lung cancer risk across histologic types. RESULTS A reduced lung cancer risk was found for OC (odds ratio (OR)=0.81; 95% confidence interval (CI): 0.68-0.97) and HRT ever users (OR=0.77; 95% CI: 0.66-0.90). Both oestrogen only and oestrogen+progestin HRT were associated with decreased risk (OR=0.76; 95% CI: 0.61-0.94, and OR=0.66; 95% CI: 0.49-0.88, respectively). No dose-response relationship was observed with years of OC/HRT use. The greatest risk reduction was seen for squamous cell carcinoma (OR=0.53; 95% CI: 0.37-0.76) in OC users and in both adenocarcinoma (OR=0.79; 95% CI: 0.66-0.95) and small cell carcinoma (OR=0.37; 95% CI: 0.19-0.71) in HRT users. No interaction with smoking status or BMI was observed. CONCLUSION Our findings suggest that exogenous hormones can play a protective role in lung cancer aetiology. However, given inconsistencies with epidemiological evidence from cohort studies, further and larger investigations are needed for a more comprehensive view of lung cancer development in women.
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Affiliation(s)
- A C Pesatori
- 1] EPOCA, Epidemiology Research Center, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via San Barnaba 8, 20122 Milan, Italy [2] Epidemiology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via San Barnaba 8, 20122 Milan, Italy
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Coté ML, Liu M, Bonassi S, Neri M, Schwartz AG, Christiani DC, Spitz MR, Muscat JE, Rennert G, Aben KK, Andrew AS, Bencko V, Bickeböller H, Boffetta P, Brennan P, Brenner H, Duell EJ, Fabianova E, Field JK, Foretova L, Friis S, Harris CC, Holcatova I, Hong YC, Isla D, Janout V, Kiemeney LA, Kiyohara C, Lan Q, Lazarus P, Lissowska J, Le Marchand L, Mates D, Matsuo K, Mayordomo JI, McLaughlin JR, Morgenstern H, Müeller H, Orlow I, Park BJ, Pinchev M, Raji OY, Rennert HS, Rudnai P, Seow A, Stucker I, Szeszenia-Dabrowska N, Dawn Teare M, Tjønnelan A, Ugolini D, van der Heijden HFM, Wichmann E, Wiencke JK, Woll PJ, Yang P, Zaridze D, Zhang ZF, Etzel CJ, Hung RJ. Increased risk of lung cancer in individuals with a family history of the disease: a pooled analysis from the International Lung Cancer Consortium. Eur J Cancer 2012; 48:1957-68. [PMID: 22436981 PMCID: PMC3445438 DOI: 10.1016/j.ejca.2012.01.038] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 12/06/2011] [Accepted: 01/04/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND METHODS Familial aggregation of lung cancer exists after accounting for cigarette smoking. However, the extent to which family history affects risk by smoking status, histology, relative type and ethnicity is not well described. This pooled analysis included 24 case-control studies in the International Lung Cancer Consortium. Each study collected age of onset/interview, gender, race/ethnicity, cigarette smoking, histology and first-degree family history of lung cancer. Data from 24,380 lung cancer cases and 23,305 healthy controls were analysed. Unconditional logistic regression models and generalised estimating equations were used to estimate odds ratios and 95% confidence intervals. RESULTS Individuals with a first-degree relative with lung cancer had a 1.51-fold increase in the risk of lung cancer, after adjustment for smoking and other potential confounders (95% CI: 1.39, 1.63). The association was strongest for those with a family history in a sibling, after adjustment (odds ratios (OR) = 1.82, 95% CI: 1.62, 2.05). No modifying effect by histologic type was found. Never smokers showed a lower association with positive familial history of lung cancer (OR = 1.25, 95% CI: 1.03, 1.52), slightly stronger for those with an affected sibling (OR = 1.44, 95% CI: 1.07, 1.93), after adjustment. CONCLUSIONS The occurrence of lung cancer among never smokers and similar magnitudes of the effect of family history on lung cancer risk across histological types suggests familial aggregation of lung cancer is independent of those risks associated with cigarette smoking. While the role of genetic variation in the aetiology of lung cancer remains to be fully characterised, family history assessment is immediately available and those with a positive history represent a higher risk group.
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Affiliation(s)
- Michele L Coté
- Wayne State University School of Medicine and the Karmanos Cancer Institute, Michigan, USA.
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Peters S, Kromhout H, Olsson A, Wuchmann HE, Bruske I, Consonni D, Landi MT, Caporaso N, Siemiatycki J, Richiardi L, Mirabelli D, Simonato L, Gustavsson P, Plato N, Jockel KH, Ahrens W, Pohlabeln H, Boffetta P, Brennan P, Zaridze D, Cassidy A, Lissowska J, Szeszenia-Dabrowska N, Rudnai P, Fabianova E, Forastiere F, Bencko V, Foretova L, Janout V, Stucker I, Dumitru RS, Benhamou S, Bueno-de-Mesquita B, Kendzia B, Pesch B, Straif K, Bruning T, Vermeulen R. Occupational exposure to organic dust increases lung cancer risk in the general population. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Paget-Bailly S, Carton M, Guida F, Radoi L, Cyr D, Wanzy K, Schmaus A, Cenee S, Menvielle G, Papadopoulos A, Stucker I, Luce D. Occupation and head and neck cancer: a population-based case-control study in France. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Trédaniel J, Durand C, Teixeira L, Staudacher L, Beuzelin C, Jagot JL, Stucker I, Robert J, Salmeron S. La pollution atmosphérique, cause de cancer bronchique ? ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Li Q, Dresler C, Heck JE, Allwright S, Haglund M, Sanchez S, Kralikova E, Stucker I, Tamang E, Gritz ER, Hashibe M. Knowledge and beliefs about smoking and cancer among women in five European countries. Cancer Epidemiol Biomarkers Prev 2010; 19:2811-20. [PMID: 20870735 DOI: 10.1158/1055-9965.epi-10-0432] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lung cancer mortality in women is increasing across Europe, reflecting the alarming increase in smoking prevalence. Understanding women's perception of smoking may help to identify ways to reduce its prevalence and prevent uptake of smoking. The aim of this study was to examine factors associated with knowledge and beliefs about smoking and cancer among European women. METHODS A cross-sectional landline telephone survey on health attitudes and knowledge was conducted in five European countries: France, Ireland, Italy, the Czech Republic, and Sweden. A general linear modeling was used to explore the factors related to knowledge and beliefs about smoking and cancer. RESULTS A total of 5,000 women were interviewed (1,000 women from each country). The mean knowledge and belief scores about smoking and cancer were lower in current smokers than those of never and former smokers (P < 0.05). Women with above-the-median income (P = 0.001) and women who held skilled occupations seemed to be more knowledgeable about tobacco health risks (P < 0.001). The number of friends and family who smoked was inversely associated with knowledge on the harmful effects of tobacco (P = 0.001). Swedish women were the most knowledgeable about tobacco-related cancer risk, whereas in France and Italy, current smokers were less knowledgeable. CONCLUSIONS Knowledge and beliefs about cancer and smoking varied significantly by smoking status. IMPACT Results emphasize the need to develop health education programs that enhance cancer knowledge among women who currently smoke and are in low socioeconomic groups.
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Agostini M, Ferro G, Olsson A, Burstyn I, De Vocht F, Hansen J, Lassen CF, Johansen C, Kjaerheim K, Langard S, Stucker I, Ahrens W, Behrens T, Lindbohm ML, Heikkilä P, Heederik D, Portengen L, Shaham J, Boffetta P, Kromhout H. Exposure assessment for a nested case-control study of lung cancer among European asphalt workers. ACTA ACUST UNITED AC 2010; 54:813-23. [PMID: 20861450 DOI: 10.1093/annhyg/meq059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Development of a method for retrospective assessment of exposure to bitumen fume, bitumen condensate, organic vapour, polycyclic aromatic hydrocarbons, and co-exposures to known or suspected lung carcinogens for a nested case-control study of lung cancer mortality among European asphalt workers. METHODS Company questionnaires and structured questionnaires used in interviews and industry-specific job-exposure matrices (JEMs) were elaborated and applied. Three sources of information were eventually used for exposure assessment and assignment: (i) data obtained in cohort phase, (ii) data from living subjects, next-of-kin, and fellow-workers questionnaires, and (iii) JEMs for bitumen exposure by inhalation and via skin and co-exposures to known or suspected lung carcinogens within and outside cohort companies. Inhalation and dermal exposure estimates for bitumen were adjusted for time trends, time spent in a job, and other determinants of exposure (e.g. oil gravel paving). Clothing patterns, personal protective devices, and personal hygiene were taken into consideration while estimating dermal exposure. RESULTS Occupational exposures could be assessed for 433 cases and 1253 controls for relevant time periods. Only 43% of work histories were spent inside original asphalt and construction companies. A total of 95.8% of job periods in cohort companies could be coded at a more detailed level. Imputation of work time and 'hygienic behaviour' multipliers was needed for <10% of work history years. Overall, downward trends in exposure were present and differences existed between countries and companies. As expected, correlations were strongest (r > 0.7) among bitumen-related agents, while correlations between coal tar, bitumen-related agents, and established lung carcinogens were weaker (r < 0.4). CONCLUSIONS A systematic and detailed approach was developed to estimate inhalation and dermal exposure for a nested case-control study among asphalt workers.
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Affiliation(s)
- Michela Agostini
- Institute of Risk Assessment Sciences, University of Utrecht, the Netherlands
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Oh DL, Heck JE, Dresler C, Allwright S, Haglund M, Del Mazo SS, Kralikova E, Stucker I, Tamang E, Gritz ER, Hashibe M. Determinants of smoking initiation among women in five European countries: a cross-sectional survey. BMC Public Health 2010; 10:74. [PMID: 20163736 PMCID: PMC2833141 DOI: 10.1186/1471-2458-10-74] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 02/17/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rate of smoking and lung cancer among women is rising in Europe. The primary aim of this study was to determine why women begin smoking in five different European countries at different stages of the tobacco epidemic and to determine if smoking is associated with certain characteristics and/or beliefs about smoking. METHODS A cross-sectional telephone survey on knowledge and beliefs about tobacco was conducted as part of the Women in Europe Against Lung Cancer and Smoking (WELAS) Project. A total of 5,000 adult women from France, Ireland, Italy, Czech Republic, and Sweden were interviewed, with 1,000 from each participating country. All participants were asked questions about demographics, knowledge and beliefs about smoking, and their tobacco use background. Current and former smokers also were asked questions about smoking initiation. Basic statistics on the cross-sectional data was reported with chi-squared and ANOVA p-values. Logistic regression was used to analyze ever versus never smokers. Linear regression analyses were used to analyze age of smoking initiation. RESULTS Being older, being divorced, having friends/family who smoke, and having parents who smoke were all significantly associated with ever smoking, though the strength of the associations varied by country. The most frequently reported reason for initiation smoking was friend smoking, with 62.3% of ever smokers reporting friends as one of the reasons why they began smoking. Mean age of smoking initiation was 18.2 years and over 80% of participants started smoking by the age of 20. The highest levels of young initiators were in Sweden with 29.3% of women initiating smoking at age 14-15 and 12.0% initiating smoking younger than age 14. The lowest level of young initiators was in the Czech Republic with 13.7% of women initiating smoking at age 14-15 and 1.4% of women initiating smoking younger than age 14. Women who started smoking because their friends smoked or to look 'cool' were more likely to start smoking at a younger age. Women who started smoking to manage stress or to feel less depressed were more likely to start smoking at an older age. CONCLUSIONS In all five participating countries, friends were the primary factor influencing ever smoking, especially among younger women. The majority of participants began smoking in adolescence and the average reported age of smoking initiation was youngest in Sweden and oldest in the Czech Republic.
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Affiliation(s)
- Debora L Oh
- International Agency for Research on Cancer, Lyon, France
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Hung RJ, Christiani DC, Risch A, Popanda O, Haugen A, Zienolddiny S, Benhamou S, Bouchardy C, Lan Q, Spitz MR, Wichmann HE, LeMarchand L, Vineis P, Matullo G, Kiyohara C, Zhang ZF, Pezeshki B, Harris C, Mechanic L, Seow A, Ng DPK, Szeszenia-Dabrowska N, Zaridze D, Lissowska J, Rudnai P, Fabianova E, Mates D, Foretova L, Janout V, Bencko V, Caporaso N, Chen C, Duell EJ, Goodman G, Field JK, Houlston RS, Hong YC, Landi MT, Lazarus P, Muscat J, McLaughlin J, Schwartz AG, Shen H, Stucker I, Tajima K, Matsuo K, Thun M, Yang P, Wiencke J, Andrew AS, Monnier S, Boffetta P, Brennan P. International Lung Cancer Consortium: pooled analysis of sequence variants in DNA repair and cell cycle pathways. Cancer Epidemiol Biomarkers Prev 2009; 17:3081-9. [PMID: 18990748 DOI: 10.1158/1055-9965.epi-08-0411] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The International Lung Cancer Consortium was established in 2004. To clarify the role of DNA repair genes in lung cancer susceptibility, we conducted a pooled analysis of genetic variants in DNA repair pathways, whose associations have been investigated by at least 3 individual studies. METHODS Data from 14 studies were pooled for 18 sequence variants in 12 DNA repair genes, including APEX1, OGG1, XRCC1, XRCC2, XRCC3, ERCC1, XPD, XPF, XPG, XPA, MGMT, and TP53. The total number of subjects included in the analysis for each variant ranged from 2,073 to 13,955 subjects. RESULTS Four of the variants were found to be weakly associated with lung cancer risk with borderline significance: these were XRCC3 T241M [heterozygote odds ratio (OR), 0.89; 95% confidence interval (95% CI), 0.79-0.99 and homozygote OR, 0.84; 95% CI, 0.71-1.00] based on 3,467 cases and 5,021 controls from 8 studies, XPD K751Q (heterozygote OR, 0.99; 95% CI, 0.89-1.10 and homozygote OR, 1.19; 95% CI, 1.02-1.39) based on 6,463 cases and 6,603 controls from 9 studies, and TP53 R72P (heterozygote OR, 1.14; 95% CI, 1.00-1.29 and homozygote OR, 1.20; 95% CI, 1.02-1.42) based on 3,610 cases and 5,293 controls from 6 studies. OGG1 S326C homozygote was suggested to be associated with lung cancer risk in Caucasians (homozygote OR, 1.34; 95% CI, 1.01-1.79) based on 2,569 cases and 4,178 controls from 4 studies but not in Asians. The other 14 variants did not exhibit main effects on lung cancer risk. DISCUSSION In addition to data pooling, future priorities of International Lung Cancer Consortium include coordinated genotyping and multistage validation for ongoing genome-wide association studies.
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Bonaïti-Pellié C, Arveux P, Billette de Villemeur A, Dantchev N, Elbaz A, Fabre-Guillevin E, Fresson J, Saura C, Saurel-Cubizolles MJ, Serre JL, Simon D, Stucker I, Thélot B, Tubert-Bitter P, Zureik M. [Treatment of information on personal health data for research purposes: nobody should ignore the law]. Med Sci (Paris) 2009; 25:93-7. [PMID: 19154701 DOI: 10.1051/medsci/200925193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Taioli E, Benhamou S, Bouchardy C, Cascorbi I, Cajas-Salazar N, Dally H, Fong KM, Larsen JE, Le Marchand L, London SJ, Risch A, Spitz MR, Stucker I, Weinshenker B, Wu X, Yang P. Myeloperoxidase G-463A polymorphism and lung cancer: a HuGE genetic susceptibility to environmental carcinogens pooled analysis. Genet Med 2007; 9:67-73. [PMID: 17304047 DOI: 10.1097/gim.0b013e31803068b1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Myeloperoxidase is a phase I metabolic enzyme that converts the metabolites of benzo[a]pyrene from tobacco smoke into highly reactive epoxides. A polymorphism in the promoter region of myeloperoxidase (463G-->A) has been found to be inversely associated with lung cancer; differences in the association with age and gender have been suggested. We conducted a pooled analysis of individual data from 10 studies (3688 cases and 3874 controls) from the Genetic Susceptibility to Environmental Carcinogens database. The odds ratio for lung cancer was 0.88 (95% confidence interval: 0.80-0.97) for the AG variant of myeloperoxidase G-463A polymorphism, and 0.71 (95% confidence interval: 0.57-0.88) for the AA variant after adjusting for smoking, age, gender, and ethnicity. The inverse association between lung cancer and myeloperoxidase G-463A polymorphism was equally found in males and females (odds ratio for the AA genotype 0.73 [95% confidence interval: 0.56-0.96] and 0.67 [95% confidence interval: 0.46-0.98], respectively), without differences in the association according to age in the two genders. The myeloperoxidase G-463A polymorphism was significantly protective in "ever" smokers but not in "never" smokers. Myeloperoxidase is a key enzyme in tobacco-induced carcinogenesis.
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Affiliation(s)
- Emanuela Taioli
- University of Pittsburgh, Cancer Institute, Pittsburgh, Pensylvania 15232, USA
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Zinzindohoué F, Blons H, Hans S, Loriot MA, Houllier AM, Brasnu D, Laccourreye O, Tregouet DA, Stucker I, Laurent-Puig P. Single nucleotide polymorphisms in MMP1 and MMP3 gene promoters as risk factor in head and neck squamous cell carcinoma. Anticancer Res 2004; 24:2021-6. [PMID: 15274394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Matrix metalloproteinase (MMP) 1 and 3 genes play an important role in initiating tumor growth and promoting cell spread. Since MMP1 and MMP3 transcription levels can be modulated by promoter polymorphism, we investigated the impact of different genotypes on the occurrence of head and neck cancer in a Caucasian case control study. DNA was extracted from 126 male head and neck cancer patients and from 249 male hospitalized-based controls. Genotyping was carried out using PCR multiplex allowing the co-amplification of MMAP1-1607 bp and MMP3-1171 bp polymorphisms. PCR products were separated on a capillary electrophoresis. The MMP1-2G and the MMP3-6A allele frequencies were significantly lower in cases than in controls. In particular homozygous 2G/2G individuals were at lower risk of cancer than the 1G/1G carriers (OR= 0.37 95%CI [0.19-0.71], p=0.003). MMP1 and MMP3 polymorphisms were in moderate linkage disequilibrium in cases and controls (D'=0.41 and D'=0.46). Haplotype frequencies distribution derived from these 2 polymorphisms was significantly different between cases and controls (p=0.01). The haplotype analysis suggested an implication of both MMP1 and MMP3 polymorphisms in the head and neck squamous cell carcinoma susceptibility. Indeed, the presence of the MMP1-2G and MMP3-6A alleles seemed to be associated with decreased risk of head and neck squamous cell carcinoma but mainly when they were carried by the same haplotype. By comparison to the 1G-5A haplotype, the 2G-6A haplotype was associated with a lower risk of head and neck squamous cell carcinoma (OR=0.52 95%CI [0.34-0.80], p=0.003).
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Affiliation(s)
- Franck Zinzindohoué
- U490 INSERM, Laboratoire de Toxicologie Moléculaire, 45 rue des Saints Pères, 75006 Paris, France
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Smits KM, Benhamou S, Garte S, Weijenberg MP, Alamanos Y, Ambrosone C, Autrup H, Autrup JL, Baranova H, Bathum L, Boffetta P, Bouchardy C, Brockmoller J, Butkiewicz D, Cascorbi I, Clapper ML, Coutelle C, Daly AK, Muzi G, Dolzan V, Duzhak TG, Farker K, Golka K, Haugen A, Hein DW, Hildesheim A, Hirvonen A, Hsieh LL, Ingelman-Sundberg M, Kalina I, Kang D, Katoh T, Kihara M, Ono-Kihara M, Kim H, Kiyohara C, Kremers P, Lazarus P, Le Marchand L, Lechner MC, London S, Manni JJ, Maugard CM, Morgan GJ, Morita S, Nazar-Stewart V, Kristensen VN, Oda Y, Parl FF, Peters WHM, Rannug A, Rebbeck T, Pinto LFR, Risch A, Romkes M, Salagovic J, Schoket B, Seidegard J, Shields PG, Sim E, Sinnett D, Strange RC, Stucker I, Sugimura H, To-Figueras J, Vineis P, Yu MC, Zheng W, Pedotti P, Taioli E. Association of metabolic gene polymorphisms with tobacco consumption in healthy controls. Int J Cancer 2004; 110:266-70. [PMID: 15069692 DOI: 10.1002/ijc.20114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Polymorphisms in genes that encode for metabolic enzymes have been associated with variations in enzyme activity between individuals. Such variations could be associated with differences in individual exposure to carcinogens that are metabolized by these genes. In this study, we examine the association between polymorphisms in several metabolic genes and the consumption of tobacco in a large sample of healthy individuals. The database of the International Collaborative Study on Genetic Susceptibility to Environmental Carcinogens was used. All the individuals who were controls from the case-control studies included in the data set with information on smoking habits and on genetic polymorphisms were selected (n = 20938). Sufficient information was available on the following genes that are involved in the metabolism of tobacco smoke constituents: CYP1A1, GSTM1, GSTT1, NAT2 and GSTP1. None of the tested genes was clearly associated with smoking behavior. Information on smoking dose, available for a subset of subjects, showed no effect of metabolic gene polymorphisms on the amount of smoking. No association between polymorphisms in the genes studied and tobacco consumption was observed; therefore, no effect of these genes on smoking behavior should be expected.
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Affiliation(s)
- Kim M Smits
- University Maastricht, Maastricht, The Netherlands
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Vineis P, Veglia F, Benhamou S, Butkiewicz D, Cascorbi I, Clapper ML, Dolzan V, Haugen A, Hirvonen A, Ingelman-Sundberg M, Kihara M, Kiyohara C, Kremers P, Le Marchand L, Ohshima S, Pastorelli R, Rannug A, Romkes M, Schoket B, Shields P, Strange RC, Stucker I, Sugimura H, Garte S, Gaspari L, Taioli E. CYP1A1 T3801 C polymorphism and lung cancer: a pooled analysis of 2451 cases and 3358 controls. Int J Cancer 2003; 104:650-7. [PMID: 12594823 DOI: 10.1002/ijc.10995] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
CYP1A1 is involved in the metabolism of benzopyrene, a suspected lung carcinogen; it is therefore conceivable that genetically determined variations in its activity modify individual susceptibility to lung cancer. The role of the CYP1A1 MspI polymorphism in lung cancer has been widely studied but has not been fully clarified. We have included 2,451 cases and 3,358 controls in a pooled analysis of 22 case-control studies on CYP1A1 and lung cancer risk. We found a clear association between the CYP1A1 homozygous MspI restriction fragment length polymorphism (RFLP) and lung cancer risk in Caucasians (age- and gender-adjusted odds ratio = 2.36; 95% confidence interval 1.16-4.81); other associations were weaker or not statistically significant. The association with the homozygous variant was equally strong for squamous cell carcinomas and adenocarcinomas among Caucasians. We analyzed the risk by duration of smoking: for Caucasian subjects with the MspI RFLP combined variants (homozygotes plus heterozygotes), the increase in the risk of lung cancer was steeper than among the individuals with the homozygous reference allele. Our analysis suggests that Caucasians with homozygous variant CYP1A1 polymorphism have a higher risk of lung cancer. The data were more consistent among Caucasians, with a strong association between the homozygous variant in both squamous cell carcinomas and adenocarcinomas, and a stronger association in men than in women. The analyses were more inconsistent and failed to reach statistical significance in Asians. This observation might be due to design specificities or unknown effect modifiers in the Asian studies.
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Affiliation(s)
- Paolo Vineis
- Università degli studi di Torino, Torino, Italy.
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Taioli E, Gaspari L, Benhamou S, Boffetta P, Brockmoller J, Butkiewicz D, Cascorbi I, Clapper ML, Dolzan V, Haugen A, Hirvonen A, Husgafvel-Pursiainen K, Kalina I, Kremers P, Le Marchand L, London S, Rannug A, Romkes M, Schoket B, Seidegard J, Strange RC, Stucker I, To-Figueras J, Garte S. Polymorphisms in CYP1A1, GSTM1, GSTT1 and lung cancer below the age of 45 years. Int J Epidemiol 2003; 32:60-3. [PMID: 12690010 DOI: 10.1093/ije/dyg001] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A genetic component of early-onset lung cancer has been suggested. The role of metabolic gene polymorphisms has never been studied in young lung cancer cases. Phase 1 and Phase 2 gene polymorphisms are involved in tobacco carcinogens' metabolism and therefore in lung cancer risk. METHODS The effect of metabolic gene polymorphisms on lung cancer at young ages was studied by pooling data from the Genetic Susceptibility to Environmental Carcinogens (GSEC) database. All primary lung cancer cases of both sexes who were Caucasian and </=45 years of age at diagnosis, and the corresponding controls were selected. We obtained 261 cases and 1452 controls. RESULTS There was a marginally significant association between lung cancer and GSTT1 null genotype (OR=1.2; 95% CI:1.0-1.6), and a significant association between lung cancer and the homozygous CYP1A1 Msp1 variant allele (CYP1A1*2A and *2B) genotype (OR=4.7 95% CI:1.2-19.0). When data were stratified by smoking status, the association between CYP1A1 genotype and lung cancer was confined to never smokers. CONCLUSIONS These results suggest that metabolic genetic factors play a role in lung cancer developing at young ages.
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Affiliation(s)
- E Taioli
- Molecular and Genetic Epidemiology Unit, Ospedale Maggiore IRCCS, Italy
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Cabelguenne A, Loriot MA, Stucker I, Blons H, Koum-Besson E, Brasnu D, Beaune P, Laccourreye O, Laurent-Puig P, De Waziers I. Glutathione-associated enzymes in head and neck squamous cell carcinoma and response to cisplatin-based neoadjuvant chemotherapy. Int J Cancer 2001; 93:725-30. [PMID: 11477586 DOI: 10.1002/ijc.1392] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Glutathione S-transferases (GSTs) are metabolic phase II enzymes that promote reactive metabolite elimination by conjugating them to glutathione (GSH). Because of their important role in xenobiotic metabolism and detoxification, they have been implicated in carcinogenesis processes, especially epithelium transformation. Moreover, their influence on response to chemotherapy in cancer patients has been demonstrated. Genetic polymorphisms for GSTM1, GSTT1 and GSTP1 have been found in human populations and have been shown to have phenotypic consequences. To investigate the role of GST enzymes in carcinogenesis and in response to chemotherapy in patients with head and neck squamous cell carcinoma (HNSCC), GSTP1, GSTM1 and GSTT1 were studied prospectively in a large series of HNSCC patients. Correlations between GST alterations, p53 mutation status and clinical response to chemotherapy were investigated. We showed that the risk of developing laryngeal cancer was increased by 2.6-fold [95% CI 1.6--6.1] in patients with the GSTM1 null genotype and by 2.8-fold [95% CI 0.9--8.1] in patients with the homozygous GSTP1 val105 genotype. Furthermore, individuals with this latter genotype were over-represented in the p53 mutation group (p = 0.05). After storage duration and hemolysis adjustment, a significantly lower plasmatic GSTP1 level was observed in complete responders compared with partial and non-responders (mean: 4.4 +/- 0.06 microg/l, 4.7 +/- 0.06 microg/l and 4.7 +/- 0.07 microg/l; p = 0.05), respectively. The prevalence of p53-mutated tumors was significantly higher in the group of non-responders (81%) compared with partial (60%) and complete responders (64%) (p = 0.05). Two types of multivariate analysis were performed including parameters that have been shown to influence response to chemotherapy significantly in univariate analysis. p53 mutations and high tumor stage are independent factors of non-response to chemotherapy, whereas plasmatic GSTP1 levels and low tumor stage are independent factors of complete response. Our data suggest that GST enzymes are associated with larynx cancer and that their use as predictive factors and treatment targets should be further explored.
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Affiliation(s)
- A Cabelguenne
- Laboratoire de Toxicologie Moléculaire, Institut National de la Santé et de la Recherche Médicale (INSERM U490), Paris, France
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Legrand M, Stucker I, Marez D, Sabbagh N, Lo-Guidice JM, Broly F. Influence of a mutation reducing the catalytic activity of the cytochrome P450 CYP2D6 on lung cancer susceptibility. Carcinogenesis 1996; 17:2267-9. [PMID: 8895499 DOI: 10.1093/carcin/17.10.2267] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The possible association between lung cancer and the CYP2D6*9 mutant allele, which reduces the catalytic activity of cytochrome P450 CYP2D6, was examined by PCR-SSCP using peripheral blood DNA from 249 cases of lung cancer and 265 controls, with detailed data on smoking. The CYP2D6*9 mutant allele was present in 4.9% of controls and 6% of cases. Adjusted for age, hospital and smoking, the odds ratio (OR) of lung cancer associated with the presence of the CYP2D6*9 mutant allele was 1.2 [95% confidence interval (CI) 0.5-2.9]. According to histological type, adenocarcinoma and small cell carcinoma were not associated with the presence of the CYP2D6*9 mutant allele and a non-significant higher occurrence of the mutant allele was observed for squamous cell carcinoma (OR 1.74, 95% CI 0.6-4.8). Moreover, no associations were observed upon stratification by number of pack-years of cigarette smoking. These results do not confirm an earlier report that this CYP2D6*9 mutant allele may be an additional risk factor for the development of lung cancer.
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Affiliation(s)
- M Legrand
- Laboratoire de Biochimie et Biologie Moleculaire de l'Hopital Calmette, Centre Hospitalier Regional et Universitaire de Lille, France
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Stucker I, Hirsch A, Doloy T, Bastie-Sigeac I, Hemon D. Urine mutagenicity, chromosomal abnormalities and sister chromatid exchanges in lymphocytes of nurses handling cytostatic drugs. Int Arch Occup Environ Health 1986; 57:195-205. [PMID: 3957439 DOI: 10.1007/bf00405788] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The effects of handling antineoplastic drugs were examined in 17 nurses working in a pneumology department in a hospital in the Paris area. Twenty-five others in the same department who were not handling such drugs acted as controls. Exposure to antineoplastic drugs was evaluated by questionnaire and by assessment of urine mutagenicity. The cytogenetic repercussions of exposure were assessed by examining sister chromatid exchanges and chromosomal abnormalities in circulating lymphocytes. The urine of the exposed nurses was significantly more mutagenic than that of the controls. No cytogenetic abnormalities were revealed in the exposed subjects since both these and the control nurses exhibited similar frequencies of chromosomal abnormalities and similar average numbers of sister chromatid exchanges in circulating lymphocytes. However, in smokers, the urine was significantly more mutagenic compared to that of nonsmokers, chromosomal abnormalities were twice as frequent, and the number of sister chromatid exchanges was significantly larger. Comparison of these results with the findings of other authors suggests that the moderate exposure to antineoplastic drugs prevailing in this pneumology department (i.e., an average of about 11 infusions per week) does not cause detectable cytogenetic abnormalities even though it significantly increases urine mutagenicity.
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