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Combined effects of smoking and HPV16 in oropharyngeal cancer
Int Agcy Res Canc, Genet Epidemiol Grp, Lyon, France..
Int Agcy Res Canc, Genet Epidemiol Grp, Lyon, France..
Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, Athens, Greece..
BIPS, Leibniz Inst Prevent Res & Epidemiol, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Bremen, Germany..
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2016 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 45, no 3, p. 752-761Article in journal (Refereed) Published
Abstract [en]

Background: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer is not understood.

Methods: Using HPV serology as a marker of HPV-related cancer, we examined the interaction between smoking and HPV16 in 459 oropharyngeal (and 1445 oral cavity and laryngeal) cancer patients and 3024 control participants from two large European multicentre studies. Odds ratios and credible intervals [CrI], adjusted for potential confounders, were estimated using Bayesian logistic regression.

Results: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29]) and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were independently associated with oropharyngeal cancer. The joint association of smoking and HPV seropositivity was consistent with that expected on the additive scale (synergy index [CrI]: 1.32 [0.51, 3.45]), suggesting they act as independent risk factors for oropharyngeal cancer.

Conclusions: Smoking was consistently associated with increase in oropharyngeal cancer risk in models stratified by HPV16 seropositivity. In addition, we report that the prevalence of oropharyngeal cancer increases with smoking for both HPV16-positive and HPV16-negative persons. The impact of smoking on HPV16-positive oropharyngeal cancer highlights the continued need for smoking cessation programmes for primary prevention of head and neck cancer.

Place, publisher, year, edition, pages
2016. Vol. 45, no 3, p. 752-761
Keywords [en]
Human papillomavirus, tobacco smoking, interaction, head and neck cancer risk, oropharynx cancer
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-306775DOI: 10.1093/ije/dyw069ISI: 000384653200029PubMedID: 27197530OAI: oai:DiVA.org:uu-306775DiVA, id: diva2:1047005
Note

Funding: The ARCAGE study was supported by a grant from the European Commission's 5th Framework Program (contract QLK1-2001-00182). The EPIC study has been supported by the Europe Against Cancer Program of the European Commission (SANCO); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra; Catalan Institute of Oncology, Spain; the ISCIII of the Spanish Ministry of Health (RETICC DR06/0020); Cancer Research UK; Medical Research Council, UK; Greek Ministry of Health; Stavros Niarchos Foundation; Hellenic Health Foundation; Italian Association for Research on Cancer (AIRC); Italian National Research Council, Fondazione-IstitutoBanco Napoli, Italy; Associazione Italiana per la Ricerca sul Cancro-AIRC Milan; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; World Cancer Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Vasterbotten, Sweden; NordForsk (Centre of excellence programme HELGA), Norway; French League against Cancer (LNCC), France; National Institute for Health and Medical Research (INSERM), France; Mutuelle Generale de l'Education Nationale (MGEN), France; 3M Co, France; Gustave Roussy Institute (IGR), France; and General Councils of France. The serology testing of EPIC prospective study was supported by the National Cancer Institute Intramural Research Program. The work done in this study was supported in part by a grant from the European Commission's 7th Framework Program (contract FP7-HEALTH-2011-282562) and partly by the Health General Directorate of the French Social Affairs and Health Ministry.

Available from: 2016-11-16 Created: 2016-11-03 Last updated: 2017-11-29Bibliographically approved

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