European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 10, pp 3773–3780 | Cite as

The association of lifetime physical inactivity with head and neck cancer: a hospital-based case–control analysis

  • Alexis J. Platek
  • Rikki A. Cannioto
  • John Lewis Etter
  • Jae Kim
  • Janine M. Joseph
  • Nicholas R. Gulati
  • Kristina L. Schmitt
  • Emily Callahan
  • Edgar Khachatryan
  • Ryan Nagy
  • Albina Minlikeeva
  • J. Brian Szender
  • Anurag K. Singh
  • Iris Danziger
  • Kirsten B. MoysichEmail author
Head and Neck


Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case–control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR = 2.73, 95% CI 1.87–3.99, p < 0.001). In subgroup analyses by body mass index (BMI) (underweight/normal-weight: OR = 3.40, 95% CI 1.89–6.12, p < 0.001; overweight/obese: OR = 2.40, 95% CI 1.43–4.02, p < 0.001) and smoking status (former smoker: OR = 3.12, 95% CI 1.89–5.14, p < 0.001; never smoker: OR = 2.71, 95% CI 1.21–6.05, p = 0.020; current smoker: OR = 1.61, 95% CI 0.66–3.95, p = 0.300), significant positive associations were also observed. Results of the current analyses suggest that lifetime physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.


Head and neck cancer Physical activity Physical inactivity Recreational physical activity Cancer epidemiology 



Head and neck squamous cell carcinoma


Human papilloma virus


Body mass index


Roswell Park Cancer Institute


Patient epidemiology data system


Physical activity questionnaire


Statistical analysis system


Odds ratio


Confidence interval


Immunoglobulin A


International Head and Neck Cancer Epidemiology Consortium


Compliance with ethical standards

Ethics approval and consent to participate

The RPCI Institutional Review Board approved the conduct of this study, and all participants provided informed consent.


Kirsten B. Moysich was supported by New York State Department of Health (NYS DOH C019286). Nicholas R. Gulati, Kristina L. Schmitt, and Ryan Nagy were supported by the Roswell Alliance Foundation. J. Brian Szender was supported by the National Institutes of Health (NIH 5T32CA108456).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Alexis J. Platek
    • 1
  • Rikki A. Cannioto
    • 1
  • John Lewis Etter
    • 1
  • Jae Kim
    • 2
  • Janine M. Joseph
    • 1
  • Nicholas R. Gulati
    • 1
  • Kristina L. Schmitt
    • 1
  • Emily Callahan
    • 1
  • Edgar Khachatryan
    • 1
  • Ryan Nagy
    • 1
  • Albina Minlikeeva
    • 1
  • J. Brian Szender
    • 3
  • Anurag K. Singh
    • 4
  • Iris Danziger
    • 2
  • Kirsten B. Moysich
    • 1
    Email author
  1. 1.Department of Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloUSA
  2. 2.Department of OtolaryngologyUniversity at Buffalo Jacobs School of Medicine and Biomedical SciencesBuffaloUSA
  3. 3.Department of GynecologyRoswell Park Cancer InstituteBuffaloUSA
  4. 4.Department of Radiation MedicineRoswell Park Cancer InstituteBuffaloUSA

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