The aetiology of upper aerodigestive tract cancers among young adults in Europe: the ARCAGE study
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The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption.
To determine the contribution of lifestyle factors to the etiology of UADT cancers occurring in those aged less than 50 years.
A case–control study was conducted in 10 European countries. Cases were cancers of the oral cavity and pharynx, larynx and esophagus, and hospital or population controls were age and sex matched.
There were 356 cases younger than 50 years and 419 controls. Risk was strongly related to current smoking [odds ratio (OR) 5.5 95%; confidence interval (CI) (3.3, 9.2)], and risk increased with number of pack-years smoked. Risk was also related to alcohol consumption for both current (OR 1.8; 0.97, 3.3) and past (OR 3.4; 1.6, 7.4) drinkers, and risk increased with number of drink-years. Persons frequently consuming fruits and vegetables were at significantly reduced risk.
Risk factors already identified as being important for UADT cancers in adults are also important influences on risk in younger adults. The implication of these results is that the public health message in preventing UADT cancers remains the same to young and old alike.
KeywordsEpidemiology Cancer Oral Pharynx Larynx Tobacco Alcohol Diet
We would like to thank all the patients and their families for their participation. We are also grateful to the support of many clinicians and staff of the hospitals, interviewers, data managers, pathology departments, and primary care clinics. GJM and TVM partly worked on this study while at the University of Manchester. We acknowledge the help of Dr. Ann-Marie Biggs and Professor Martin Tickle in study conducted in the Manchester centre and Professor Phil Sloan and Professor Nalin Thakker who in addition coordinated sample collection and processing for all the UK centers. In Glasgow, we acknowledge the clinical support of Dr. Gerry Robertson and Mr. John Devine and their colleagues. We are deeply thankful to Drs. R. Mele and L. Forner for providing hospital controls and S. Sulfaro for pathology support from General Hospital of Pordenone (Italy). In Dublin, we acknowledge the clinical support of Prof. J. Reynolds, Prof C Timon, and their colleagues.
Funding was received from: European Community (5th Framework Programme) grant no QLK1-CT-2001-00182; University of Athens Medical School, for the Athens centre; Padova University (Contract No CPDA057222) for the Padova centre; Compagnia San Paolo, AIRC, for the Turin centre.
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