Racial differences in the relationship between tobacco, alcohol, and the risk of head and neck cancer: pooled analysis of US studies in the INHANCE Consortium
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There have been few published studies on differences between Blacks and Whites in the estimated effects of alcohol and tobacco use on the incidence of head and neck cancer (HNC) in the United States. Previous studies have been limited by small numbers of Blacks. Using pooled data from 13 US case–control studies of oral, pharyngeal, and laryngeal cancers in the International Head and Neck Cancer Epidemiology Consortium, this study comprised a large number of Black HNC cases (n = 975). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for several tobacco and alcohol consumption characteristics. Blacks were found to have consistently stronger associations than Whites for the majority of tobacco consumption variables. For example, compared to never smokers, Blacks who smoked cigarettes for > 30 years had an OR 4.53 (95% CI 3.22–6.39), which was larger than that observed in Whites (OR 3.01, 95% CI 2.73–3.33; pinteraction < 0.0001). The ORs for alcohol use were also larger among Blacks compared to Whites. Exclusion of oropharyngeal cases attenuated the racial differences in tobacco use associations but not alcohol use associations. These findings suggest modest racial differences exist in the association of HNC risk with tobacco and alcohol consumption.
KeywordsHead and neck cancer Alcohol Tobacco Cigarette smoking African American Racial difference
The INHANCE Consortium core data pooling was supported by NIH Grants (NCI R03CA113157 and NIDCR R03DE016611). The individual studies were supported by the following Grants: New York Multicenter study, NIH P01CA068384 K07CA104231; Seattle study (1985–1995), NIH R01CA048996 and R01DE012609; Iowa study, NIDCR R01DE011979, NIDCR R01DE013110, NIH FIRCA TW001500 and Veterans Affairs Merit Review Funds; North Carolina study (1994–1997), NIH R01CA061188, and in part by a Grant from the National Institute of Environmental Health Sciences P30ES010126; Tampa study: NIH P01CA068384, K07CA104231, and R01DE013158; Los Angeles study: NIH P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, and R21ES011667 and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center; Houston study: NIH R01ES011740 and R01CA100264; Boston study: NIH R01CA078609 and R01CA100679; US Multicenter study, The Intramural Program of the NCI, NIH, United States; MSKCC study, NIH R01CA051845; Seattle-LEO study, NIH R01CA030022; North Carolina (2002–2006), NCI R01CA90731-01 and NIEHS P30ES010126; Baltimore study, NIH DE016631.
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