Cancer Causes & Control

, Volume 29, Issue 7, pp 619–630 | Cite as

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

  • Kristin J. VoltzkeEmail author
  • Yuan-Chin Amy Lee
  • Zuo-Feng Zhang
  • Jose P. Zevallos
  • Guo-Pei Yu
  • Deborah M. Winn
  • Thomas L. Vaughan
  • Erich M. Sturgis
  • Elaine Smith
  • Stephen M. Schwartz
  • Stimson Schantz
  • Joshua Muscat
  • Hal Morgenstern
  • Michael McClean
  • Guojun Li
  • Philip Lazarus
  • Karl Kelsey
  • Maura Gillison
  • Chu Chen
  • Paolo Boffetta
  • Mia Hashibe
  • Andrew F. Olshan
Original paper


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.


Head 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.

Supplementary material

10552_2018_1026_MOESM1_ESM.docx (55 kb)
Supplementary material 1 (DOCX 54 KB)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kristin J. Voltzke
    • 1
    Email author
  • Yuan-Chin Amy Lee
    • 2
  • Zuo-Feng Zhang
    • 3
  • Jose P. Zevallos
    • 4
  • Guo-Pei Yu
    • 5
  • Deborah M. Winn
    • 6
  • Thomas L. Vaughan
    • 7
  • Erich M. Sturgis
    • 8
  • Elaine Smith
    • 9
  • Stephen M. Schwartz
    • 7
  • Stimson Schantz
    • 10
  • Joshua Muscat
    • 11
  • Hal Morgenstern
    • 12
  • Michael McClean
    • 13
  • Guojun Li
    • 8
  • Philip Lazarus
    • 14
  • Karl Kelsey
    • 15
  • Maura Gillison
    • 16
  • Chu Chen
    • 7
  • Paolo Boffetta
    • 17
  • Mia Hashibe
    • 2
  • Andrew F. Olshan
    • 1
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  2. 2.Division of Public Health, Department of Family & Preventive MedicineUniversity of Utah School of MedicineSalt Lake CityUSA
  3. 3.UCLA School of Public HealthLos AngelesUSA
  4. 4.Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck SurgeryWashington University School of MedicineSt. LouisUSA
  5. 5.Medical Informatics CenterPeking UniversityBeijingChina
  6. 6.National Cancer InstituteBethesdaUSA
  7. 7.Fred Hutchinson Cancer Research CenterSeattleUSA
  8. 8.UT-M.D. Anderson Cancer CenterHoustonUSA
  9. 9.College of Public HealthUniversity of IowaIowa CityUSA
  10. 10.New York Eye and Ear InfirmaryNew YorkUSA
  11. 11.Penn State College of MedicineHersheyUSA
  12. 12.Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer CenterUniversity of MichiganAnn ArborUSA
  13. 13.Boston University School of Public HealthBostonUSA
  14. 14.Washington State University College of PharmacySpokaneUSA
  15. 15.Brown UniversityProvidenceUSA
  16. 16.Johns Hopkins Medical InstituteBaltimoreUSA
  17. 17.The Tisch Cancer InstituteMount Sinai School of MedicineNew YorkUSA

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