年轻成年人头颈癌的危险因素：INHANCE联盟的一项汇总分析。
Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium.
作者信息
Toporcov Tatiana Natasha, Znaor Ariana, Zhang Zuo-Feng, Yu Guo-Pei, Winn Deborah M, Wei Qingyi, Vilensky Marta, Vaughan Thomas, Thomson Peter, Talamini Renato, Szeszenia-Dabrowska Neonila, Sturgis Erich M, Smith Elaine, Shangina Oxana, Schwartz Stephen M, Schantz Stimson, Rudnai Peter, Richiardi Lorenzo, Ramroth Heribert, Purdue Mark P, Olshan Andrew F, Eluf-Neto José, Muscat Joshua, Moyses Raquel Ajub, Morgenstern Hal, Menezes Ana, McClean Michael, Matsuo Keitaro, Mates Dana, Macfarlane Tatiana V, Lissowska Jolanta, Levi Fabio, Lazarus Philip, La Vecchia Carlo, Lagiou Pagona, Koifman Sergio, Kjaerheim Kristina, Kelsey Karl, Holcatova Ivana, Herrero Rolando, Healy Claire, Hayes Richard B, Franceschi Silvia, Fernandez Leticia, Fabianova Eleonora, Daudt Alexander W, Curioni Otávio Alberto, Maso Luigino Dal, Curado Maria Paula, Conway David I, Chen Chu, Castellsague Xavier, Canova Cristina, Cadoni Gabriella, Brennan Paul, Boccia Stefania, Antunes José Leopoldo Ferreira, Ahrens Wolfgang, Agudo Antonio, Boffetta Paolo, Hashibe Mia, Lee Yuan-Chin Amy, Filho Victor Wünsch
机构信息
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil, Croatian National Cancer Registry, Zagreb, Croatia, UCLA School of Public Health, Los Angeles, CA, USA, Medical Informatics Center, Peking University, Beijing, China, and New York Medical College, Valhalla, NY, USA, National Cancer Institute, Bethesda, MD, USA, UT-MD Anderson Cancer Center, Houston, TX, USA, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, School of Dental Sciences, University of Newcastle, Newcastle, UK, Aviano Cancer Centre, Aviano, Italy, Institute of Occupational Medicine, Lodz, Poland, College of Public Health, University of Iowa, Iowa City, IA, USA, Cancer Research Centre, Moscow, Russia, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York Eye and Ear Infirmary, New York, NY, USA, National Institute of Environmental Health, Budapest, Hungary, Department of Medical Science, Cancer Epidemiology Unit, University of Turin, Turin, Italy, Institute of Public Health, University of Heidelberg, Heidelberg, Germany, University of North Carolina School of Public Health, Chapel Hill, NC, USA, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, Penn State College of Medicine, Hershey, PA, USA, Cirurgia de Cabeça e Pescoço (LIM 28), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Comprehensive Cancer Center, University of Michigan Ann Arbor, Ann Arbor, MI, USA, Universidade Federal de Pelotas, Pelotas, Brazil, Boston University School of Public Health, Boston, MA, USA, Aichi Cancer Center Research Institute, Nagoya, Japan, Institute of Public Health, Bucharest, Romania, University of Aberdeen Dental School, Aberdeen, UK, The M Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Cancer Epidemiology and Pre
出版信息
Int J Epidemiol. 2015 Feb;44(1):169-85. doi: 10.1093/ije/dyu255. Epub 2015 Jan 22.
BACKGROUND
Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients.
METHODS
We pooled data from 25 case-control studies and conducted separate analyses for adults ≤ 45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity / oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI=9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking=5.3% (-11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR=2.27 (95% CI=1.26, 4.10)], but not in the older adults [OR=1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (-2.41%, 5.80%) in older adults.
CONCLUSIONS
Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.
背景
有报道称，年轻成年人头颈癌（HNC）的发病率在不断上升。我们旨在比较主要危险因素及癌症家族史在年轻成年人和老年患者头颈癌发病中的作用。
方法
我们汇总了25项病例对照研究的数据，并分别对45岁及以下的成年人（“年轻成年人”，2010例病例和4042例对照）和45岁以上的成年人（“老年成年人”，17700例病例和22704例对照）进行分析。使用将研究视为随机效应的逻辑回归，我们估计了调整后的优势比（OR）和95%置信区间（CI）。
结果
与老年病例相比，年轻病例组中口腔舌癌（女性为16.0%；男性为11.0%）和未明确的口腔/口咽癌（16.2%；11.1%）的比例更高，而喉癌的比例更低（12.1%；16.6%）。在两个年龄组中，女性病例中从不吸烟者或从不饮酒者的比例均高于男性病例。吸烟和饮酒的持续时间或吸烟包年数与头颈癌的正相关在各年龄组中相似。然而，与老年人相比，年轻人吸烟和饮酒的归因分数较低（年轻女性、老年女性、年轻男性和老年男性的吸烟归因分数分别为19.9%（95%CI = 9.8%，27.9%）、48.9%（46.6%，50.8%）、46.2%（38.5%，52.5%）、64.3%（62.2%，66.4%）；饮酒归因分数分别为5.3%（-11.2%，18.0%）、20.0%（14.5%，25.0%）、21.5%（5.0%，34.9%）和50.4%（46.1%，54.3%）。早发性癌症家族史与年轻人群的头颈癌风险相关[OR = 2.27（95%CI = 1.26，4.10）]，但与老年人群无关[OR = 1.10（0.91，1.31）]。早发性癌症家族史的归因分数在年轻人中为23.2%（8.60%至31.4%），而在老年人中为2.20%（-2.41%，5.80%）。
结论
头颈癌的病因可能因年龄组而异。年轻人吸烟和饮酒的归因分数较低可能是由于年龄较小导致暴露时间缩短。与老年人相比，其他特征，如遗传特征，可能在年轻成年人的头颈癌发病中起更重要的作用。
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