A multivariable Mendelian randomization analysis investigating smoking and alcohol consumption in oral and oropharyngeal cancer

Mark Gormley*, Tom Dudding, Eleanor Sanderson, Richard M Martin, Steven Thomas, Jessica Tyrrell, Andrew R Ness, Paul Brennan, Marcus Munafò, Miranda Pring, Stefania Boccia, Andrew F Olshan, Brenda Diergaarde, Rayjean J. Hung, Geoffrey Liu, George Davey Smith, Rebecca C Richmond

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

Abstract

The independent effects of smoking and alcohol in head and neck cancer are not clear, given the strong association between these risk factors. Their apparent synergistic effect reported in previous observational studies may also underestimate independent effects. Here we report multivariable Mendelian randomization performed in a two-sample approach using summary data on 6,034 oral/oropharyngeal cases and 6,585 controls from a recent genome-wide association study. Our results demonstrate strong evidence for an independent causal effect of smoking on oral/oropharyngeal cancer (IVW OR 2.6, 95% CI= 1.7, 3.9 per standard deviation increase in lifetime smoking behaviour) and an independent causal effect of alcohol consumption when controlling for smoking (IVW OR 2.1, 95% CI= 1.1, 3.8 per standard deviation increase in drinks consumed per week). This suggests the possibility that the causal effect of alcohol may have been underestimated. However, the extent to which alcohol is modified by smoking requires further investigation.
Original languageEnglish
Article number6071 (2020)
Number of pages10
JournalNature Communications
Volume11
DOIs
Publication statusPublished - 27 Nov 2020

Structured keywords

  • Physical and Mental Health
  • Tobacco and Alcohol

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