Projects per year
Abstract
Tobacco smoking and alcohol consumption are well-established risk factors for head and neck cancer. The prognostic role of smoking and alcohol intake at diagnosis have been less well studied. We analysed 1,393 people prospectively enrolled into the Head and Neck 5000 study (oral cavity cancer, n=403; oropharyngeal cancer, n=660; laryngeal cancer, n=330) and followed up for a median of 3.5 years. The primary outcome was all-cause mortality. We used Cox proportional hazard models to derive minimally adjusted (age and gender) and fully adjusted (age, gender, ethnicity, stage, comorbidity, body mass index, HPV status, treatment, education, deprivation index, income, marital status, and either smoking or alcohol use) mortality hazard ratios (HR) for the effects of smoking status and alcohol intake at diagnosis. Models were stratified by cancer site, stage and HPV status. The fully-adjusted HR for current versus never-smokers was 1.7 overall (95% confidence interval [CI] 1.1, 2.6). In stratified analyses, associations of smoking with mortality were observed for oropharyngeal and laryngeal cancers (fully adjusted HRs for current smokers: 1.8 (95% CI=0.9, 3.40 and 2.3 (95% CI=0.8, 6.4)). We found no evidence that people who drank hazardous to harmful amounts of alcohol at diagnosis had a higher mortality risk compared to non-drinkers (HR=1.2 (95% CI=0.9, 1.6)). There was no strong evidence that HPV status or tumour stage modified the association of smoking with survival. Smoking status at the time of a head and neck cancer diagnosis influenced all-cause mortality in models adjusted for important prognostic factors.
Original language | English |
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Pages (from-to) | 1114-1127 |
Number of pages | 14 |
Journal | International Journal of Cancer |
Volume | 143 |
Issue number | 5 |
Early online date | 23 Apr 2018 |
DOIs | |
Publication status | Published - Sep 2018 |
Structured keywords
- ICEP
Keywords
- alcohol
- head and neck cancer
- human papillomavirus
- smoking
- survival
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Projects
- 1 Active
Profiles
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Professor Richard M Martin
- Bristol Population Health Science Institute
- MRC Integrative Epidemiology Unit
- Cancer
- Bristol Medical School (PHS) - Professor of Clinical Epidemiology
Person: Academic , Member
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Professor Andy R Ness
- Bristol Dental School - Professor of Epidemiology
- Bristol Population Health Science Institute
- Cancer
Person: Academic , Member
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Professor Steve J Thomas
- Cancer
- Bristol Dental School - Professor in Oral and Maxillofacial Surgery
Person: Academic , Member