Farsi NJ, et al. - In this work, the independent effects of tobacco, alcohol, and human papillomavirus (HPV) infection on oropharyngeal cancer (OPC) risk were assessed in the Head and Neck Cancer(HeNCe) Life study. Results revealed the independent roles of smoking, alcohol and HPV infection in OPC risk. These could have a combined effect. Researchers recommended making efforts to tackle these major risk factors simultaneously.

Methods

• Researchers performed the Head and Neck Cancer(HeNCe) Life study, which was a hospital-based case-control study of head and neck squamous cell carcinoma (HNSCC) with frequency-matched controls by age and sex from four Montreal hospitals.
• Information was collected regarding socio-demographic and behavioural factors.
• Exfoliated oral cells were examined for HPV-DNA by polymerase chain reaction.
• Only OPC cases (n=188) and controls (n=427) without missing values for HPV, smoking, or alcohol were included.
• Associations were assessed by estimating odds ratios (OR) and corresponding 95% confidence intervals (CI) using unconditional logistic regression.

Results

• An increased risk of OPC irrespective of of HPV status was revealed related to smoking (OR=1.90, 95%CI: 1.04–3.45) and alcohol (OR=2.74, 95%CI: 1.45–5.15).
• Compared to the participants who were HPV negative, positivity for HPV16 among heavy smokers and heavy alcohol users seemed associated with a 30.4-fold (95%CI: 8.94–103.26) and 18.6-fold (95%CI: 5.75–60.13) elevation in risk of OPC.
• In addition, a substantial increase in OPC risk was evident with the combined effect of heavy smoking and alcohol comsumption with HPV16 infection (OR=48.76, 95%CI: 15.83–150.17) and (OR=50.60, 95%CI: 15.96–160.40), respectively.