Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease

Elaine M Smith; Linda M Rubenstein; Thomas H Haugen; Michael Pawlita; Lubomir P Turek

doi:10.1155/2012/571862

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Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease

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Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease

Elaine M Smith, Linda M Rubenstein, Thomas H Haugen, Michael Pawlita and Lubomir P Turek

Journal of oncology, Vol.2012, 571862

2012

DOI: 10.1155/2012/571862

PMCID: PMC3270416

PMID: 22315596

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Abstract

Findings are inconsistent about whether tobacco, alcohol, and human papillomavirus (HPV) are two independent HNC risk factor groups that distinguish an infection-associated cancer from a tobacco/alcohol-associated HNC. We found that cancer in the oral cavity risk was greater in HPV-E6/E7 seropositive/heavy tobacco users (adjusted OR = 3.5) than in HPV-seronegative/heavy tobacco users (adjusted OR = 1.4); and HPV-seropositive/heavy alcohol users (adjusted OR = 9.8) had greater risk than HPV-seronegative/heavy alcohol users (adjusted OR = 3.1). In contrast, the risk of oropharyngeal cancer was greater in the HPV-seronegative/heavy tobacco (adjusted OR = 11.0) than in HPV-seropositive/heavy tobacco (adjusted OR = 4.7) users and greater in HPV-seronegative/heavy alcohol users (adjusted OR = 24.3) compared to HPV-seropositive/heavy alcohol users (adjusted OR = 8.5). Disease-specific and recurrence-free adjusted survival were significantly worse in oropharyngeal HPV-seronegative cases with no survival differences by HPV status seen in oral cavity cases. The association between tobacco/alcohol, HPV, and tumor site is complex. There appear to be distinct tumor site differences in the combined exposure risks, suggesting that different molecular pathways are involved.

Details

Title: Subtitle: Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease
Creators: Elaine M Smith - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA
Linda M Rubenstein - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA
Thomas H Haugen - Veterans Affairs Medical Center and the Department of Pathology, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA
Michael Pawlita - Research Program Infection and Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
Lubomir P Turek - Veterans Affairs Medical Center and the Department of Pathology, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: Journal of oncology, Vol.2012, 571862
DOI: 10.1155/2012/571862
PMID: 22315596
PMCID: PMC3270416
NLM abbreviation: J Oncol
ISSN: 1687-8450
eISSN: 1687-8450
Grant note: DOI: 10.13039/501100001809, name: National Natural Science Foundation of China, award: 60775049, 60805033
Language: English
Date published: 2012
Academic Unit: Epidemiology; Pathology; Internal Medicine
Record Identifier: 9984047718502771

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