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Aetiological Heterogeneity of Head and Neck Squamous Cell Carcinomas: The Role of Human Papillomavirus Infections, Smoking, and Alcohol

Farsi, Nada; Rousseau, Marie-Claude; Schlecht, Nicolas F; Castonguay, Geneviève; Allison, Paul; Nguyen-Tan, Phuc Felix; Soulières, Denis; Coutlée, François; Hier, Micheal; Madathil, Sreenath A; Franco, Eduardo L; Nicolau, Belinda (2017). Aetiological Heterogeneity of Head and Neck Squamous Cell Carcinomas: The Role of Human Papillomavirus Infections, Smoking, and Alcohol Carcinogenesis , vol. 38 , nº 12. p. 1188-1195. DOI: 10.1093/carcin/bgx106.

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Résumé

Tobacco and alcohol consumption are the main risk factors for head and neck squamous cell carcinoma (HNSCC). In addition, human papillomavirus (HPV) infection plays a causal role in oropharyngeal cancer (OPC), a subset of HNSCC. We assessed the independent effects of tobacco, alcohol, and HPV infection on OPC risk in the Head and Neck Cancer(HeNCe) Life study, a hospital-based case-control study of HNSCC with frequency-matched controls by age and sex from four Montreal hospitals. Interviewers collected information on socio-demographic and behavioural factors. We tested exfoliated oral cells for HPV-DNA by polymerase chain reaction. We included only OPC cases (n=188) and controls (n=427) without missing values for HPV, smoking, or alcohol. We examined associations by estimating odds ratios (OR) and corresponding 95% confidence intervals (CI) using unconditional logistic regression. Smoking (OR=1.90, 95%CI: 1.04-3.45) and alcohol (OR=2.74, 95%CI: 1.45-5.15) were associated with an increased risk of OPC independent of HPV status. Positivity for HPV16 among heavy smokers and heavy alcohol users was 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 relative to participants who were HPV negative, respectively. Moreover, the combined effect of heavy smoking and alcohol comsumption with HPV16 infection substantially increased OPC risk (OR=48.76, 95%CI: 15.83-150.17) and (OR=50.60, 95%CI: 15.96-160.40), respectively. Our results support the independent roles of smoking, alcohol and HPV infection in OPC risk, and a possible combined effect. Efforts should be made to tackle these major risk factors simultaneously.

Type de document: Article
Mots-clés libres: ethanol; smoking; human papillomavirus; alcohol drinking; tobacco; infection; head and neck squamous cell carcinoma; human papillomavirus 16
Centre: Centre INRS-Institut Armand Frappier
Date de dépôt: 26 mars 2019 05:13
Dernière modification: 26 mars 2019 05:13
URI: http://espace.inrs.ca/id/eprint/6725

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