Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach

Gioia Di Credico , Valeria Edefonti (1) , Jerry Polesel , Francesco Pauli , Nicola Torelli , Diego Serraino , Eva Negri , Daniele Luce (2) , Isabelle Stucker (3) , Keitaro Matsuo , Paul Brennan (4) , Marta Vilensky , Leticia Fernandez , Maria Paula Curado , Ana Menezes , Alexander Daudt , Rosalina Koifman , Victor Wunsch-Filho , Ivana Holcátová , Wolfgang Ahrens , Pagona Lagiou , Lorenzo Simonato , Lorenzo Richiardi , Claire Healy , Kristina Kjaerheim , David Conway (5) , Tatiana Macfarlane , Peter Thomson , Antonio Agudo , Ariana Znaor , Leonardo Boaventura Rios , Tatiana Toporcov , Silvia Franceschi , Rolando Herrero , Joshua Muscat , Andrew F. Olshan , Jose Zevallos , Carlo La Vecchia , Deborah Winn , Erich Sturgis , Guojun Li , Eleonora Fabianova , Jolanda Lissowska , Dana Mates , Peter Rudnai , Oxana Shangina , Beata Swiatkowska , Kirsten Moysich , Zuo-Feng Zhang , Hal Morgenstern , Fabio Levi , Elaine Smith , Philip Lazarus , Cristina Bosetti , Werner Garavello , Karl Kelsey , Michael Mcclean , Heribert Ramroth , Chu Chen , Stephen Schwartz , Thomas Vaughan , Tongzhang Zheng , Gwenn Menvielle (6) , Stefania Boccia , Gabriella Cadoni , Richard Hayes , Mark P. Purdue , Maura Gillison , Stimson Schantz , Guo-Pei Yu , Hermann Brenner , Gypsyamber d'Souza , Neil Gross , Chu Chuang , Paolo Boffetta , Mia Hashibe , Yuan-Chin Amy Yu , Luigino Dal Maso

1 UNIMI - Università degli Studi di Milano = University of Milan
2 Irset - Institut de recherche en santé, environnement et travail
3 CESP - Centre de recherche en épidémiologie et santé des populations
4 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
5 University of Glasgow
6 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique

OBJECTIVES: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. MATERIALS AND METHODS: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. RESULTS: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) >5 was reached after 30 years in current smokers of ∼20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs >20 were found for current smokers of ≥20 cigarettes/day for ≥30  years. In former smokers who quit ≥10  years ago, the ORs were approximately halved for OCP cancers, and ∼1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. CONCLUSION: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.

Keywords: Laryngeal cancer; Bivariate spline models; Cigarette smoking duration; Cigarette smoking intensity; Head and neck cancer; INHANCE; Oral cavity and pharyngeal cancers

Domains: Life Sciences [q-bio]; Cancer

Gioia Di Credico, Valeria Edefonti, Jerry Polesel, Francesco Pauli, Nicola Torelli, et al.. Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach. Oral Oncology, 2019, 94, pp.47-57. ⟨10.1016/j.oraloncology.2019.05.006⟩. ⟨hal-02177701⟩