Head and Neck Cancers in Young Adults More Likely to Be a Result of Inherited Factors
Data from 25 case-control studies and separate analyses show that head and neck cancers in young adults are more likely to occur as a result of inherited factors rather than lifestyle factors, such as smoking or drinking alcohol, according to a new study by Toporcov et al published in the International Journal of Epidemiology.
Approximately 550,000 new cases of head and neck cancer are diagnosed worldwide annually, with an increased incidence in young adults also being reported. In particular, reports indicate an increase in tumors affecting the tongue and oropharynx among young adults in Europe, the United States, India, and China.
Study Background
Tatiana Natasha Toporcov, PhD, of the Universidade de São Paulo, and colleagues pooled data from 25 studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to compare the role of major risk factors and family history in head and neck cancers for young adults (45 years of age or younger) and older adults (over 45 years of age). Participants were surveyed about their history of cigarette smoking, alcohol use, and diet, as well as family history of cancer. In total, there were 2,010 cases and 4,042 controls in young adults, and 17,700 cases and 22,704 controls in older adults.
Key Findings
The attributable fraction (an estimate of the proportion of cases which could be avoided if the exposures were eliminated) for smoking on the risk of head and neck cancers was 20% in young women, 49% in older women, 46% in young men, and 64% in older men. The attributable fraction for drinking alcohol on the risk of head and neck cancers was 5% in young women, 20% in older women, 22% in young men, and 50% in older men.
Eating a diet rich in fruits and vegetables was shown to be inversely associated with the risk of head and neck cancers in both age groups.
Family history of any type of cancer was directly associated with head and neck cancer risk only among the older group, but a family history of early-onset cancer was associated with head and neck cancer risk only in the young adults. The attributable fraction for family history of early-onset cancer on the risk of head and neck cancers was 23% in young adults and 2% in older adults.
Dr. Toporcov said: “To our knowledge, this is the largest study to evaluate the role of the major risk factors for head and neck cancers in young adults as well as to compare risks in younger and older patients. The large sample size allowed us to elucidate any differences in the role of risk factors in head and neck cancers in young adults according to age group, sex, and cancer subsites.”
She continued, “Although they were less likely to be drinkers and/or smokers, alcohol consumption was a risk factor for head and neck cancers in the younger adults. However, a stronger association with heavy drinking was observed for the older group. Our results also indicate that the inverse association with fruit and vegetable intake is similar among young and older populations. Younger adults were more likely to have been diagnosed with oral and oropharynx cancer than older adults. Also, early-onset cancer in the family was associated with head and neck cancers risk only among young adults. Our results support public health efforts to decrease exposure to major risk factors for head and neck cancers in the population regardless of age. However, investigations of the role of other risk factors—such as human papillomavirus (HPV) and other inherited characteristics—on these cancers in the younger age group are warranted.”
Dr. Torpocov is the corresponding author for the International Journal of Epidemiology article.
This study was supported by the National Institutes of Health, the National Cancer Institute, and the National Institute of Dental and Craniofacial Health.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
