Combined effects of smoking and HPV16 in oropharyngeal cancer

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Title: Combined effects of smoking and HPV16 in oropharyngeal cancer
Authors: Anantharaman, D
Muller, DC
Lagiou, P
Ahrens, W
Holcátová, I
Merletti, F
Kjærheim, K
Polesel, J
Simonato, L
Canova, C
Castellsague, X
Macfarlane, TV
Znaor, A
Thomson, P
Robinson, M
Conway, DI
Healy, CM
Tjønneland, A
Westin, U
Ekström, J
Chang-Claude, J
Kaaks, R
Overvad, K
Drogan, D
Hallmans, G
Laurell, G
Bueno-de-Mesquita, HB
Peeters, PH
Agudo, A
Larrañaga, N
Travis, RC
Palli, D
Barricarte, A
Trichopoulou, A
George, S
Trichopoulos, D
Quirós, JR
Grioni, S
Sacerdote, C
Navarro, C
Sánchez, MJ
Tumino, R
Severi, G
Boutron-Ruault, MC
Clavel-Chapelon, F
Panico, S
Weiderpass, E
Lund, E
Gram, IT
Riboli, E
Pawlita, M
Waterboer, T
Kreimer, AR
Johansson, M
Brennan, P
Item Type: Journal Article
Abstract: BACKGROUND: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer is not understood. METHODS: Using HPV serology as a marker of HPV-related cancer, we examined the interaction between smoking and HPV16 in 459 oropharyngeal (and 1445 oral cavity and laryngeal) cancer patients and 3024 control participants from two large European multi-centre studies. Odds ratios and credible intervals [CrI], adjusted for potential confounders, were estimated using Bayesian logistic regression. RESULTS: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29]) and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were independently associated with oropharyngeal cancer. The joint association of smoking and HPV seropositivity was consistent with that expected on the additive scale (synergy index [CrI]: 1.32 [0.51, 3.45]), suggesting they act as independent risk factors for oropharyngeal cancer. CONCLUSIONS: Smoking was consistently associated with increase in oropharyngeal cancer risk in models stratified by HPV16 seropositivity. In addition, we report that the prevalence of oropharyngeal cancer increases with smoking for both HPV16-positive and HPV16-negative persons. The impact of smoking on HPV16-positive oropharyngeal cancer highlights the continued need for smoking cessation programmes for primary prevention of head and neck cancer.
Issue Date: 19-May-2016
Date of Acceptance: 1-May-2016
ISSN: 1464-3685
Publisher: Oxford University Press
Start Page: 752
End Page: 761
Journal / Book Title: International Journal of Epidemiology
Volume: 45
Issue: 3
Copyright Statement: © 2016 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in International Journal of Epidemiology following peer review. The definitive publisher-authenticated version is available online at:
Sponsor/Funder: University Medical Center Utrecht
Imperial College Trust
Funder's Grant Number: N/A
Keywords: Human papillomavirus
head and neck cancer risk
oropharynx cancer
tobacco smoking
0104 Statistics
1117 Public Health And Health Services
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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