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Aviano, Italy

Galeone C.,University of Milan | Tavani A.,University of Milan | Pelucchi C.,University of Milan | Turati F.,University of Milan | And 20 more authors.
Cancer Epidemiology Biomarkers and Prevention | Year: 2010

Background: Only a few studies have explored the relation between coffee and tea intake and head and neck cancers, with inconsistent results. Methods: We pooled individual-level data from nine case-control studies of head and neck cancers, including 5,139 cases and 9,028 controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI), adjusting for potential confounders. Results: Caffeinated coffee intake was inversely related with the risk of cancer of the oral cavity and pharynx: the ORs were 0.96 (95% CI, 0.94-0.98) for an increment of 1 cup per day and 0.61 (95% CI, 0.47-0.80) in drinkers of >4 cups per day versus nondrinkers. This latter estimate was consistent for different anatomic sites (OR, 0.46; 95% CI, 0.30-0.71 for oral cavity; OR, 0.58; 95% CI, 0.41-0.82 for oropharynx/ hypopharynx; and OR, 0.61; 95% CI, 0.37-1.01 for oral cavity/pharynx not otherwise specified) and across strata of selected covariates. No association of caffeinated coffee drinking was found with laryngeal cancer (OR, 0.96; 95% CI, 0.64-1.45 in drinkers of >4 cups per day versus nondrinkers). Data on decaffeinated coffee were too sparse for detailed analysis, but indicated no increased risk. Tea intake was not associated with head and neck cancer risk (OR, 0.99; 95% CI, 0.89-1.11 for drinkers versus nondrinkers). Conclusions: This pooled analysis of case-control studies supports the hypothesis of an inverse association between caffeinated coffee drinking and risk of cancer of the oral cavity and pharynx. Impact: Given widespread use of coffee and the relatively high incidence and low survival of head and neck cancers, the observed inverse association may have appreciable public health relevance. ©2010 AACR. Source

Dondog B.,International Agency for Research on Cancer | Lise M.,Aviano Cancer Center | Baldandorj B.,National Center for Communicable Diseases | Franceschi S.,International Agency for Research on Cancer
European Journal of Cancer Prevention | Year: 2011

The incidence of hepatocellular carcinoma (HCC) in Mongolia is far higher than that of any other cancer in the country, and among the highest worldwide. The relative importance of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is unclear. We reviewed (i) medical records for 963 patients with HCC and 941 patients with cirrhosis admitted for the first time to the National Cancer Center of Mongolia and the National Center for Communicable Diseases, respectively, from 2000 to 2009, and (ii) articles published from 1990 to 2010 on the seroprevalence of hepatitis B surface antigen (HBsAg) and antibodies against hepatitis C virus (anti-HCV) among individuals with and without liver disease. Among those with HCC, the seroprevalence of HBsAg, anti-HCV and dual infections was 50, 27 and 21%, respectively. Corresponding percentages among the patients with cirrhosis were 40, 39, and 20%. In both diseases, HCV infection was relatively more prevalent in women than in men and, in cirrhosis, in patients older than 45 years of age. In healthy individuals, from published articles, anti-HCV seroprevalence steadily increased with age (from 3% at age 0-5 years to 34% at age =50 years), whereas HBsAg seroprevalence stayed constant at about 8%. The future benefit of childhood vaccination against HBV in Mongolia will be undermined by the consequences of a severe HCV epidemic and a uniquely high burden of dual infections. © 2010 Wolters Kluwer Health. Source

Marron M.,International Agency for Research on Cancer | Marron M.,Kings College London | Boffetta P.,International Agency for Research on Cancer | Zhang Z.-F.,University of California at Los Angeles | And 43 more authors.
International Journal of Epidemiology | Year: 2010

Background: Quitting tobacco or alcohol use has been reported to reduce the head and neck cancer risk in previous studies. However, it is unclear how many years must pass following cessation of these habits before the risk is reduced, and whether the risk ultimately declines to the level of never smokers or never drinkers. Methods: We pooled individual-level data from case-control studies in the International Head and Neck Cancer Epidemiology Consortium. Data were available from 13 studies on drinking cessation (9167 cases and 12 593 controls), and from 17 studies on smoking cessation (12 040 cases and 16 884 controls). We estimated the effect of quitting smoking and drinking on the risk of head and neck cancer and its subsites, by calculating odds ratios (ORs) using logistic regression models. Results: Quitting tobacco smoking for 1-4 years resulted in a head and neck cancer risk reduction [OR 0.70, confidence interval (CI) 0.61-0.81 compared with current smoking], with the risk reduction due to smoking cessation after ≥20 years (OR 0.23, CI 0.18-0.31), reaching the level of never smokers. For alcohol use, a beneficial effect on the risk of head and neck cancer was only observed after ≥20 years of quitting (OR 0.60, CI 0.40-0.89 compared with current drinking), reaching the level of never drinkers. Conclusions: Our results support that cessation of tobacco smoking and cessation of alcohol drinking protect against the development of head and neck cancer. © The Author 2009; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association. Source

Galeone C.,Istituto di Ricerche Farmacologiche Mario Negri | Edefonti V.,University of Milan | Parpinel M.,University of Udine | Leoncini E.,Institute of Public Health | And 21 more authors.
International Journal of Cancer | Year: 2015

There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPCs), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. Our study aims to investigate the association between folate intake and the risk of OPC within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual-level data from ten case-control studies participating in the INHANCE consortium, including 5,127 cases and 13,249 controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated for the associations between total folate intake (natural, fortification and supplementation) and natural folate only, and OPC risk. We found an inverse association between total folate intake and overall OPC risk (the adjusted OR for the highest vs. the lowest quintile was 0.65, 95% CI: 0.43-0.99), with a stronger association for oral cavity (OR50.57, 95% CI: 0.43-0.75). A similar inverse association,though somewhat weaker, was observed for folate intake from natural sources only in oral cavity cancer (OR50.64, 95% CI: 0.45-0.91). The highest OPC risk was observed in heavy alcohol drinkers with low folate intake as compared to never/light drinkers with high folate (OR54.05, 95% CI: 3.43-4.79); the attributable proportion (AP) owing to interaction was 11.1% (95% CI: 1.4-20.8%). Lastly, we reported an OR of 2.73 (95% CI:2.34-3.19) for those ever tobacco users with low folateintake, compared with nevere tobacco users and high folate intake (AP of interaction 510.6%, 95% CI: 0.41-20.8%). Our project of a large pool of case-control studies supports a protective effect of total folate intake on OPC risk. © 2014 UICC. Source

Ahrens W.,Leibniz Institute for Prevention Research and Epidemiology BIPS | Ahrens W.,University of Bremen | Pohlabeln H.,Data Management | Foraita R.,Data Management | And 33 more authors.
Oral Oncology | Year: 2014

Objective We aimed to assess the association of oral health (OH), dental care (DC) and mouthwash with upper-aerodigestive tract (UADT) cancer risk, and to examine the extent that enzymes involved in the metabolism of alcohol modify the effect of mouthwash. Materials and methods The study included 1963 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1993 controls. Subjects were interviewed about their oral health and dental care behaviors (which were converted to scores of OH and DC respectively), as well as smoking, alcohol drinking, diet, occupations, medical conditions and socio-economic status. Blood samples were taken for genetic analyses. Mouthwash use was analyzed in relation to the presence of polymorphisms of alcohol-metabolizing genes known to be associated with UADT. Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models adjusting for multiple confounders. Results Fully adjusted ORs of low versus high scores of DC and OH were 2.36[CI = 1.51-3.67] and 2.22[CI = 1.45-3.41], respectively, for all UADT sites combined. The OR for frequent use of mouthwash use (3 or more times/day) was 3.23[CI = 1.68-6.19]. The OR for the rare variant ADH7 (coding for fast ethanol metabolism) was lower in mouthwash-users (OR = 0.53[CI = 0.35-0.81]) as compared to never-users (OR = 0.97[CI = 0.73-1.29]) indicating effect modification (pheterogeneity = 0.065) while no relevant differences were observed between users and non-users for the variant alleles of ADH1B, ADH1C or ALDH2. Conclusions Poor OH and DC seem to be independent risk factors for UADT because corresponding risk estimates remain substantially elevated after detailed adjustment for multiple confounders. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be fully clarified. © 2014 Elsevier Ltd. All rights reserved. Source

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