Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration

Gioia Di Credico, Jerry Polesel, Luigino Dal Maso, Francesco Pauli, Nicola Torelli, Daniele Luce, Loredana Radoï, Keitaro Matsuo, Diego Serraino, Paul Brennan, Ivana Holcatova, Wolfgang Ahrens, Pagona Lagiou, Cristina Canova, Lorenzo Richiardi, Claire M. Healy, Kristina Kjaerheim, David I. Conway, Gary J. Macfarlane, Peter ThomsonAntonio Agudo, Ariana Znaor, Silvia Franceschi, Rolando Herrero, Tatiana N. Toporcov, Raquel A. Moyses, Joshua Muscat, Eva Negri, Marta Vilensky, Leticia Fernandez, Maria Paula Curado, Ana Menezes, Alexander W. Daudt, Rosalina Koifman, Victor Wunsch-Filho, Andrew F. Olshan, Jose P. Zevallos, Erich M. Sturgis, Guojun Li, Fabio Levi, Zuo Feng Zhang, Hal Morgenstern, Elaine Smith, Philip Lazarus, Carlo La Vecchia, Werner Garavello, Chu Chen, Stephen M. Schwartz, Tongzhang Zheng, Thomas L. Vaughan, Karl Kelsey, Michael McClean, Simone Benhamou, Richard B. Hayes, Mark P. Purdue, Maura Gillison, Stimson Schantz, Guo Pei Yu, Shu Chun Chuang, Paolo Boffetta, Mia Hashibe, Amy Lee Yuan-Chin, Valeria Edefonti

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Background: Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk. Methods: Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking. Results: For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx). Conclusions: Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.

Original languageEnglish (US)
Pages (from-to)1456-1463
Number of pages8
JournalBritish Journal of Cancer
Issue number9
StatePublished - Oct 27 2020

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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