Background: Whether the association between alcohol drinking and head and neck cancer risk differ by age is unclear, as most studies of head and neck cancer risk factors included only small numbers of young and old subjects. We pooled individual-level data from 19 case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium to assess the age-specific risk of these malignancies in relation to patterns of alcohol consumption. Methods: Data were available from 19 studies (13,269 cases/18,261 controls) with 1,197 case and 2,421 control subjects under age 45. We estimated the effect of alcohol drinking on the risk of head and neck cancer and its subsites among younger (<45 years), middle age (45-59 years) and older subjects (>59 years) by calculating odds ratios (OR) and 95% confidence intervals (CI) using random-effects logistic regression model. Results: Compared to never drinkers in the corresponding age group, the odds ratios for ever alcohol drinking were 1.63 (95%CI 1.24, 2.13) among those under age 45, 2.24 (1.62, 3.09) among those between age 45 and 59, and 1.71(1.21, 2.41) among those over age 59 (p for heterogeneity by age group = 0.308). The attributable fractions (95% CI) due to ever alcohol drinking across the three age groups were 30% (15%, 63%) among age <45, 49% (19%, 126%) among age 45-59, and 35% (13%, 96%) among age >59. However, subjects over age 59 showed a lower risk of oral cavity cancer due to consuming more than 4 drinks per day [OR=2.20 (1.49, 3.26)] compared to the oral cavity cancer risk among younger subjects [age 45-59: OR=4.37 (2.90, 6.59); age <45: OR=4.06 (2.25, 7.31); p for heterogeneity by age group = 0.042]. Further, women under age 45 [OR=1.04 (0.70, 1.54)] and over age 59 [OR=1.33 (1.00, 1.76)] showed a lower risk and lower attributable fraction of head and neck cancer due to ever alcohol drinking compared to women between age 45 and 59 [OR=1.96 (1.47, 2.61); p for heterogeneity by age group = 0.026]. The odds ratios for ever alcohol drinking for never smokers were 0.82 (0.53, 1.26) for subjects under age 45, 1.23 (0.95, 1.59) for subjects between age 45 and 59, and 0.92 (0.71, 1.20) for subjects over age 59. Conclusions: The overall risk of head and neck cancer due to alcohol drinking is similar for younger (<45 years), middle age (45-59 years) and older (>59 years) populations. However, further research is needed to understand why there may be a higher risk of oral cavity cancer due to alcohol drinking among younger subjects (\#8804;59 years) and a higher risk of head and neck cancer among women and never smokers between ages 45 to 59.
Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 2132.
100th AACR Annual Meeting-- Apr 18-22, 2009; Denver, CO