IJE Advance Access published online on October 5, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp291
Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk
1International Agency for Research on Cancer, Lyon, France.
2King's College London, School of Medicine, Thames Cancer Registry, London, UK.
3UCLA School of Public Health, Los Angeles, CA, USA.
4Cancer Research Centre, Moscow, Russia.
5Universidade de Sao Paulo, Sao Paulo, Brazil.
6National Cancer Institute, Bethesda, MD, USA.
7UT-M.D. Anderson Cancer Center, Houston, TX, USA.
8Aviano Cancer Centre, Aviano, Italy.
9Institute of Occupational Medicine, Lodz, Poland.
10College of Public Health, University of Iowa, Iowa City, IA, USA.
11Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
12National Institute of Environmental Health, Budapest, Hungary.
13UNC School of Public Health, Chapel Hill, NC, USA.
14Penn State College of Medicine, Hershey, PA, USA.
15University of Michigan School of Public Health and Comprehensive Cancer Center, Ann Arbor, MI, USA.
16Universidade Federal de Pelotas, Pelotas, Brazil.
17Boston University, Boston, MA, USA.
18Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina.
19University of Medicine and Pharmacy, Carol Davila, Bucharest, Romania.
20The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Cancer Epidemiology and Prevention, Warsaw, Poland.
21Institut Universitaire de Médecine Sociale et Préventive (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
22Istituto di Ricerche Farmacologiche Mario Negri and University of Milan, Milan, Italy.
23Escola Nacional de Saude Publica, Rio de Janeiro, Brazil.
24Brown University, Boston, MA, USA.
25Instituto de Investigación Epidemiológica, San José, Costa Rica.
26New York University School of Medicine, New York, NY, USA.
27Institute of Oncology and Radiobiology, Havana, Cuba.
28Regional Authority of Public Health in Banská Bystrica, Slovakia.
29Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
30Hospital Araujo Jorge, Goiania, Brazil.
31Università Cattolica del Sacro Cuore, Rome, Italy.
32Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L’Hospitalet de Llobregat, Spain.
33INSERM U794, Paris, France.
34Institut Gustave Roussy, Villejuif, France.
35Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France.
* Corresponding author. Lifestyle, Environment and Cancer Group, International Agency for Research on Cancer, 150 cours Albert Thomas, 69008 Lyon, France. E-mail: hashibe{at}iarc.fr
 |
Abstract |
|---|
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.
Keywords Epidemiology, head and neck cancer, cessation, alcohol drinking, tobacco smoking
Accepted 28 September 2008