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Racial differences in the relationship between tobacco, alcohol, and squamous cell carcinoma of the head and neck

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Abstract

Purpose

Tobacco and alcohol use are well-known risk factors for squamous cell carcinoma of the head and neck (SCCHN), but there has been little examination of disparities in SCCHN and racial patterns of tobacco and alcohol use, especially for African-Americans. The Carolina Head and Neck Cancer Study, a population-based case–control study, was utilized to determine whether relationships between tobacco and alcohol use and SCCHN differed by race.

Methods

Using a rapid case ascertainment system, cases were recruited from 46 contiguous counties in North Carolina from 2002 to 2006. Controls, selected from motor vehicle records, were frequency-matched to cases on age, sex, and race. This analysis was based on 989 white and 351 African-American cases and 1,114 white and 264 African-American controls. Analyses were performed using unconditional logistic regression, adjusting for age, sex, race, education, and fruit and vegetable consumption.

Results

The association between SCCHN and ever tobacco use among African-Americans (odds ratio (OR), 9.68; 95 % confidence interval (CI), 4.70, 19.9) was much greater than that observed in whites (OR, 1.94; 95 % CI, 1.51, 2.50). Smaller differences were observed when examining ever alcohol use (African-Americans: OR, 3.71; CI, 1.65, 8.30, and Whites: OR, 1.31: CI 0.96, 1.78). African-Americans consistently had greater effect measure estimates when examining common levels of duration and intensity metrics of tobacco and alcohol use, both independently and jointly. No racial differences in the effects of environmental (passive) tobacco smoke were observed.

Conclusions

These findings suggest racial differences in SCCHN are not solely explained by differences in consumption patterns, and tobacco and alcohol may have greater impact in African-Americans.

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Abbreviations

CHANCE:

Carolina Head and Neck Cancer Study

CI:

Confidence interval

ETS:

Environmental tobacco smoke

HPV:

Human papillomavirus

ICR:

Interaction contrast ratio

INHANCE:

International Head and Neck Cancer Epidemiology Consortium

OR:

Odds ratio

RR:

Relative risk

SCCHN:

Squamous cell carcinoma of the head and neck

SEER:

Surveillance Epidemiology and End Results

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Acknowledgments

This study was supported in part by the National Cancer Institute (R01-CA90731); National Institute of Environmental Health Sciences (P30ES10126); and Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD05246803A2).

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, CB#7435, Chapel Hill, NC, 27599-7435, USA

    Jeanette A. Stingone & Andrew F. Olshan

  2. Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, NC, USA

    William K. Funkhouser

  3. Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA

    Mark C. Weissler & Andrew F. Olshan

  4. School of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Mary E. Bell & Andrew F. Olshan

Authors
  1. Jeanette A. Stingone
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  2. William K. Funkhouser
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  3. Mark C. Weissler
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  5. Andrew F. Olshan
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Corresponding author

Correspondence to Andrew F. Olshan.

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Stingone, J.A., Funkhouser, W.K., Weissler, M.C. et al. Racial differences in the relationship between tobacco, alcohol, and squamous cell carcinoma of the head and neck. Cancer Causes Control 24, 649–664 (2013). https://doi.org/10.1007/s10552-012-9999-5

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  • DOI: https://doi.org/10.1007/s10552-012-9999-5

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