Risk of Head and Neck Cancer in Former Smokers by Subsite: A Multicenter Analysis From the <scp>INHANCE</scp> Consortium

This study investigated risk factors associated with HNC by subsite including oral cavity cancer (OCC), oropharyngeal cancer (OPC), and laryngeal cancer (LC) among former smokers in the International Head and Neck Cancer Epidemiology Consortium (INHANCE). Case-control study including former smokers from the pooled INHANCE data, with information on sociodemographic, smoking, and alcohol history. Associations were assessed using logistic regression with 95% confidence intervals (CI). The study included 2143 cases with HNC and 5799 controls. Cancer cases were categorized by their respective subsites: 954 LC (44.5%), 685 OPC (32.0%), 504 OCC (23.5%). The risk of developing OCC was 2.8-fold higher [CI: 1.9-4.1], LC 2.6-fold higher [CI: 1.9-3.5], and OPC 2.1-fold higher [CI: 1.5-2.8] in individuals who smoked > 50 pack-years, compared to < 10 pack-years. The risk of OCC/OPC/LC increased with tobacco consumption in North-America, whereas in Western/Southern-Europe and South-America the association plateaued beyond 31-50 pack-years. Cessation after age 55 increased the risk of LC by 3.0-fold [CI: 2.2-4.2], and OCC by 2.2-fold [CI: 1.4-3.3] versus cessation age ≤ 45 years. Consuming ≥ 5 drinks/day was associated with 5-fold higher risk of OPC [CI: 3.7-6.6], 4.4-fold higher risk of OCC [CI: 3.2-6.1] and 3.1-fold higher risk of LC [CI: 2.4-3.9] compared to 0-0.9 drinks/day. The risk of HNC among former smokers is not homogeneous across regions and that there were distinct patterns for OCC, OPC, and LC. The amount of tobacco and alcohol consumption are key risk factors, with alcohol being more important for OCC/OPC, and tobacco being more strongly associated with LC risk.

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Publication Details

Journal
International Journal of Cancer
Published
2026-04-21
DOI
https://doi.org/10.1002/ijc.70497
Primary Topic
Head and Neck Cancer Studies
Type
article
Field-Weighted Citation Impact
0.00

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article

Risk of Head and Neck Cancer in Former Smokers by Subsite: A Multicenter Analysis From the INHANCE Consortium

Jolanta Lissowska, Christine Barul, Werner Garavello, Dana Mateș et al.
International Journal of Cancer
Head and Neck Cancer Studies
article

Risk of Head and Neck Cancer in Former Smokers by Subsite: A Multicenter Analysis From the INHANCE Consortium

Jolanta Lissowska, Christine Barul, Werner Garavello, Dana Mateș, Paolo Boffetta, Luigino Dal Maso, Oxana Shangina, Michele Sassano, Tamás Pándics, A F. Olshan, Stefania Boccia, Heribert Ramroth, Loredana Radoï, Z F Zhang, Hermann Brenner, Mahsa Abedini, Ettore Bidoli, Jerry Polesel, María Paula Curado, Matheus de Abreu, Joshua Muscat, C La Vecchia, Winkler, Yuan-Chin Amy Lee, V. Edefonti, Eva Negri, Jose Zevallos, Mia Hashibe, Hal Morgenstern, Rossana Mendoza López, Beata Świątkowska, Gabriella Cadoni, Gypsyamber D'Souza, Paul Brennan, Chu Chen, Victor Wunsch‐Filho, Karl Kelsey, Neil Gross, Luiz Paulo Kowalski, Michael McClean, Eleonora Fabianova, Stephen M. Schwartz
article en

Abstract

This study investigated risk factors associated with HNC by subsite including oral cavity cancer (OCC), oropharyngeal cancer (OPC), and laryngeal cancer (LC) among former smokers in the International Head and Neck Cancer Epidemiology Consortium (INHANCE). Case-control study including former smokers from the pooled INHANCE data, with information on sociodemographic, smoking, and alcohol history. Associations were assessed using logistic regression with 95% confidence intervals (CI). The study included 2143 cases with HNC and 5799 controls. Cancer cases were categorized by their respective subsites: 954 LC (44.5%), 685 OPC (32.0%), 504 OCC (23.5%). The risk of developing OCC was 2.8-fold higher [CI: 1.9-4.1], LC 2.6-fold higher [CI: 1.9-3.5], and OPC 2.1-fold higher [CI: 1.5-2.8] in individuals who smoked > 50 pack-years, compared to < 10 pack-years. The risk of OCC/OPC/LC increased with tobacco consumption in North-America, whereas in Western/Southern-Europe and South-America the association plateaued beyond 31-50 pack-years. Cessation after age 55 increased the risk of LC by 3.0-fold [CI: 2.2-4.2], and OCC by 2.2-fold [CI: 1.4-3.3] versus cessation age ≤ 45 years. Consuming ≥ 5 drinks/day was associated with 5-fold higher risk of OPC [CI: 3.7-6.6], 4.4-fold higher risk of OCC [CI: 3.2-6.1] and 3.1-fold higher risk of LC [CI: 2.4-3.9] compared to 0-0.9 drinks/day. The risk of HNC among former smokers is not homogeneous across regions and that there were distinct patterns for OCC, OPC, and LC. The amount of tobacco and alcohol consumption are key risk factors, with alcohol being more important for OCC/OPC, and tobacco being more strongly associated with LC risk.

International Journal of Cancer
Semmelweis University (HU), Università Cattolica del Sacro Cuore (IT), Boston University (US), University of North Carolina at Chapel Hill (US), The University of Texas MD Anderson Cancer Center (US), Johns Hopkins University (US), Inserm (FR), University of California, Los Angeles (US), University of Pittsburgh (US), German Cancer Research Center (DE), University of Milan (IT), Nofer Institute of Occupational Medicine (PL), University of Utah (US), Heidelberg University (DE), Brown University (US), University of Michigan (US), UCLA Health (US), Huntsman Cancer Institute (US), University Hospital Heidelberg (DE), Agostino Gemelli University Polyclinic (IT), AC Camargo Hospital (BR), Instituto do Câncer do Estado de São Paulo (BR), Fred Hutch Cancer Center (US), Russian Cancer Research Center NN Blokhin (RU), National Public Health and Medical Officer Service (HU), Centre de recherche en Epidémiologie et Santé des Populations (FR), Public Health Authority of the Slovak Republic (SK), Institut de Recherche en Santé, Environnement et Travail (FR), National Institute of Oncology (HU), Heidelberg Engineering (Germany) (DE), Centro di Riferimento Oncologico (IT), Instituto de Saúde (BR), The Maria Sklodowska-Curie National Research Institute of Oncology (PL), Istituti di Ricovero e Cura a Carattere Scientifico (IT), National School of Public Health, Management and Professional Development (RO), Centre international de recherche sur le cancer (FR), Université de Rennes (FR), Stony Brook University (US), University of Milano-Bicocca (IT), Fielding Graduate University (US), Penn State Milton S. Hershey Medical Center (US), University of Bologna (IT)
Fondazione AIRC per la ricerca sul cancro ETS, Memorial Sloan-Kettering Cancer Center, Johns Hopkins University, New York Eye and Ear Infirmary of Mount Sinai, European Commission, Agence Nationale de la Recherche, Fundação de Amparo à Pesquisa do Estado de São Paulo, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Bundesministerium für Bildung und Forschung, Fondation pour la Recherche Médicale, Ministero dell’Istruzione, dell’Università e della Ricerca, Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg, Fondation ARC pour la Recherche sur le Cancer, Fondation de France, Associazione Italiana per la Ricerca sul Cancro, Institut National Du Cancer, Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, Institut de Veille Sanitaire, National Institutes of Health, World Cancer Research Fund, National Cancer Institute, National Institute of Environmental Health Sciences, Jonsson Comprehensive Cancer Center
Good health and well-being
Openalex Percentile: Top 17%
Head and Neck Cancer Studies
DOIOpen Access PDFOpenAlex
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