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Involuntary Smoking and Head and Neck Cancer Risk: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium

¹ IARC, Lyon, France; ² The University of Texas M. D. Anderson Cancer Center, Houston, Texas; ³ University of California-Los Angeles School of Public Health, Los Angeles, California; ⁴ Penn State College of Medicine, Hershey, Pennsylvania; ⁵ Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina; ⁶ National Cancer Institute, Bethesda, Maryland; ⁷ Cancer Research Centre, Moscow, Russia; ⁸ Universidade de São Paulo, São Paulo, Brazil; ⁹ Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil; ¹⁰ Institute of Public Health, Bucharest, Romania; ¹¹ Hospital Araujo Jorge, Goiânia, Brazil; ¹² Universidade Federal de Pelotas, Pelotas, Brazil; ¹³ Institute of Oncology and Radiobiology, Havana, Cuba; ¹⁴ Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; ¹⁵ Institute of Occupational Medicine, Lodz, Poland; ¹⁶ Specialized State Health Institute, Banská Bystrica, Slovakia; and ¹⁷ National Institute of Environmental Health, Budapest, Hungary

Requests for reprints: Mia Hashibe, Lifestyle, Environment and Cancer Group, IARC, 150 cours Albert Thomas, 69008 Lyon, France. Fax: 33-472738320. E-mail: hashibe{at}iarc.fr

Although active tobacco smoking has been identified as a major risk factor for head and neck cancer, involuntary smoking has not been adequately evaluated because of the relatively low statistical power in previous studies. We took advantage of data pooled in the International Head and Neck Cancer Epidemiology Consortium to evaluate the role of involuntary smoking in head and neck carcinogenesis. Involuntary smoking exposure data were pooled across six case-control studies in Central Europe, Latin America, and the United States. Adjusted odds ratios (OR) and 95% confidence interval (95% CI) were estimated for 542 cases and 2,197 controls who reported never using tobacco, and the heterogeneity among the study-specific ORs was assessed. In addition, stratified analyses were done by subsite. No effect of ever involuntary smoking exposure either at home or at work was observed for head and neck cancer overall. However, long duration of involuntary smoking exposure at home and at work was associated with an increased risk (OR for >15 years at home, 1.60; 95% CI, 1.12-2.28; P_trend < 0.01; OR for >15 years at work, 1.55; 95% CI, 1.04-2.30; P_trend = 0.13). The effect of duration of involuntary smoking exposure at home was stronger for pharyngeal and laryngeal cancers than for other subsites. An association between involuntary smoking exposure and the risk of head and neck cancer, particularly pharyngeal and laryngeal cancers, was observed for long duration of exposure. These results are consistent with those for active smoking and suggest that elimination of involuntary smoking exposure might reduce head and neck cancer risk among never smokers. (Cancer Epidemiol Biomarkers Prev 2008;17(8):1974–81)