Alcohol and Tobacco Use Prediagnosis and Postdiagnosis, and Survival in a Cohort of Patients with Early Stage Cancers of the Oral Cavity, Pharynx, and Larynx

Susan T. Mayne; Brenda Cartmel; Victoria Kirsh; W. Jarrard Goodwin

doi:10.1158/1055-9965.EPI-09-0944

DOI: 10.1158/1055-9965.EPI-09-0944 Published December 2009

Article Figures & Data

Tables

Table 1.

Baseline characteristics of early stage head and neck cancer patients according to survival status at the end of follow-up

Characteristics	Patients who died, n = 62	Patients who survived, n = 202	P
Age (mean ± SD)	64.0 ± 7.5	61.0 ± 9.9	0.01
Sex			0.52
Male	52 (84%)	162 (80%)
Female	10 (16%)	40 (20%)
Race			0.85
White/non-Hispanic	54 (87%)	181 (90%)
Hispanic/Puerto Rican	4 (6%)	11 (5%)
Non-White	4 (6%)	10 (5%)
Tumor site			0.15
Oral cavity	19 (31%)	46 (23%)
Pharynx	7 (11%)	13 (6%)
Larynx	36 (58%)	143 (71%)
Treatment			0.33
Surgery	20 (32%)	61 (30%)
Radiation	32 (52%)	111 (55%)
Surgery and Radiation	9 (15%)	18 (9%)
Unknown	1 (2%)	12 (6%)
Stage*			0.002
Carcinoma in situ	4 (7%)	9 (4%)
I	27 (44%)	138 (69%)
II	30 (49%)	54 (27%)
Recruitment site			0.23
Connecticut	52 (84%)	155 (77%)
Florida	10 (16%)	47 (23%)
Years of education*			0.82
<12	8 (13%)	23 (11%)
12	29 (47%)	88 (44%)
>12	25 (40%)	90 (45%)
BMI (kg/m²)	24.4 ± 3.8	25.8 ± 3.8	0.01

↵*Stage category missing for two patients and education for one.

Table 2.

Association between smoking status/smoking history at diagnosis and mortality during the follow-up period in a cohort of early stage head and neck cancer patients

Smoking	Person-years	All-cause mortality
Smoking	Person-years	No. of deaths	RR* (95% CI)
Cigarette smoking
Never smokers (n = 17)	75	1	1.0
Former smokers (n = 111)	460	18	2.14 (0.28, 16.47)
Current smokers (n = 136)	568	43	4.91 (0.67, 35.98)
Smoking intensity, cigarettes/d^†
1-15 (n = 49)	222	9	2.43 (0.30, 19.69)
16-30 (n = 103)	423	22	3.59 (0.48, 27.04)
>30 (n = 95)	382	30	5.33 (0.71, 40.00)
P-trend			0.17
Smoking duration, y^†
1-30 (n = 78)	347	10	1.95 (0.24, 15.86)
31-40 (n = 61)	256	15	3.59 (0.47, 27.54)
>40 (n = 108)	423	36	5.15 (0.69, 38.47)
P-trend			0.004
Pack-years^†
Up to 40 (n = 96)	407	15	2.49 (0.33, 19.11)
41-60 (n = 67)	276	16	3.88 (0.50, 30.26)
>60 (n = 84)	344	30	5.39 (0.73, 40.12)
P-trend			0.003

↵*Adjusted for age, sex, educational level, BMI, race, randomization group, beer, wine, and liquor. P-trend refers to the test for a linear dose-response relationship for each measure of tobacco use (smoking intensity, duration, and pack-years separately).
↵^†Among current and former smokers combined, relative to never smokers.

Table 3.

Association between usual alcohol intake before diagnosis and mortality during the follow-up period, for total alcohol and by type of alcohol, in a cohort of early stage head and neck cancer patients

Alcohol intake	Person-years	All-cause mortality
Alcohol intake	Person-years	No. of deaths	RR* (95% CI)
Total (drinks/wk)
0 (n = 30)	145	3	1.0
1-7 (n = 49)	197	6	1.46 (0.35, 6.14)
8-21 (n = 60)	275	11	1.44 (0.39, 5.35)
22-35 (n = 32)	133	7	2.36 (0.60, 9.31)
>35 (n = 93)	352	35	4.87 (1.46, 16.27)
P-trend			<0.0001
Beer (drinks/wk)
0 (n = 82)	367	14	1.0
1-7 (n = 76)	314	14	1.20 (0.53, 2.73)
8-21 (n = 52)	201	13	2.37 (1.03, 5.44)
>21 (n = 54)	219	21	2.86 (1.34, 6.12)
P-trend			0.04
Wine (drinks/wk)
0 (n = 160)	675	44	1.0
1-2 (n = 43)	180	7	0.58 (0.25, 1.35)
3-7 (n = 30)	121	4	0.44 (0.14, 1.35)
>7 (n = 31)	125	7	0.75 (0.32, 1.76)
P-trend			0.27
Liquor (drinks/wk)
0 (n = 91)	405	16	1.0
1-7 (n = 61)	244	12	1.27 (0.59, 2.75)
8-21 (n = 48)	217	13	1.04 (0.47, 2.33)
>21 (n = 64)	235	21	2.11 (1.04, 4.28)
P-trend			0.0001

↵*Adjusted for age, sex, smoking history (pack-years, current versus former/never), educational level, BMI, race, randomization group, and other types of alcohol (where applicable). P-trend refers to the test for a linear dose-response relationship for each measure of alcohol use (total, beer, wine, and liquor separately).

Table 4.

Association between continued drinking and smoking habits postdiagnosis, and mortality during follow-up in a cohort of early stage head and neck cancer patients

Habits during follow-up	Person-years	All-cause mortality
Habits during follow-up	Person-years	No. of deaths	RR* (95% CI)	RR^† (95% CI)
Drinking
Nondrinker (n = 101)	451	13	1.0	1.0
Transitional drinker (n = 64)	315	8	0.86 (0.36, 2.08)	0.73 (0.29, 1.86)
Continuous drinker (n = 73)	305	20	2.48 (1.23, 5.02)	2.72 (1.20, 6.14)
Cigarette smoking
Nonsmoker (n = 163)	736	22	1.0	1.0
Transitional smoker (n = 28)	133	3	0.86 (0.26, 2.90)	0.36 (0.10, 1.31)
Continuous smoker (n = 50)	206	17	3.30 (1.74, 6.26)	1.83 (0.85, 3.94)

↵*Adjusted for age.
↵^†Adjusted for age, sex, smoking history, educational level, BMI, race, randomization group, history of beer, wine, and liquor consumption, and, as appropriate, smoking or drinking during follow-up.