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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention

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Research Articles

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 and W. Jarrard Goodwin Jr.
Susan T. Mayne
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Brenda Cartmel
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Victoria Kirsh
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W. Jarrard Goodwin
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DOI: 10.1158/1055-9965.EPI-09-0944 Published December 2009
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Tables

  • Table 1.

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

    CharacteristicsPatients who died, n = 62Patients who survived, n = 202P
    Age (mean ± SD)64.0 ± 7.561.0 ± 9.90.01
    Sex0.52
        Male52 (84%)162 (80%)
        Female10 (16%)40 (20%)
    Race0.85
        White/non-Hispanic54 (87%)181 (90%)
        Hispanic/Puerto Rican4 (6%)11 (5%)
        Non-White4 (6%)10 (5%)
    Tumor site0.15
        Oral cavity19 (31%)46 (23%)
        Pharynx7 (11%)13 (6%)
        Larynx36 (58%)143 (71%)
    Treatment0.33
        Surgery20 (32%)61 (30%)
        Radiation32 (52%)111 (55%)
        Surgery and Radiation9 (15%)18 (9%)
        Unknown1 (2%)12 (6%)
    Stage*0.002
        Carcinoma in situ4 (7%)9 (4%)
        I27 (44%)138 (69%)
        II30 (49%)54 (27%)
    Recruitment site0.23
        Connecticut52 (84%)155 (77%)
        Florida10 (16%)47 (23%)
    Years of education*0.82
        <128 (13%)23 (11%)
        1229 (47%)88 (44%)
        >1225 (40%)90 (45%)
    BMI (kg/m2)24.4 ± 3.825.8 ± 3.80.01
    • ↵*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

    SmokingPerson-yearsAll-cause mortality
    No. of deathsRR* (95% CI)
    Cigarette smoking
        Never smokers (n = 17)7511.0
        Former smokers (n = 111)460182.14 (0.28, 16.47)
        Current smokers (n = 136)568434.91 (0.67, 35.98)
    Smoking intensity, cigarettes/d†
        1-15 (n = 49)22292.43 (0.30, 19.69)
        16-30 (n = 103)423223.59 (0.48, 27.04)
        >30 (n = 95)382305.33 (0.71, 40.00)
        P-trend0.17
    Smoking duration, y†
        1-30 (n = 78)347101.95 (0.24, 15.86)
        31-40 (n = 61)256153.59 (0.47, 27.54)
        >40 (n = 108)423365.15 (0.69, 38.47)
        P-trend0.004
    Pack-years†
        Up to 40 (n = 96)407152.49 (0.33, 19.11)
        41-60 (n = 67)276163.88 (0.50, 30.26)
        >60 (n = 84)344305.39 (0.73, 40.12)
        P-trend0.003
    • ↵*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 intakePerson-yearsAll-cause mortality
    No. of deathsRR* (95% CI)
    Total (drinks/wk)
        0 (n = 30)14531.0
        1-7 (n = 49)19761.46 (0.35, 6.14)
        8-21 (n = 60)275111.44 (0.39, 5.35)
        22-35 (n = 32)13372.36 (0.60, 9.31)
        >35 (n = 93)352354.87 (1.46, 16.27)
        P-trend<0.0001
    Beer (drinks/wk)
        0 (n = 82)367141.0
        1-7 (n = 76)314141.20 (0.53, 2.73)
        8-21 (n = 52)201132.37 (1.03, 5.44)
        >21 (n = 54)219212.86 (1.34, 6.12)
        P-trend0.04
    Wine (drinks/wk)
        0 (n = 160)675441.0
        1-2 (n = 43)18070.58 (0.25, 1.35)
        3-7 (n = 30)12140.44 (0.14, 1.35)
        >7 (n = 31)12570.75 (0.32, 1.76)
        P-trend0.27
    Liquor (drinks/wk)
        0 (n = 91)405161.0
        1-7 (n = 61)244121.27 (0.59, 2.75)
        8-21 (n = 48)217131.04 (0.47, 2.33)
        >21 (n = 64)235212.11 (1.04, 4.28)
        P-trend0.0001
    • ↵*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-upPerson-yearsAll-cause mortality
    No. of deathsRR* (95% CI)RR† (95% CI)
    Drinking
        Nondrinker (n = 101)451131.01.0
        Transitional drinker (n = 64)31580.86 (0.36, 2.08)0.73 (0.29, 1.86)
        Continuous drinker (n = 73)305202.48 (1.23, 5.02)2.72 (1.20, 6.14)
    Cigarette smoking
        Nonsmoker (n = 163)736221.01.0
        Transitional smoker (n = 28)13330.86 (0.26, 2.90)0.36 (0.10, 1.31)
        Continuous smoker (n = 50)206173.30 (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.

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Cancer Epidemiology Biomarkers & Prevention: 18 (12)
December 2009
Volume 18, Issue 12
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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 and W. Jarrard Goodwin Jr.
Cancer Epidemiol Biomarkers Prev December 1 2009 (18) (12) 3368-3374; DOI: 10.1158/1055-9965.EPI-09-0944

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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 and W. Jarrard Goodwin Jr.
Cancer Epidemiol Biomarkers Prev December 1 2009 (18) (12) 3368-3374; DOI: 10.1158/1055-9965.EPI-09-0944
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