Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries

David I. Conway, Darren R. Brenner, Alex D. McMahon, Lorna M D Macpherson, Antonio Agudo, Wolfgang Ahrens, Cristina Bosetti, Hermann Brenner, Xavier Castellsague, Chu Chen, Maria Paula Curado, Otávio A. Curioni, Luigino Dal Maso, Alexander W. Daudt, José F. De Gois Filho, Gypsyamber D'Souza, Valeria Edefonti, Eleonora Fabianova, Leticia Fernandez, Silvia FranceschiMaura Gillison, Richard B. Hayes, Claire M. Healy, Rolando Herrero, Ivana Holcatova, Vijayvel Jayaprakash, Karl Kelsey, Kristina Kjaerheim, Sergio Koifman, Carlo La Vecchia, Pagona Lagiou, Philip Lazarus, Fabio Levi, Jolanta Lissowska, Daniele Luce, Tatiana V. Macfarlane, Dana Mates, Elena Matos, Michael McClean, Ana M. Menezes, Gwenn Menvielle, Franco Merletti, Hal Morgenstern, Kirsten Moysich, Heiko Müller, Joshua Muscat, Andrew F. Olshan, Mark P. Purdue, Heribert Ramroth, Lorenzo Richiardi, Peter Rudnai, Stimson Schantz, Stephen M. Schwartz, Oxana Shangina, Lorenzo Simonato, Elaine Smith, Isabelle Stucker, Erich M. Sturgis, Neonila Szeszenia-Dabrowska, Renato Talamini, Peter Thomson, Thomas L. Vaughan, Qingyi Wei, Deborah M. Winn, Victor Wunsch-Filho, Guo Pei Yu, Zuo Feng Zhang, Tongzhang Zheng, Ariana Znaor, Paolo Boffetta, Shu Chun Chuang, Marianoosh Ghodrat, Yuan Chin Amy Lee, Mia Hashibe, Paul Brennan

Research output: Contribution to journalArticle

Abstract

Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR 5 2.50; 95% CI 5 2.02-3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR 5 1.61; 95% CI 5 1.13-2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.

Original languageEnglish (US)
Pages (from-to)1125-1139
Number of pages15
JournalInternational Journal of Cancer
Volume136
Issue number5
DOIs
StatePublished - Mar 1 2015

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Head and Neck Neoplasms
Case-Control Studies
Education
Smoking
Alcohols
Central America
Neoplasms
Oropharynx
South America
North America
Social Class
Tobacco

Keywords

  • Epidemiology
  • Head and neck cancer
  • Socioeconomic inequalities

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Estimating and explaining the effect of education and income on head and neck cancer risk : INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. / Conway, David I.; Brenner, Darren R.; McMahon, Alex D.; Macpherson, Lorna M D; Agudo, Antonio; Ahrens, Wolfgang; Bosetti, Cristina; Brenner, Hermann; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Curioni, Otávio A.; Maso, Luigino Dal; Daudt, Alexander W.; De Gois Filho, José F.; D'Souza, Gypsyamber; Edefonti, Valeria; Fabianova, Eleonora; Fernandez, Leticia; Franceschi, Silvia; Gillison, Maura; Hayes, Richard B.; Healy, Claire M.; Herrero, Rolando; Holcatova, Ivana; Jayaprakash, Vijayvel; Kelsey, Karl; Kjaerheim, Kristina; Koifman, Sergio; La Vecchia, Carlo; Lagiou, Pagona; Lazarus, Philip; Levi, Fabio; Lissowska, Jolanta; Luce, Daniele; Macfarlane, Tatiana V.; Mates, Dana; Matos, Elena; McClean, Michael; Menezes, Ana M.; Menvielle, Gwenn; Merletti, Franco; Morgenstern, Hal; Moysich, Kirsten; Müller, Heiko; Muscat, Joshua; Olshan, Andrew F.; Purdue, Mark P.; Ramroth, Heribert; Richiardi, Lorenzo; Rudnai, Peter; Schantz, Stimson; Schwartz, Stephen M.; Shangina, Oxana; Simonato, Lorenzo; Smith, Elaine; Stucker, Isabelle; Sturgis, Erich M.; Szeszenia-Dabrowska, Neonila; Talamini, Renato; Thomson, Peter; Vaughan, Thomas L.; Wei, Qingyi; Winn, Deborah M.; Wunsch-Filho, Victor; Yu, Guo Pei; Zhang, Zuo Feng; Zheng, Tongzhang; Znaor, Ariana; Boffetta, Paolo; Chuang, Shu Chun; Ghodrat, Marianoosh; Lee, Yuan Chin Amy; Hashibe, Mia; Brennan, Paul.

In: International Journal of Cancer, Vol. 136, No. 5, 01.03.2015, p. 1125-1139.

Research output: Contribution to journalArticle

Conway, DI, Brenner, DR, McMahon, AD, Macpherson, LMD, Agudo, A, Ahrens, W, Bosetti, C, Brenner, H, Castellsague, X, Chen, C, Curado, MP, Curioni, OA, Maso, LD, Daudt, AW, De Gois Filho, JF, D'Souza, G, Edefonti, V, Fabianova, E, Fernandez, L, Franceschi, S, Gillison, M, Hayes, RB, Healy, CM, Herrero, R, Holcatova, I, Jayaprakash, V, Kelsey, K, Kjaerheim, K, Koifman, S, La Vecchia, C, Lagiou, P, Lazarus, P, Levi, F, Lissowska, J, Luce, D, Macfarlane, TV, Mates, D, Matos, E, McClean, M, Menezes, AM, Menvielle, G, Merletti, F, Morgenstern, H, Moysich, K, Müller, H, Muscat, J, Olshan, AF, Purdue, MP, Ramroth, H, Richiardi, L, Rudnai, P, Schantz, S, Schwartz, SM, Shangina, O, Simonato, L, Smith, E, Stucker, I, Sturgis, EM, Szeszenia-Dabrowska, N, Talamini, R, Thomson, P, Vaughan, TL, Wei, Q, Winn, DM, Wunsch-Filho, V, Yu, GP, Zhang, ZF, Zheng, T, Znaor, A, Boffetta, P, Chuang, SC, Ghodrat, M, Lee, YCA, Hashibe, M & Brennan, P 2015, 'Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries', International Journal of Cancer, vol. 136, no. 5, pp. 1125-1139. https://doi.org/10.1002/ijc.29063
Conway, David I. ; Brenner, Darren R. ; McMahon, Alex D. ; Macpherson, Lorna M D ; Agudo, Antonio ; Ahrens, Wolfgang ; Bosetti, Cristina ; Brenner, Hermann ; Castellsague, Xavier ; Chen, Chu ; Curado, Maria Paula ; Curioni, Otávio A. ; Maso, Luigino Dal ; Daudt, Alexander W. ; De Gois Filho, José F. ; D'Souza, Gypsyamber ; Edefonti, Valeria ; Fabianova, Eleonora ; Fernandez, Leticia ; Franceschi, Silvia ; Gillison, Maura ; Hayes, Richard B. ; Healy, Claire M. ; Herrero, Rolando ; Holcatova, Ivana ; Jayaprakash, Vijayvel ; Kelsey, Karl ; Kjaerheim, Kristina ; Koifman, Sergio ; La Vecchia, Carlo ; Lagiou, Pagona ; Lazarus, Philip ; Levi, Fabio ; Lissowska, Jolanta ; Luce, Daniele ; Macfarlane, Tatiana V. ; Mates, Dana ; Matos, Elena ; McClean, Michael ; Menezes, Ana M. ; Menvielle, Gwenn ; Merletti, Franco ; Morgenstern, Hal ; Moysich, Kirsten ; Müller, Heiko ; Muscat, Joshua ; Olshan, Andrew F. ; Purdue, Mark P. ; Ramroth, Heribert ; Richiardi, Lorenzo ; Rudnai, Peter ; Schantz, Stimson ; Schwartz, Stephen M. ; Shangina, Oxana ; Simonato, Lorenzo ; Smith, Elaine ; Stucker, Isabelle ; Sturgis, Erich M. ; Szeszenia-Dabrowska, Neonila ; Talamini, Renato ; Thomson, Peter ; Vaughan, Thomas L. ; Wei, Qingyi ; Winn, Deborah M. ; Wunsch-Filho, Victor ; Yu, Guo Pei ; Zhang, Zuo Feng ; Zheng, Tongzhang ; Znaor, Ariana ; Boffetta, Paolo ; Chuang, Shu Chun ; Ghodrat, Marianoosh ; Lee, Yuan Chin Amy ; Hashibe, Mia ; Brennan, Paul. / Estimating and explaining the effect of education and income on head and neck cancer risk : INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. In: International Journal of Cancer. 2015 ; Vol. 136, No. 5. pp. 1125-1139.
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T1 - Estimating and explaining the effect of education and income on head and neck cancer risk

T2 - INHANCE consortium pooled analysis of 31 case-control studies from 27 countries

AU - Conway, David I.

AU - Brenner, Darren R.

AU - McMahon, Alex D.

AU - Macpherson, Lorna M D

AU - Agudo, Antonio

AU - Ahrens, Wolfgang

AU - Bosetti, Cristina

AU - Brenner, Hermann

AU - Castellsague, Xavier

AU - Chen, Chu

AU - Curado, Maria Paula

AU - Curioni, Otávio A.

AU - Maso, Luigino Dal

AU - Daudt, Alexander W.

AU - De Gois Filho, José F.

AU - D'Souza, Gypsyamber

AU - Edefonti, Valeria

AU - Fabianova, Eleonora

AU - Fernandez, Leticia

AU - Franceschi, Silvia

AU - Gillison, Maura

AU - Hayes, Richard B.

AU - Healy, Claire M.

AU - Herrero, Rolando

AU - Holcatova, Ivana

AU - Jayaprakash, Vijayvel

AU - Kelsey, Karl

AU - Kjaerheim, Kristina

AU - Koifman, Sergio

AU - La Vecchia, Carlo

AU - Lagiou, Pagona

AU - Lazarus, Philip

AU - Levi, Fabio

AU - Lissowska, Jolanta

AU - Luce, Daniele

AU - Macfarlane, Tatiana V.

AU - Mates, Dana

AU - Matos, Elena

AU - McClean, Michael

AU - Menezes, Ana M.

AU - Menvielle, Gwenn

AU - Merletti, Franco

AU - Morgenstern, Hal

AU - Moysich, Kirsten

AU - Müller, Heiko

AU - Muscat, Joshua

AU - Olshan, Andrew F.

AU - Purdue, Mark P.

AU - Ramroth, Heribert

AU - Richiardi, Lorenzo

AU - Rudnai, Peter

AU - Schantz, Stimson

AU - Schwartz, Stephen M.

AU - Shangina, Oxana

AU - Simonato, Lorenzo

AU - Smith, Elaine

AU - Stucker, Isabelle

AU - Sturgis, Erich M.

AU - Szeszenia-Dabrowska, Neonila

AU - Talamini, Renato

AU - Thomson, Peter

AU - Vaughan, Thomas L.

AU - Wei, Qingyi

AU - Winn, Deborah M.

AU - Wunsch-Filho, Victor

AU - Yu, Guo Pei

AU - Zhang, Zuo Feng

AU - Zheng, Tongzhang

AU - Znaor, Ariana

AU - Boffetta, Paolo

AU - Chuang, Shu Chun

AU - Ghodrat, Marianoosh

AU - Lee, Yuan Chin Amy

AU - Hashibe, Mia

AU - Brennan, Paul

PY - 2015/3/1

Y1 - 2015/3/1

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AB - Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR 5 2.50; 95% CI 5 2.02-3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR 5 1.61; 95% CI 5 1.13-2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.

KW - Epidemiology

KW - Head and neck cancer

KW - Socioeconomic inequalities

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