How much do smoking and alcohol consumption explain socioeconomic inequalities in head and neck cancer risk?

Author(s)

Boing, A. F. ^[1] ; Ferreira Antunes, J. L. ^[2] ; Brasilino de Carvalho, M. ^[3] ; Francisco de Gois Filho, J. ^[4] ; Kowalski, L. P. ^[5] ; Michaluart, Jr., P. ^[6] ; Eluf-Neto, J. ; Boffetta, P. ^[7] ; Wuensch-Filho, V. ^[8] ; GENCAPO, Head Neck Genome Project

Affiliation

^[1] Univ Fed Santa Catarina, Ctr Ciencias Saude, Florianopolis, SC - Brazil

^[2] Univ Sao Paulo, Escola Artes Ciencias & Humanidades, Fac Odontol, BR-03828900 Sao Paulo - Brazil

^[3] Secretaria Estado Saude Sao Paulo, Hosp Heliopolis, Sao Paulo - Brazil

^[4] Inst Canc Arnaldo Vieira de Carvalho, Sao Paulo - Brazil

^[5] Hosp Canc AC Camargo, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Hosp Clin, Fac Med, BR-03828900 Sao Paulo - Brazil

^[7] Int Agcy Res Canc, F-69372 Lyon - France

^[8] Univ Sao Paulo, Fac Saude Publ, BR-03828900 Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH; v. 65, n. 8, p. 709-714, AUG 2011.
• Web of Science Citations: 26

Abstract

Background A higher burden of head and neck cancer has been reported to affect deprived populations. This study assessed the association between socioeconomic status and head and neck cancer, aiming to explore how this association is related to differences of tobacco and alcohol consumption across socioeconomic strata. Methods We conducted a case-control study in Sao Paulo, Brazil (1998-2006), including 1017 incident cases of oral, pharyngeal and laryngeal cancer, and 951 sex- and age-matched controls. Education and occupation were distal determinants in the hierarchical approach; cumulative exposure to tobacco and alcohol were proximal risk factors. Outcomes of the hierarchical model were compared with fully adjusted ORs. Results Individuals with lower education (OR 2.27; 95% CI 1.61 to 3.19) and those performing manual labour (OR 1.55; 95% CI 1.26 to 1.92) had a higher risk of disease. However, 54% of the association with lower education and 45% of the association with manual labour were explained by proximal lifestyle exposures, and socioeconomic status remained significantly associated with disease when adjusted for smoking and alcohol consumption. Conclusions Socioeconomic differences in head and neck cancer are partially attributable to the distribution of tobacco smoking and alcohol consumption across socioeconomic strata. Additional mediating factors may explain the remaining variation of socioeconomic status on head and neck cancer. (AU)

• FAPESP's process: 04/12054-9 - Markers of aggressive behavior in head and neck tumors
• Grantee: Eloiza Helena Tajara da Silva
• Support Opportunities: Research Projects - Thematic Grants