Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease
Table 2
Site-specific head and neck cancer associated with tobacco, alcohol, and HPV E6/E7 status.1
Cases
Controls
Oral Cavity versus controls
Oropharynx versus controls
Oral cavity )
Oropharynx ()
()
OR2 (95% CI)
OR2 (95% CI)
Characteristic
N (%)
N (%)
N (%)
Tobacco
Never
57 (33.7)
10 (13.7)
160 (37.7)
1.0
1.0
≤30
44 (26.0)
25 (34.2)
142 (33.4)
0.9 (0.5–1.4)
2.1 (0.9–5.2)
>30
68 (40.2)
38 (52.1)
123 (28.9)
1.5 (0.9–2.4)
5.6 (2.3–13.7)
Alcohol
Never
60 (35.5)
8 (11.0)
184 (43.2)
1.0
1.0
≤21
59 (34.9)
37 (50.7)
181 (42.5)
1.1 (0.7–1.8)
4.3 (1.7–10.4)
>21
50 (29.6)
28 (38.4)
61 (14.3)
3.6 (2.1–6.2)
11.7 (4.2–32.7)
Tobacco/alcohol
Never/never
42 (25.0)
3 (4.1)
100 (23.6)
1.0
1.0
≤30/≤21
23 (13.7)
14 (19.2)
72 (17.0)
1.0 (0.5–1.8)
5.2 (1.2–21.7)
≤30/>21
10 (6.0)
8 (11.0)
26 (6.1)
1.4 (0.6–3.5)
15.9 (3.2–80.2)
>30/≤21
22 (13.1)
17 (23.3)
55 (13.0)
1.3 (0.6–2.4)
16.6 (3.9–71.4)
>30/>21
39 (23.2)
19 (26.0)
29 (6.9)
5.2 (2.6–10.5)
34.6 (7.5–158.8)
HPV E6/E7 status1
Positive
16 (9.4)
47 (63.5)
31 (7.2)
1.7 (0.9–3.3)
24.3 (12.9–45.8)
Negative3
154 (90.6)
27 (36.5)
397 (92.8)
1.0
1.0
1Percentages based on available data; 2odds ratio adjusted by age (continuous), gender, HPV status, tobacco, and alcohol; 3HPV E6/E7 negative status for all types, E6/E7 positive status for HPV-16, -18, and/or -33.
