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Lifestyle risk factors for head and neck cancer

Principal Investigator
Name
Mia Hashibe
Institution
University of Utah
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
2010-0067
Initial CDAS Request Approval
Apr 29, 2010
Title
Lifestyle risk factors for head and neck cancer
Summary
Head and neck cancers are malignancies that arise in the oral cavity, pharynx, and larynx. It is the sixth most common type of cancer in the world, representing about 6% of all cancer cases (Parkin DM, 2005). Worldwide, more than half a million head and neck cancer cases and 300,000 deaths due to head and neck cancer are estimated to occur each year (Globocan 2002). In the United States, it is estimated that in 2009, 35,160 head and neck cancer cases occurred among men and 12,850 for women. While risk factors such as tobacco smoking and alcohol drinking have become well established, the role of other factors such as body mass index (BMI), coffee and tea intake, physical activity, reproductive factors in women, and previous disease such as diabetes in the development of head and neck cancer are still unclear. Family history of head and neck cancer appears to be a risk factor, but the increased risk may be restricted to tobacco smokers and alcohol drinkers. Fruit and vegetable intake are considered to be protective factors, but the role of other dietary factors on head and neck cancer risk is not well established. The majority of previous epidemiologic studies reporting on head and neck cancer risk factors have been case-control studies in which recall bias and temporal ambiguity are serious concerns. Examining these factors in a cohort study where the exposure measurements occurred before the cancer diagnosis occurred is an ideal approach.
Aims

Specific aim 1: To examine body mass index (BMI), coffee and tea intake, physical activity, reproductive factors in women, and diabetes as possible risk factors for head and neck cancer in the PLCO cohort study. Hypothesis 1: Pre-diagnostic body mass index is not associated with the risk of head and neck cancer. Hypothesis 2: Coffee and tea intake are protective factors for head and neck cancer. Increasing frequency of intake will be associated with a decreasing risk of head and neck cancer. Hypothesis 3: Reproductive factors including age at first period, age at first birth, number of children, oral contraceptive use, and hormone therapy are not associated with head and neck cancer risk. Hypothesis 4: Diagnosis of diabetes is associated with an increased risk of head and neck cancer. Other previous existing conditions such as high blood pressure, etc are not associated with head and neck cancer. Hypothesis 5: Fruit, vegetable and vitamin intake are protective against head and neck cancer. Meat and dairy intake are not associated with head and neck cancer. Intake of eggs is associated with an increased head and neck cancer risk. Hypothesis 6: Increased physical activity is associated with a decreased head and neck cancer risk. Hypothesis 7: Family history of head and neck cancer is a risk factor for head and neck cancer. Specific aim 2: To calculate population attributable fraction for the established risk factors (tobacco and alcohol), as well as for the new factors that may be identified as risk factors in this study. Hypothesis 7: Approximately 50% of head and neck cancers in the PLCO population are attributable to the combination of tobacco and alcohol. Other risk factors will be responsible for a small proportion of cases (<10%).

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