Table 2.
Associations (multivariablea adjusted incidence RRs) between alcohol consumption and risk of subtypes of head-neck cancer; Netherlands Cohort Study (NLCS), 1986 – 2003
| |
|
Subcohort |
Head-neck cancer cases |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| |
|
|
Overall |
Subtypes |
|
|
|||||
| |
|
|
|
|
OCC
b
|
|
OHPC
b
|
|
LC
b
|
|
|
| Categorical median | Person time at risk (years) | No. of cases | RR (95% CI) | No. of cases | RR (95% CI) | No. of cases | RR (95% CI) | No. of cases | RR (95% CI) | P for heterogeneity | |
|
Alcohol consumption (grams ethanol/day) | |||||||||||
| Abstainers |
0 |
15 255 |
49 |
1 (reference) |
12 |
1 (reference) |
11 |
1 (reference) |
26 |
1 (reference) |
0.86 |
| >0 to <5 |
2 |
19 008 |
67 |
1.11 (0.75-1.65) |
17 |
1.25 (0.59-2.65) |
14 |
1.06 (0.47-2.40) |
36 |
1.03 (0.60-1.77) |
|
| 5 to <15 |
9 |
14 468 |
72 |
1.15 (0.77-1.71) |
19 |
1.91 (0.91-4.03) |
12 |
0.90 (0.38-2.13) |
40 |
0.94 (0.56-1.58) |
|
| 15 to <30 |
22 |
9 961 |
92 |
1.52 (1.02-2.27) |
30 |
3.88 (1.86-8.12) |
13 |
0.99 (0.41-2.38) |
49 |
1.10 (0.66-1.83) |
|
| ≥30 |
40 |
5 659 |
115 |
2.74 (1.85-4.06) |
32 |
6.39 (3.13-13.03) |
33 |
3.52 (1.69-7.36) |
48 |
1.54 (0.91-2.60) |
|
|
P for trendc |
|
|
|
<0.001 |
|
<0.001 |
|
<0.001 |
|
0.05 |
|
| Continuous, 10 gram |
|
|
|
|
|
|
|
|
|
|
|
| ethanol/day increments |
|
|
|
|
|
|
|
|
|
|
|
| Overall |
|
64 352 |
395 |
1.20 (1.12-1.27) |
110 |
1.28 (1.18-1.39) |
83 |
1.27 (1.16-1.38) |
199 |
1.10 (1.02-1.18) |
0.18 |
| Men |
|
30 169 |
314 |
1.19 (1.12-1.27) |
65 |
1.27 (1.17-1.38) |
61 |
1.27 (1.16-1.39) |
187 |
1.10 (1.03-1.19) |
|
| Women |
|
34 183 |
81 |
1.40 (1.18-1.65) |
45 |
1.58 (1.33-1.87) |
22 |
1.31 (0.91-1.87) |
12 |
0.85 (0.46-1.59) |
|
|
P for interactiond |
|
|
|
0.02 |
|
0.004 |
|
0.68 |
|
0.67 |
|
|
Alcohol consumption (grams ethanol/day) stable users
e
| |||||||||||
| Abstainers |
0 |
11 810 |
38 |
1 (reference) |
9 |
1 (reference) |
9 |
1 (reference) |
20 |
1 (reference) |
1.00 |
| >0 to <5 |
2 |
11 813 |
36 |
0.98 (0.60-1.61) |
12 |
1.65 (0.68-4.01) |
7 |
0.86 (0.30-2.41) |
17 |
0.72 (0.35-1.46) |
|
| 5 to <15 |
9 |
8 749 |
38 |
0.96 (0.58-1.59) |
9 |
1.68 (0.63-4.47) |
8 |
0.89 (0.32-2.47) |
21 |
0.72 (0.37-1.40) |
|
| 15 to <30 |
22 |
5 293 |
45 |
1.27 (0.76-2.11) |
12 |
3.20 (1.25-8.19) |
6 |
0.72 (0.23-2.26) |
27 |
0.96 (0.50-1.83) |
|
| ≥30 |
42 |
3 047 |
69 |
2.90 (1.78-4.73) |
17 |
7.50 (3.15-17.88) |
20 |
3.46 (1.46-8.20) |
31 |
1.57 (0.82-3.02) |
|
|
P for trend |
|
|
|
<0.001 |
|
<0.001 |
|
0.001 |
|
0.03 |
|
| Continuous, 10 grams |
|
39712 |
226 |
1.26 (1.16-1.36) |
59 |
1.37 (1.24-1.52) |
50 |
1.35 (1.20-1.52) |
116 |
1.16 (1.04-1.28) |
0.72 |
| ethanol/day increments |
|
|
|
|
|
|
|
|
|
|
|
|
Alcoholic beverages (glasses/day)
f
| |||||||||||
|
Beer |
|
|
|
|
|
|
|
|
|
|
|
| No beer |
0 |
43 519 |
183 |
1 (reference) |
59 |
1 (reference) |
36 |
1 (reference) |
87 |
1 (reference) |
0.84 |
| >0- < 1 |
0.2 |
16 408 |
129 |
0.94 (0.71-1.24) |
34 |
1.10 (0.65-1.86) |
24 |
0.98 (0.54-1.76) |
69 |
0.85 (0.60-1.22) |
|
| 1- < 2 |
1.4 |
2 853 |
37 |
1.12 (0.72-1.74) |
8 |
1.17 (0.49-2.77) |
6 |
1.04 (0.41-2.66) |
23 |
1.19 (0.71-2.01) |
|
| ≥2 |
3.4 |
1 554 |
46 |
1.39 (0.83-2.34) |
9 |
0.99 (0.34-2.82) |
17 |
2.48 (1.03-5.98) |
20 |
1.30 (0.69-2.46) |
|
|
P for trend |
|
|
|
0.14 |
|
0.95 |
|
0.03 |
|
0.20 |
|
| Continuous, 1 |
|
64 335 |
395 |
1.07 (0.97-1.19) |
110 |
0.97 (0.80-1.16)g |
83 |
1.19 (1.01-1.40) |
199 |
1.08 (0.96-1.23) |
0.07 |
| glass/day increments |
|
|
|
|
|
|
|
|
|
|
|
|
Wine |
|
|
|
|
|
|
|
|
|
|
|
| No wine |
0 |
30 263 |
197 |
1 (reference) |
44 |
1 (reference) |
38 |
1 (reference) |
114 |
1 (reference) |
0.93 |
| >0- < 1 |
0.2 |
25 975 |
132 |
0.88 (0.67-1.14) |
40 |
1.07 (0.67-1.71) |
33 |
1.01 (0.59-1.75) |
57 |
0.74 (0.52-1.05) |
|
| 1- < 2 |
1.4 |
5 277 |
39 |
0.95 (0.63-1.44) |
14 |
1.31 (0.67-2.55) |
5 |
0.52 (0.19-1.39) |
20 |
1.07 (0.63-1.83) |
|
| ≥2 |
2.6 |
2 751 |
24 |
0.56 (0.29-1.07) |
11 |
0.93 (0.34-2.57) |
7 |
0.52 (0.15-1.81)g |
6 |
0.39 (0.15-0.99) |
|
|
P for trend |
|
|
|
0.15 |
|
0.93 |
|
0.16 |
|
0.21 |
|
| Continuous, 1 |
|
64 265 |
392 |
0.88 (0.74-1.05) |
109 |
0.89 (0.69-1.16) |
83 |
0.86 (0.64-1.17) |
197 |
0.88 (0.68-1.14) |
0.26 |
| glass/day increments |
|
|
|
|
|
|
|
|
|
|
|
|
Liquor |
|
|
|
|
|
|
|
|
|
|
|
| No liquor |
0 |
33 299 |
137 |
1 (reference) |
40 |
1 (reference) |
34 |
1 (reference) |
63 |
1 (reference) |
0.44 |
| >0- < 1 |
0.2 |
23 492 |
133 |
1.09 (0.84-1.43) |
31 |
1.10 (0.67-1.80) |
23 |
0.86 (0.48-1.53) |
78 |
1.17 (0.81-1.67) |
|
| 1- < 2 |
1.9 |
5 370 |
67 |
1.09 (0.76-1.57) |
18 |
1.65 (0.87-3.15) |
12 |
0.79 (0.39-1.62) |
37 |
1.08 (0.67-1.74) |
|
| ≥2 |
2.8 |
2 115 |
56 |
1.18 (0.71-1.95) |
20 |
2.26 (1.02-4.99) |
14 |
0.83 (0.33-2.13) |
20 |
0.95 (0.47-1.93) |
|
|
P for trend |
|
|
|
0.61 |
|
0.03 |
|
0.64 |
|
0.83 |
|
| Continuous, 1 |
|
64 275 |
393 |
1.01 (0.86-1.18) |
109 |
1.18 (0.89-1.56) |
83 |
0.89 (0.68-1.15) |
198 |
0.98 (0.80-1.21) |
0.25 |
| glass/day increments | |||||||||||
aAdjusted for age (years), sex, cigarette smoking (status (never/former/current), frequency (continuous; centered), and duration (continuous; centered)).
bOCC: oral cavity cancer; OHPC: oro-/hypopharyngeal cancer; LC: laryngeal cancer.
cTests for dose-response trends were assessed by fitting ordinal variables as continuous terms in the Cox proportional hazards model.
dP Value for interaction between sex and alcohol consumption, based on cross-product terms in the Cox proportional hazards model and Wald test.
eSubjects who had not changed their continuous alcohol consumption habits in the 5 years before baseline: for “beer” and “other alcoholic beverages”, participants could indicate whether 5 years before baseline they drunk (1) more than, (2) equal amounts of or (3) less than at baseline; the fourth answer option was (4) “I never use this”.
fAdditionally adjusted for continuous ethanol intake (g ethanol/day).
gProportional hazards assumption was possibly violated for the exposure variable, and there was a statistically significant interaction with time.