Table 1.
Univariate and multivariate analyses of risk factors for early onset OTC.
| Characteristic | Typical onset | Early onset | ||||
|---|---|---|---|---|---|---|
| No. patients = 282 | No. patients = 113 | |||||
| No. patients (% of typical) | No. patients (% of early) | OR (95% CI) | P value | aOR (95% CI) | Adjusted p value | |
| Age at diagnosis (yrs) | ||||||
| Median (IQR) | 63 (58–70) | 42 (36–45) | ||||
| Gender | ||||||
| Male | 171 (60.6) | 67 (59.3) | ref | ref | ||
| Female | 111 (39.4) | 46 (40.7) | 1.1 (0.7–1.7) | 0.805 | 1.0 (0.5–1.7) | 0.898 |
| Race | ||||||
| White | 265 (94.0) | 111 (98.2) | ref | ref | ||
| African American or Black | 10 (3.6) | 1 (0.9) | 0.2 (0.1–1.9) | 0.175 | - | - |
| Asian | 6 (2.1) | 1 (0.9) | 0.4 (0.1–3.3) | 0.396 | 0.2 (0.1–2.2) | 0.207 |
| American Indian/AK native | 1 (0.4) | 0 | - | - | - | - |
| Native Hawaiian | 0 | 0 | - | - | - | - |
| Clinical Stage | ||||||
| T | ||||||
| T1 | 110 (39.0) | 44 (38.9) | ref | |||
| T2 | 90 (31.9) | 41 (36.3) | 1.1 (0.7–1.9) | 0.616 | ||
| T3 | 41 (14.5) | 14 (12.4) | 0.9 (0.4–1.7) | 0.658 | ||
| T4a | 18 (6.4) | 4 (3.5) | 0.6 (0.2–1.7) | 0.312 | ||
| TX | 18 (6.4) | 10 (8.9) | 1.4 (0.6–3.2) | 0.448 | ||
| Missing | 5 (1.8) | 0 | - | - | ||
| N | ||||||
| N0 | 193 (68.4) | 74 (65.5) | ref | |||
| N1 | 35 (12.4) | 14 (12.4) | 1.0 (0.5–2.0) | 0.902 | ||
| N2a | 2 (0.7) | 1 (0.9) | 1.3 (0.1–14.6) | 0.829 | ||
| N2b | 22 (7.8) | 9 (8.0) | 1.1 (0.5–2.4) | 0.877 | ||
| N2c | 11 (3.9) | 4 (3.5) | 1.0 (0.3–3.1) | 0.930 | ||
| NX | 14 (5.0) | 11 (9.7) | 2.0 (0.9–4.7) | 0.092 | ||
| Missing | 5 (1.8) | 0 | - | - | ||
| M | ||||||
| M0 | 258 (91.5) | 99 (87.6) | ref | |||
| MX | 19 (6.7) | 13 (11.5) | 1.8 (0.9–3.8) | 0.127 | ||
| Missing | 5 (1.8) | 1 (0.9) | - | - | ||
| Overallb | ||||||
| I | 102 (36.2) | 41 (36.3) | ref | ref | ||
| II | 67 (23.8) | 25 (22.1) | 0.9 (0.5–1.7) | 0.803 | 0.9 (0.4–1.9) | 0.771 |
| III | 45 (16.0) | 20 (17.7) | 1.1 (0.6–2.1) | 0.758 | 1.0 (0.4–2.2) | 0.908 |
| IVA | 45 (16.0) | 16 (14.2) | 0.9 (0.5–1.7) | 0.722 | 0.7 (0.3–1.8) | 0.473 |
| IVB | 1 (0.4) | 0 | - | - | - | - |
| Missing | 22 (7.8) | 11 (9.7) | - | - | - | - |
| Grade | ||||||
| I: Well differentiated | 58 (20.6) | 25 (22.1) | 1.1 (0.6–1.9) | 0.691 | ||
| II: Moderately differentiated | 166 (58.9) | 64 (56.6) | ref | |||
| III: Poorly differentiated | 33 (11.7) | 13 (11.5) | 1.0 (0.5–2.1) | 0.952 | ||
| Non-high grade | 25 (8.9) | 11 (9.7) | 1.1 (0.5–2.5) | 0.735 | ||
| Treatment | ||||||
| Surgery only | 171 (60.6) | 59 (52.2) | ref | ref | ||
| Surgery + chemoradiation | 54 (19.2) | 24 (21.2) | 1.3 (0.7–2.3) | 0.379 | 1.2 (0.5–2.6) | 0.661 |
| Surgery + radiation | 30 (10.6) | 21 (18.6) | 2.0 (1.1–3.8) | 0.028 | 2.7 (1.2–6.3) | 0.019 |
| Otherc | 27 (9.6) | 9 (8.0) | 1.0 (0.4–2.2) | 0.934 | 1.4 (0.5–4.0) | 0.498 |
| Alcohol Use at Diagnosisd | ||||||
| None | 74 (26.2) | 33 (29.2) | ref | ref | ||
| Light | 67 (23.8) | 26 (23.0) | 0.9 (0.5–1.6) | 0.656 | 1.0 (0.5–2.2) | 0.980 |
| Mild to moderate | 70 (24.8) | 37 (32.7) | 1.2 (0.7–2.1) | 0.560 | 1.3 (0.6–2.8) | 0.452 |
| Heavyg | 37 (13.1) | 5 (4.4) | 0.3 (0.1–0.8) | 0.022 | 0.4 (0.1–1.2) | 0.100 |
| Missing | 34 (12.1) | 12 (10.6) | - | - | - | - |
| Drinks per week, Median (IQR) | 8 (2–20)f | 4 (2–6)g | ||||
| Past Alcohol Used | ||||||
| None | 72 (25.5) | 32 (28.3) | ref | |||
| Light | 32 (11.4) | 13 (11.5) | 0.9 (0.4–2.0) | 0.818 | ||
| Mild to moderate | 56 (19.9) | 28 (24.8) | 1.1 (0.6–2.1) | 0.708 | ||
| Heavyg | 61 (21.6) | 20 (17.7) | 0.7 (0.4–1.4) | 0.362 | ||
| Missing | 61 (21.6) | 20 (17.7) | - | - | ||
| Drinks per week, Median (IQR) | 24 (10–40)h | 18 (9–36)i | ||||
| Reported Tobacco Use | ||||||
| Never | 90 (31.9) | 52 (46.0) | 1.8 (1.2–2.8) | 0.009 | ||
| Everj | 192 (68.1) | 61 (54.0) | ref | |||
| Reported Smoking Tobacco Usek | ||||||
| No | 100 (35.5) | 61 (54.0) | 2.1 (1.4–3.3) | 0.001 | ||
| Yes | 182 (64.5) | 52 (46.0) | ref | |||
| Cigarette Use | ||||||
| Never | 107 (37.9) | 63 (55.8) | ref | ref | ||
| Former | 95 (33.7) | 23 (20.4) | 0.4 (0.2–0.7) | 0.002 | 0.5 (0.2–0.9) | 0.034 |
| Current | 80 (28.4) | 27 (23.9) | 0.6 (0.3–0.9) | 0.042 | 0.7 (0.4–1.4) | 0.350 |
| Pack-years, Median (IQR) | 42 (30–63)l | 20 (11.5–36)m | ||||
| Reported Cigar Use | ||||||
| No | 250 (88.7) | 103 (91.2) | ref | |||
| Yes | 32 (11.4) | 10 (8.9) | 0.8 (0.4–1.6) | 0.468 | ||
| Cigar-years, Median (IQR) | 45 (12.9–294)n | 6 (1–15)o | ||||
| Reported Pipe Use | ||||||
| No | 265 (94.0) | 111 (98.2) | ref | |||
| Yes | 17 (6.0) | 2 (1.8) | 0.3 (0.1–1.2) | 0.093 | ||
| Pipe-years, Median (IQR) | 4.5 (3–30)p | 5.5 (5–6)q | ||||
| Reported Smokeless Tobacco User | ||||||
| No | 250 (88.7) | 93 (82.3) | ref | |||
| Yes | 32 (11.4) | 20 (17.7) | 1.7 (0.9–3.1) | 0.094 | ||
| Reported Snuff Use | ||||||
| No | 274 (97.2) | 99 (87.6) | ref | ref | ||
| Yes | 8 (2.8) | 14 (12.4) | 4.8 (2.0–11.9) | 0.001 | 5.4 (1.8–15.8) | 0.002 |
| Can-years, Median (IQR) | 18 (5–30)s | 9.5 (2–20)t | ||||
| Reported Chewing Tobacco Use | ||||||
| No | 257 (91.1) | 99 (87.6) | ref | |||
| Yes | 25 (8.9) | 14 (12.4) | 1.5 (0.7–2.9) | 0.291 | ||
| Pouch-years, Median (IQR) | 6.75 (1.4–20)u | 11 (2–14)v | ||||
| Reported Illicit Drug Use | ||||||
| No | 201 (71.0) | 76 (67.3) | ref | |||
| Yes | 17 (6.0)w | 12 (10.6)x | 1.9 (0.9–4.1) | 0.119 | ||
| Missing | 65 (23.0) | 25 (22.1) | - | - | ||
| Highest Education Level | ||||||
| < HS | 29 (10.3) | 4 (3.5) | 0.4 (0.1–1.1) | 0.061 | ||
| HS | 98 (34.8) | 39 (34.5) | ref | |||
| College | 57 (20.2) | 30 (26.6) | 1.3 (0.7–2.4) | 0.342 | ||
| Graduate | 15 (5.3) | 11 (9.7) | 1.8 (0.8–4.4) | 0.165 | ||
| Post-Grad | 15 (5.3) | 4 (3.5) | 0.7 (0.2–2.2) | 0.500 | ||
| Missing | 68 (24.1) | 25 (22.1) | - | - |
Italicized variables were included in the multivariate analysis
Abbreviations: OR – odds ratio; aOR – adjusted odds ratio; CI – confidence interval; IQR – interquartile range
Contains 2 patients listed as “T4”, 19 patients listed as “T4a”, and 1 patient listed as “T4b”
13 patients (8 typical, 5 early) with only T and N stages were given an overall classification assuming no distant metastases (M0)
Surgery and induction chemotherapy followed by chemoradiation (N=8), chemoradiation (N=6), induction chemotherapy followed by chemoradiation (N=5), palliative care (N=3), radiation only (N=3), surgery with induction chemotherapy (N=3), chemotherapy only (N=2), surgery with chemotherapy (N=2), chemotherapy followed by chemoradiation (N=1), chemotherapy followed by radiation (N=1), induction chemotherapy (N=1), surgery with induction chemotherapy and radiation (N=1),
None: <12 drinks lifetime; Light: >12 weeks lifetime but 0 drinks/week; Mild to moderate: <8 drinks/week (F) or <15 drinks/week (M); Heavy: >=8 drinks/week (F) or >=15 drinks/week (M)
Patient labeled as heavy alcohol use if specified 'heavy use', 'significant use', 'a loť, 'alcohol abuse', or 'alcoholism'
82 typical onset mild to moderate and heavy alcohol users
37 early onset mild to moderate and heavy alcohol users
49 typical onset mild to moderate and heavy alcohol users
25 early onset mild to moderate and heavy alcohol users
Defined as former/current cigarette smoker or reported user of cigars, pipes, snuff, or chewing tobacco
Cigarette, cigar, or pipe use
138 typical onset former or current cigarette users
42 early onset former or current cigarette users
21 typical onset cigar users
5 early onset cigar users
9 typical onset pipe users
2 early onset pipe users
Snuff or chewing tobacco use
5 typical onset snuff users
10 early onset snuff users
10 typical onset chewing tobacco users
6 early onset chewing tobacco users
Marijuana (N=15), cocaine (N=5), LSD (N=2)
Marijuana (N=9), cocaine (N=4), methamphetamine (N=1)