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May 30, 2016

The Statistics of Throat Cancer Risk Factors

Image by Nikita2706 in Wikipedia
Pretty much everybody knows that smoking and alcohol increases risk of throat cancer. Some even realize that oral sex contributes to increased risk of throat cancer due to the HPV virus. However, what is more hazy is how high these risks are compared to individuals who do not partake of such activities.

So, here are some statistics of throat cancer risks (references listed below)...

• 93% of all throat cancers are preventable [1]
• 79% are due to smoking [1]
• 45% are due to not eating enough fruits and vegetables [1, 12]
• 25% is linked to alcohol consumption [1]
• 8.3x higher risk of throat cancer developing in a smoker compared to a non-smoker, and this risk increases the longer and the more you smoke [2]
• The risk is substantially higher when an individual smokes and drinks alcohol (the risk is higher than simply adding the individual risks of smoking and alcohol) [3]
• Cigar and pipe smoking also has a risk of throat cancer even among those who have never smoked cigarettes [2, 3]
• 30% lower risk of throat cancer in smokers who quit for 1-4 years compared with those who continue to smoke. This increases to 64% lower risk after 10-19 years. Throat cancer risk approaches that of non-smokers after 20 years [4]
• 2.5x higher risk of throat cancer developing in someone who drinks 6 units or more of alcohol per day compared to a non-drinker. The risk is 1.5x higher in those who drink 1.5 - 6 units of alcohol per day. There is no risk of cancer for those who drink less than 1.5 units of alcohol per day. [5]
• Risk of throat cancer decreases by 2% per year after quitting alcohol consumption. Throat cancer risk approaches that of non-drinkers after 35 years [6]
• 36% higher risk of throat cancer in those who consume the highest amounts of processed meats compared to those who consume the lowest. There is no throat cancer risk associated with red or white meat intake. [7]
• 2.2x higher risk of throat cancer in those who have reflux vs those who do not. [8, 9]
• 5.4x higher risk of throat cancer in those who have HPV infection. HPV 16 has a higher risk of throat cancer than HPV 18. [10]
• 2x higher risk of throat cancer with H. pylori infection vs those who do not [11]
• Throat cancer not associated with marijuana, tea, carbonated drinks, and coffee. [13,14, 15]


References:
1. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Summary and conclusions (link is external). Br J Cancer 2011;105 (S2):S77-S81. See Table 2.

2. Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol 2013;178(5):679-90.

3. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 2009;18(2):541-50.

4. Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk. Int J Epidemiol 2010;39(1):182-96.

5. Alcohol drinking and laryngeal cancer: overall and dose-risk relation--a systematic review and meta-analysis. Oral Oncol 2010;46(11):802-10.

6. Alcohol drinking cessation and the risk of laryngeal and pharyngeal cancers: a systematic review and meta-analysis. PLoS One 2013;8(3):e58158.

7. Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium. Cancer Causes Control 2012;23(1):69-88.

8. Gastric Reflux Is an Independent Risk Factor for Laryngopharyngeal Carcinoma. Cancer Epidemiology Biomarkers & Prevention. Published Online First May 23, 2013; doi: 10.1158/1055-9965.EPI-13-0183

9. Gastroesophageal reflux and carcinoma of larynx or pharynx: a meta-analysis. Acta Otolaryngol 2014;134(10):982-9.

10. Human papillomavirus infection and laryngeal cancer risk: a systematic review and meta-analysis. J Infect Dis 2013;207(3):479-88.

11. Possible association of Helicobacter pylori infection with laryngeal cancer risk: an evidence-based meta-analysis. Arch Med Res 2008;39(6):625-8.

12. Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium. Cancer Causes Control 2012;23(1):69-88.

13. Marijuana smoking and the risk of head and neck cancer: pooled analysis in the INHANCE consortium. Cancer Epidemiol Biomarkers Prev 2009;18(5):1544-51.

14. Coffee and tea intake and risk of head and neck cancer: pooled analysis in the international head and neck cancer epidemiology consortium. Cancer Epidemiol Biomarkers Prev. 2010;19(7):1723-36.

15. Coffee and cancers of the upper digestive and respiratory tracts: meta-analyses of observational studies. Ann Oncol 2011;22(3):536-44.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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