ABSTRACT
Many studies have reported a positive association between lower socioeconomic status (SES) and higher head and neck cancer (HNC) risk. Fewer studies have examined the impact of SES on the association between alcohol or cigarette use and HNC risk. The current case-control study (1104 HNC cases and 1363 controls) investigated the influence of education, a SES indicator, on the association between HNC and the use of alcohol, cigarettes, or betel quids in Taiwan, a country with universal health care. Our results showed a larger increase in HNC risk associated with alcohol among those with lower educational level (odds ratio [OR] = 2.07; 95% confidence interval [CI], 1.53-2.80) than those with higher educational level (OR = 1.38; 95% CI, 1.04-1.85) (heterogeneity-P = .03). Educational level had an influence on the association between alcohol use and HNC risk among those with genetic susceptibility (ALDH2-deficient) to the carcinogenic effect of alcohol. The association between cigarette or betel quid use and HNC risk was similar between the high and low educational groups. National policies and social interventions have led to the decline in the prevalence of cigarette and betel quid users in Taiwan. In contrast, due to the lack of adequate alcohol control policies, alcohol consumption in Taiwan has continued to rise. A higher impact of alcohol on HNC risk among lower SES individuals even with universal health care could be the result of insufficient alcohol control policies in Taiwan.
Subject(s)
Head and Neck Neoplasms/epidemiology , Health Status Disparities , Life Style , Squamous Cell Carcinoma of Head and Neck/epidemiology , Alcohol Drinking/adverse effects , Alcohol Drinking/epidemiology , Aldehyde Dehydrogenase, Mitochondrial/deficiency , Aldehyde Dehydrogenase, Mitochondrial/genetics , Calcium Compounds/administration & dosage , Calcium Compounds/adverse effects , Case-Control Studies , Educational Status , Female , Genetic Predisposition to Disease , Head and Neck Neoplasms/etiology , Humans , Male , Middle Aged , Oxides/administration & dosage , Oxides/adverse effects , Piper/adverse effects , Plant Extracts/administration & dosage , Plant Extracts/adverse effects , Polymorphism, Single Nucleotide , Prevalence , Risk Factors , Smoking/adverse effects , Smoking/epidemiology , Social Class , Squamous Cell Carcinoma of Head and Neck/etiology , Taiwan/epidemiology , Universal Health CareABSTRACT
BACKGROUND: The current study evaluated the association between tea consumption and head and neck cancer (HNC) in Taiwan, where tea is a major agricultural product and a popular beverage. METHODS: Interviews regarding tea consumption (frequency, duration, and types) were conducted with 396 HNC cases and 413 controls. Unconditional logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of HNC risk associated with tea drinking, adjusted for sex, age, education, cigarette smoking, betel quid chewing, and alcohol drinking. RESULTS: A reduced HNC risk associated with tea drinking (OR for every cup per dayâ=â0.96, 95% CI: 0.93-0.99; OR for â§5 cups per dayâ=â0.60, 95% CI: 0.39-0.94) was observed. The association was especially significant for pharyngeal cancer (OR for every cup per dayâ=â0.93, 95% CI: 0.88-0.98; OR for â§5 cups per dayâ=â0.32, 95% CI: 0.16-0.66). A significant inverse association between HNC and tea consumption was observed particularly for green tea. CONCLUSIONS: This study suggests that tea drinking may reduce the risk of HNC. The anticancer property of tea, if proven, may offer a natural chemopreventive measure to reduce the occurrence of HNC.