Human papillomavirus (HPV) is a sexually transmitted infection but it is unclear whether differences in transmission efficacy
exist between individual HPV types. Information on sexual behavior was ...collected from 11 areas in four continents among population-based,
age-stratified random samples of women of ages ≥15 years. HPV testing was done using PCR-based enzyme immunoassay. Unconditional
logistic regression was used to estimate odds ratios (OR) of being HPV positive and corresponding 95% confidence intervals
(95% CI). Variables were analyzed categorically. When more than two groups were compared, floating confidence intervals were
estimated by treating ORs as floating absolute risks. A total of 11,337 women (mean age, 41.9 years) were available. We confirmed
that lifetime number of sexual partners is associated with HPV positivity (OR for ≥2 versus 1, 1.86; 95% CI, 1.63-2.11) but
the association was not a linear one for HPV18, 31, and 33 (i.e., no clear increase for ≥3 versus 2 sexual partners). Women
who had multiple-type infection and high-risk HPV type infection reported a statistically nonsignificant higher number of
sexual partners than women who had single-type and low-risk type infections, respectively. Early age at sexual debut was not
significantly related to HPV positivity. Husband's extramarital sexual relationships were associated with an OR of 1.45 (95%
CI, 1.24-1.70) for HPV positivity in their wives after adjustment for age and lifetime number of women's sexual partners.
We did not observe a significant association with condom use. Our study showed an effect of both women's and their husbands'
sexual behavior on HPV positivity. Furthermore, it suggests some differences in the pattern of the association between sexual
behavior and different HPV types.(Cancer Epidemiol Biomarkers Prev 2006;15(2):326–33)
The authors pooled data from 15 case-control studies of head and neck cancer (9,107 cases, 14,219 controls) to investigate the independent associations with consumption of beer, wine, and liquor. In ...particular, they calculated associations with different measures of beverage consumption separately for subjects who drank beer only (858 cases, 986 controls), for liquor-only drinkers (499 cases, 527 controls), and for wine-only drinkers (1,021 cases, 2,460 controls), with alcohol never drinkers (1,124 cases, 3,487 controls) used as a common reference group. The authors observed similar associations with ethanol-standardized consumption frequency for beer-only drinkers (odds ratios (ORs) = 1.6, 1.9, 2.2, and 5.4 for ≤5, 6–15, 16–30, and >30 drinks per week, respectively; Ptrend < 0.0001) and liquor-only drinkers (ORs = 1.6, 1.5, 2.3, and 3.6; P < 0.0001). Among wine-only drinkers, the odds ratios for moderate levels of consumption frequency approached the null, whereas those for higher consumption levels were comparable to those of drinkers of other beverage types (ORs = 1.1, 1.2, 1.9, and 6.3; P < 0.0001). Study findings suggest that the relative risks of head and neck cancer for beer and liquor are comparable. The authors observed weaker associations with moderate wine consumption, although they cannot rule out confounding from diet and other lifestyle factors as an explanation for this finding. Given the presence of heterogeneity in study-specific results, their findings should be interpreted with caution.
High parity, early age at first full-term pregnancy (FTP), and long-term oral contraceptive (OC) use increase cervical cancer
risk, but it is unclear whether these variables are also associated with ...increased risk of acquisition and persistence of
human papillomavirus (HPV) infection, the main cause of cervical cancer. Information on reproductive and menstrual characteristics
and OC use were collected from 14 areas worldwide, among population-based, age-stratified random samples of women aged 15
years or older. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate
the odds ratios (OR) of being HPV-positive according to reproductive and menstrual factors and corresponding 95% confidence
intervals (CI). When more than two groups were compared, floating CIs (FCI) were estimated. A total of 15,145 women (mean
age, 40.9 years) were analyzed. Women with ≥5 FTPs (OR, 0.90; 95% FCI, 0.76-1.06) showed a similar risk of being HPV-positive
compared with women with only one FTP (OR, 1.00; 95% FCI, 0.86-1.16). However, nulliparous women showed an OR of 1.40 (95%
CI, 1.16-1.69) compared with parous women. Early age at first FTP was not significantly related to HPV positivity. HPV positivity
was similar for women who reported ≥10 years of use of OCs (OR, 1.16; 95% FCI, 0.85-1.58) and never users of OCs (OR, 1.00;
95% FCI, 0.90-1.12). Our study suggests, therefore, that high parity, early age at first FTP, and long-term OC use are not
associated with HPV prevalence, but rather these factors might be involved in the transition from HPV infection to neoplastic
cervical lesions. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2148–53)
Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height2 (m2)). Using data from the International Head and Neck Cancer ...Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of ≤10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis. Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers. Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer (P < 0.01), while smoking odds ratios were greater for laryngeal cancer (P < 0.01). Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cancer (P < 0.01), while BMI did not modify smoking and drinking odds ratios for laryngeal cancer. The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer.
Although active tobacco smoking has been identified as a major risk factor for head and neck cancer, involuntary smoking has
not been adequately evaluated because of the relatively low statistical ...power in previous studies. We took advantage of data
pooled in the International Head and Neck Cancer Epidemiology Consortium to evaluate the role of involuntary smoking in head
and neck carcinogenesis. Involuntary smoking exposure data were pooled across six case-control studies in Central Europe,
Latin America, and the United States. Adjusted odds ratios (OR) and 95% confidence interval (95% CI) were estimated for 542
cases and 2,197 controls who reported never using tobacco, and the heterogeneity among the study-specific ORs was assessed.
In addition, stratified analyses were done by subsite. No effect of ever involuntary smoking exposure either at home or at
work was observed for head and neck cancer overall. However, long duration of involuntary smoking exposure at home and at
work was associated with an increased risk (OR for >15 years at home, 1.60; 95% CI, 1.12-2.28; P trend < 0.01; OR for >15 years at work, 1.55; 95% CI, 1.04-2.30; P trend = 0.13). The effect of duration of involuntary smoking exposure at home was stronger for pharyngeal and laryngeal cancers
than for other subsites. An association between involuntary smoking exposure and the risk of head and neck cancer, particularly
pharyngeal and laryngeal cancers, was observed for long duration of exposure. These results are consistent with those for
active smoking and suggest that elimination of involuntary smoking exposure might reduce head and neck cancer risk among never
smokers. (Cancer Epidemiol Biomarkers Prev 2008;17(8):1974–81)
Background During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and ...youth outside this system are not reached. A mobile app (“Meine Zeit ohne”) has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness. Objective The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants’ characteristics, and (3) to study how variations in app use were related to participants’ baseline characteristics. Methods Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection (“congruent use”: eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models. Results The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high. Conclusions The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users’ characteristics. Trial Registration German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj International Registered Report Identifier (IRRID) RR2-10.1186/s13063-022-06231-x
Background: Marijuana contains carcinogens similar to tobacco smoke and has been suggested by relatively small studies to
increase the risk of head and neck cancer (HNC). Because tobacco is a major ...risk factor for HNC, large studies with substantial
numbers of never tobacco users could help to clarify whether marijuana smoking is independently associated with HNC risk.
Methods: We pooled self-reported interview data on marijuana smoking and known HNC risk factors on 4,029 HNC cases and 5,015
controls from five case-control studies within the INHANCE Consortium. Subanalyses were conducted among never tobacco users
(493 cases and 1,813 controls) and among individuals who did not consume alcohol or smoke tobacco (237 cases and 887 controls).
Results: The risk of HNC was not elevated by ever marijuana smoking odds ratio (OR), 0.88; 95% confidence intervals (95%
CI), 0.67-1.16, and there was no increasing risk associated with increasing frequency, duration, or cumulative consumption
of marijuana smoking. An increased risk of HNC associated with marijuana use was not detected among never tobacco users (OR,
0.93; 95% CI, 0.63-1.37; three studies) nor among individuals who did not drink alcohol and smoke tobacco (OR, 1.06; 95% CI,
0.47-2.38; two studies).
Conclusion: Our results are consistent with the notion that infrequent marijuana smoking does not confer a risk of these malignancies.
Nonetheless, because the prevalence of frequent marijuana smoking was low in most of the contributing studies, we could not
rule out a moderately increased risk, particularly among subgroups without exposure to tobacco and alcohol. (Cancer Epidemiol
Biomarkers Prev 2009;18(5):1544–51)
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