History of diabetes and risk of head and neck cancer: a pooled analysis from the international head and neck cancer epidemiology consortium

Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):294-304. doi: 10.1158/1055-9965.EPI-11-0590. Epub 2011 Dec 5.

Abstract

Background: A history of diabetes is associated with an increased risk of several types of cancers. Whether diabetes is a risk factor for head and neck cancer (HNC) has received little attention.

Methods: We pooled data from 12 case-control studies including 6,448 cases and 13,747 controls, and estimated OR and 95% CI for the associations between diabetes and HNC, adjusted for age, education level, sex, race/ethnicity, study center, cigarette smoking, alcohol use, and body mass index.

Results: We observed a weak association between diabetes and the incidence of HNC overall (OR, 1.09; 95% CI: 0.95-1.24). However, we observed a modest association among never smokers (OR, 1.59; 95% CI: 1.22-2.07), and no association among ever smokers (OR, 0.96; 95% CI: 0.83-1.11); likelihood ratio test for interaction P = 0.001.

Conclusion: A history of diabetes was weakly associated with HNC overall, but we observed evidence of effect modification by smoking status, with a positive association among those who never smoked cigarettes.

Impact: This study suggests that glucose metabolism abnormalities may be a HNC risk factor in subgroups of the population. Prospective studies incorporating biomarkers are needed to improve our understanding of the relationship between diabetes and HNC risk, possibly providing new strategies in the prevention of HNC.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Europe / epidemiology
  • Female
  • Head and Neck Neoplasms / epidemiology*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Risk Factors
  • United States / epidemiology
  • Young Adult