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LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Alcohol and tobacco, and the risk of cancers of the upper aerodigestive tract in Latin America: a case-control study(2011) SZYMANSKA, K.; HUNG, R. J.; WUENSCH-FILHO, V.; ELUF-NETO, J.; CURADO, M. P.; KOIFMAN, S.; MATOS, E.; MENEZES, A.; FERNANDEZ, L.; DAUDT, A. W.; BOFFETTA, P.; BRENNAN, P.Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited. We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba. We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37-30.32) for oesophagus. Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72-16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use. In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.
- Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium(2012) CHUANG, Shu-Chun; JENAB, Mazda; HECK, Julia E.; BOSETTI, Cristina; TALAMINI, Renato; MATSUO, Keitaro; CASTELLSAGUE, Xavier; FRANCESCHI, Silvia; HERRERO, Rolando; WINN, Deborah M.; VECCHIA, Carlo La; MORGENSTERN, Hal; ZHANG, Zuo-Feng; LEVI, Fabio; MASO, Luigino Dal; KELSEY, Karl; MCCLEAN, Michael D.; VAUGHAN, Thomas; LAZARUS, Philip; MUSCAT, Joshua; RAMROTH, Heribert; CHEN, Chu; SCHWARTZ, Stephen M.; ELUF-NETO, Jose; HAYES, Richard B.; PURDUE, Mark; BOCCIA, Stefania; CADONI, Gabriella; ZARIDZE, David; KOIFMAN, Sergio; CURADO, Maria Paula; AHRENS, Wolfgang; BENHAMOU, Simone; MATOS, Elena; LAGIOU, Pagona; SZESZENIA-DABROWSKA, Neonilla; OLSHAN, Andrew F.; FERNANDEZ, Leticia; MENEZES, Ana; AGUDO, Antonio; DAUDT, Alexander W.; MERLETTI, Franco; MACFARLANE, Gary J.; KJAERHEIM, Kristina; MATES, Dana; HOLCATOVA, Ivana; SCHANTZ, Stimson; YU, Guo-Pei; SIMONATO, Lorenzo; BRENNER, Hermann; MUELLER, Heiko; CONWAY, David I.; THOMSON, Peter; FABIANOVA, Eleonora; ZNAOR, Ariana; RUDNAI, Peter; HEALY, Claire M.; FERRO, Gilles; BRENNAN, Paul; BOFFETTA, Paolo; HASHIBE, MiaWe investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).
- Physical activity for cancer patients during COVID-19 pandemic: a call to action(2021) REZENDE, Leandro F. M.; LEE, Dong Hoon; FERRARI, Gerson; ELUF-NETO, Jose; GIOVANNUCCI, Edward L.Self-isolation is strongly recommended for cancer patients during the COVID-19 pandemic, but may lead to physical inactivity and prolonged sitting time. The benefits of physical activity for cancer patients are manifold, such as reduced anxiety, fewer depressive symptoms, less fatigue, better quality of life, and improved physical function. In the last decade, several oncology-related organizations have provided guidance and summarized the evidence on the role of physical activity for cancer survivors. In this comment, we provide a brief summary of these recommendations and benefits of physical activity for cancer patients; and we recommend that oncologists and health practitioners should promote an active lifestyle for these patients during the pandemic and thereafter. Suggestions for implementing these actions in the clinical settings are also provided.
- Human papillomavirus (HPV) 16 and the prognosis of head and neck cancer in a geographical region with a low prevalence of HPV infection(2014) LOPEZ, Rossana Veronica Mendoza; LEVI, Jose Eduardo; ELUF-NETO, Jose; KOIFMAN, Rosalina Jorge; KOIFMAN, Sergio; CURADO, Maria Paula; MICHALUART-JUNIOR, Pedro; FIGUEIREDO, David Livingstone Alves; SAGGIORO, Fabiano Pinto; CARVALHO, Marcos Brasilino de; KOWALSKI, Luiz Paulo; ABRAHAO, Marcio; GOIS-FILHO, Francisco de; TAJARA, Eloiza Helena; WATERBOER, Tim; BOFFETTA, Paolo; BRENNAN, Paul; WUENSCH-FILHO, VictorThe role of human papillomavirus (HPV) on head and neck squamous cell carcinoma (HNSCC) survival in regions with low HPV prevalence is not yet clear. We evaluated the HPV16 infection on survival of HNSCC Brazilian patient series. This cohort comprised 1,093 HNSCC cases recruited from 1998 to 2008 in four Brazilian cities and followed up until June 2009. HPV16 antibodies were analyzed by multiplex Luminex assay. In a subset of 398 fresh frozen or paraffin blocks of HNSCC specimens, we analyzed for HPV16 DNA by L1 generic primer polymerase chain reaction. HNSCC survival according to HPV16 antibodies was evaluated through Kaplan-Meier method and Cox regression. Prevalence of HPV16 E6 and E6/E7 antibodies was higher in oropharyngeal cancer than in other head and neck tumor sites. HPV16 DNA positive in tumor tissue was also higher in the oropharynx. Seropositivity for HPV16 E6 antibodies was correlated with improved HNSCC survival and oropharyngeal cancer. The presence of HPV16 E6/E7 antibodies was correlated with improved HNSCC survival and oropharyngeal cancer survival. The death risk of oropharyngeal squamous cell carcinoma patients HPV16 E6/E7 antibodies positive was 78 % lower than to those who test negative. Oropharyngeal squamous cell carcinoma is less aggressive in the HPV16 E6/E7 positive serology patients. HPV16 E6/E7 antibody is a clinically sensible surrogate prognostic marker of oropharyngeal squamous cell carcinoma.
- An examination of male and female odds ratios by BMI, cigarette smoking, and alcohol consumption for cancers of the oral cavity, pharynx, and larynx in pooled data from 15 case-control studies(2011) LUBIN, Jay H.; MUSCAT, Joshua; GAUDET, Mia M.; OLSHAN, Andrew F.; CURADO, Maria Paula; MASO, Luigino Dal; WUENSCH-FILHO, Victor; STURGIS, Erich M.; SZESZENIA-DABROWSKA, Neonilia; CASTELLSAGUE, Xavier; ZHANG, Zuo-Feng; SMITH, Elaine; FERNANDEZ, Leticia; MATOS, Elena; FRANCESCHI, Silvia; FABIANOVA, Eleonora; RUDNAI, Peter; PURDUE, Mark P.; MATES, Dana; WEI, Qingyi; HERRERO, Rolando; KELSEY, Karl; MORGENSTERN, Hal; SHANGINA, Oxana; KOIFMAN, Sergio; LISSOWSKA, Jolanta; LEVI, Fabio; DAUDT, Alexander W.; ELUF NETO, Jose; CHEN, Chu; LAZARUS, Philip; WINN, Deborah M.; SCHWARTZ, Stephen M.; BOFFETTA, Paolo; BRENNAN, Paul; MENEZES, Ana; VECCHIA, Carlo La; MCCLEAN, Michael; TALAMINI, Renato; RAJKUMAR, Thangarajan; HAYES, Richard B.; HASHIBE, MiaGreater tobacco smoking and alcohol consumption and lower body mass index (BMI) increase odds ratios (OR) for oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancers; however, there are no comprehensive sex-specific comparisons of ORs for these factors. We analyzed 2,441 oral cavity (925 women and 1,516 men), 2,297 oropharynx (564 women and 1,733 men), 508 hypopharynx (96 women and 412 men), and 1,740 larynx (237 women and 1,503 men) cases from the INHANCE consortium of 15 head and neck cancer case-control studies. Controls numbered from 7,604 to 13,829 subjects, depending on analysis. Analyses fitted linear-exponential excess ORs models. ORs were increased in underweight (< 18.5 BMI) relative to normal weight (18.5-24.9) and reduced in overweight and obese categories (a parts per thousand yen25 BMI) for all sites and were homogeneous by sex. ORs by smoking and drinking in women compared with men were significantly greater for oropharyngeal cancer (p < 0.01 for both factors), suggestive for hypopharyngeal cancer (p = 0.05 and p = 0.06, respectively), but homogeneous for oral cavity (p = 0.56 and p = 0.64) and laryngeal (p = 0.18 and p = 0.72) cancers. The extent that OR modifications of smoking and drinking by sex for oropharyngeal and, possibly, hypopharyngeal cancers represent true associations, or derive from unmeasured confounders or unobserved sex-related disease subtypes (e.g., human papillomavirus-positive oropharyngeal cancer) remains to be clarified.