The aetiology of upper aerodigestive tract cancers among young adults in Europe: The ARCAGE study

Tatiana V. MacFarlane, Gary J. MacFarlane, Richard J. Oliver, Simone Benhamou, Christine Bouchardy, Wolfgang Ahrens, Hermann Pohlabeln, Pagona Lagiou, Areti Lagiou, Xavier Castellsague, Antonio Agudo, Franco Merletti, Lorenzo Richiardi, Kristina Kjaerheim, Alena Slamova, Miriam Schejbalova, Cristina Canova, Lorenzo Simonato, Renato Talamini, Luigi BarzanDavid I. Conway, Patricia A. McKinney, Ariana Znaor, Raymond J. Lowry, Peter Thomson, Claire M. Healy, Bernard E. McCartan, Manuela Marron, Mia Hashibe, Paul Brennan

Research output: Contribution to journalArticlepeer-review


Background: The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption. Objective: To determine the contribution of lifestyle factors to the etiology of UADT cancers occurring in those aged less than 50 years. Methods: A case-control study was conducted in 10 European countries. Cases were cancers of the oral cavity and pharynx, larynx and esophagus, and hospital or population controls were age and sex matched. Results: There were 356 cases younger than 50 years and 419 controls. Risk was strongly related to current smoking [odds ratio (OR) 5.5 95%; confidence interval (CI) (3.3, 9.2)], and risk increased with number of pack-years smoked. Risk was also related to alcohol consumption for both current (OR 1.8; 0.97, 3.3) and past (OR 3.4; 1.6, 7.4) drinkers, and risk increased with number of drink-years. Persons frequently consuming fruits and vegetables were at significantly reduced risk. Conclusions: Risk factors already identified as being important for UADT cancers in adults are also important influences on risk in younger adults. The implication of these results is that the public health message in preventing UADT cancers remains the same to young and old alike.

Original languageEnglish
Pages (from-to)2213-2221
Number of pages9
JournalCancer Causes and Control
Issue number12
Publication statusPublished - Dec 2010


  • Alcohol
  • Cancer
  • Diet
  • Epidemiology
  • Larynx
  • Oral
  • Pharynx
  • Tobacco

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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