Open AccessInvestigating the health disparities in the association between lifestyle behaviors and the risk of head and neck cancer
Author(s) -
Hsiao JennRen,
Huang ChengChih,
Ou ChunYen,
Chang ChanChi,
Lee WeiTing,
Tsai SenTien,
Huang JehnShyun,
Chen KenChung,
Lai YuHsuan,
Wu YuanHua,
Hsueh WeiTing,
Wu ShangYin,
Yen ChiaJui,
Chang JangYang,
Lin ChenLin,
Weng YaLing,
Yang HanChien,
Chen YuShan,
Chang Jeffrey S.
Publication year - 2020
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.14530
Subject(s) - medicine , odds ratio , betel , socioeconomic status , environmental health , demography , confidence interval , case control study , psychological intervention , alcohol , population , psychiatry , biochemistry , structural engineering , sociology , nut , engineering , chemistry
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.