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American Journal of Epidemiology Advance Access originally published online on December 8, 2008
American Journal of Epidemiology 2009 169(2):132-142; doi:10.1093/aje/kwn306
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2008.

Type of Alcoholic Beverage and Risk of Head and Neck Cancer—A Pooled Analysis Within the INHANCE Consortium

Mark P. Purdue, Mia Hashibe, Julien Berthiller, Carlo La Vecchia, Luigino Dal Maso, Rolando Herrero, Silvia Franceschi, Xavier Castellsague, Qingyi Wei, Erich M. Sturgis, Hal Morgenstern, Zuo-Feng Zhang, Fabio Levi, Renato Talamini, Elaine Smith, Joshua Muscat, Philip Lazarus, Stephen M. Schwartz, Chu Chen, Jose Eluf Neto, Victor Wünsch-Filho, David Zaridze, Sergio Koifman, Maria Paula Curado, Simone Benhamou, Elena Matos, Neonilia Szeszenia-Dabrowska, Andrew F. Olshan, Juan Lence, Ana Menezes, Alexander W. Daudt, Ioan Nicolae Mates, Agnieszka Pilarska, Eleonora Fabianova, Peter Rudnai, Debbie Winn, Gilles Ferro, Paul Brennan, Paolo Boffetta and Richard B. Hayes

Correspondence to Dr. Mark P. Purdue, National Cancer Institute, 6120 Executive Boulevard, EPS 8111, Rockville, MD 20852 (e-mail: purduem{at}mail.nih.gov).

Received for publication March 14, 2008. Accepted for publication September 8, 2008.

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.

alcohol drinking; alcoholic beverages; beer; case-control studies; head and neck neoplasms; meta-analysis; wine

Abbreviations: CI, confidence interval; HNC, head and neck cancer; INHANCE, International Head and Neck Cancer Epidemiology; OR, odds ratio


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