complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol a case for multifactor disease复杂的病因构成风险和生存在头部和颈部癌症的人类乳头状瘤病毒,烟草和酒精的多因素疾病.pdfVIP

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complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol a case for multifactor disease复杂的病因构成风险和生存在头部和颈部癌症的人类乳头状瘤病毒,烟草和酒精的多因素疾病.pdf

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complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol a case for multifactor disease复杂的病因构成风险和生存在头部和颈部癌症的人类乳头状瘤病毒,烟草和酒精的多因素疾病

Hindawi Publishing Corporation Journal of Oncology Volume 2012, Article ID 571862, 9 pages doi:10.1155/2012/571862 Research Article Complex Etiology Underlies Risk and Survival in Head and Neck Cancer Human Papillomavirus, Tobacco, and Alcohol: A Case for Multifactor Disease Elaine M. Smith,1 Linda M. Rubenstein,1 Thomas H. Haugen,2 Michael Pawlita,3 and Lubomir P. Turek2 1 Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA 2 Veterans Aﬀ airs Medical Center and the Department of Pathology, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA 3 Research Program Infection and Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany Correspondence should be addressed to Elaine M. Smith, elaine-smith@ Received 30 July 2011; Revised 14 September 2011; Accepted 15 September 2011 Academic Editor: Adhemar Longatto-Filho Copyright © 2012 Elaine M. Smith et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Findings are inconsistent about whether tobacco, alcohol, and human papillomavirus (HPV) are two independent HNC risk factor groups that distinguish an infection-associated cancer from a tobacco/alcohol-associated HNC. We found that cancer in the oral cavity risk was greater in HPV-E6/E7 seropositive/heavy tobacco users (adjusted OR = 3.5) than in HPV-seronegative/heavy tobacco users (adjusted OR = 1.4); and HPV-seropositive/heavy alcohol users (adjusted OR = 9.8) had greater risk than HPV- seronegative/heavy alcohol users (adjusted OR = 3.1). In contrast, the risk of oropharyngeal cance