204 / 220
We also found no association between self-reported
medical diagnosis of GERD and the odds of overall HNSCC
(Table II). Most ORs were again in an inverse direction,
but laryngeal cases had a slightly greater odds of having
been diagnosed with GERD compared to controls.
In analyses of combined laryngeal and pharyngeal
cases, among those who were neither heavy smokers nor
heavy drinkers we detected no association between
GERD and the development of laryngopharyngeal cancer
for either self-reported history of GERD symptoms or
medical diagnosis of GERD (Table III). Likewise, no
associations between GERD and laryngopharyngeal
cancer were detected among subjects who were heavy
smokers and/or heavy drinkers (Table III).
TABLE I.
Subject Characteristics.
Variable
Controls
(N
5
1,378)
All Cases
(N
5
1,340)
P
Value*
Hypopharynx
Cases
(N
5
67)
Larynx
Cases
(N
5
473)
NOS
Cases
(N
5
247)
Oral Cavity
Cases
(N
5
192)
Oropharynx
Cases
(N
5
361)
Age (years)
<
0.0001
20–49
156 (11%)
254 (19%)
9 (13%)
64 (14%)
58 (23%)
37 (19%)
86 (24%)
50–54
161 (12%)
210 (16%)
16 (24%)
50 (11%)
40 (16%)
20 (10%)
84 (23%)
55–59
207 (15%)
222 (17%)
13 (19%)
71 (15%)
38 (15%)
31 (16%)
69 (19%)
60–64
205 (15%)
229 (17%)
10 (15%)
95 (20%)
41 (17%)
30 (16%)
53 (15%)
65–69
247 (18%)
178 (13%)
7 (10%)
81 (17%)
30 (12%)
25 (13%)
35 (10%)
70–74
231 (17%)
152 (11%)
3 (4%)
73 (15%)
22 (9%)
29 (15%)
25 (7%)
75–80
171 (12%)
95 (7%)
9 (13%)
39 (8%)
18 (7%)
20 (10%)
9 (2%)
Sex
0.0001
Male
960 (70%) 1,021 (76%)
56 (84%)
372 (79%) 171 (69%) 123 (64%) 299 (83%)
Female
418 (30%)
319 (24%)
11 (16%)
101 (21%)
76 (31%)
69 (36%)
62 (17%)
Race
<
0.0001
White
1,114 (81%)
989 (74%)
39 (58%)
345 (73%) 188 (76%) 140 (73%) 277 (77%)
Black
264 (19%)
351 (26%)
28 (42%)
128 (27%)
59 (24%)
52 (27%)
84 (23%)
Years Smoked Cigarettes
<
0.0001
Never smoker
525 (38%)
173 (13%)
5 (8%)
19 (4%)
57 (23%)
21 (11%)
71 (20%)
1–19
293 (21%)
118 (9%)
3 (5%)
26 (6%)
30 (12%)
12 (6%)
47 (13%)
20–39
334 (24%)
499 (38%)
26 (41%)
180 (38%)
68 (28%)
79 (42%) 146 (41%)
40–49
142 (10%)
344 (26%)
19 (30%)
150 (32%)
65 (27%)
47 (25%)
63 (18%)
50
1
78 (6%)
194 (15%)
10 (16%)
97 (21%)
25 (10%)
31 (16%)
31 (9%)
Lifetime Alcohol Consumption (mL)
<
0.0001
Never had alcohol
296 (22%)
125 (10%)
1 (2%)
45 (10%)
27 (12%)
23 (13%)
29 (9%)
<
11,232
161 (12%)
58 (5%)
3 (5%)
21 (5%)
15 (7%)
6 (3%)
13 (4%)
11,232-
<
204,469
406 (31%)
234 (19%)
3 (5%)
77 (18%)
46 (20%)
23 (13%)
85 (25%)
204,469-
<
927,946
321 (24%)
319 (26%)
12 (20%)
122 (28%)
53 (23%)
42 (23%)
90 (27%)
927,946
1
144 (11%)
497 (40%)
40 (68%)
169 (39%)
85 (38%)
86 (48%) 117 (35%)
Body Mass Index
<
0.0001
Underweight (
<
18.5)
30 (2%)
100 (7%)
14 (21%)
25 (5%)
20 (8%)
20 (10%)
21 (6%)
Normal (18.5-
<
25.0)
405 (29%)
482 (36%)
26 (39%)
161 (34%)
93 (38%)
88 (46%) 114 (32%)
Overweight (25.0-
<
30.0)
551 (40%)
434 (32%)
19 (28%)
159 (34%)
71 (29%)
55 (29%) 130 (36%)
Obese (30.0
1
)
392 (28%)
324 (24%)
8 (12%)
128 (27%)
63 (26%)
29 (15%)
96 (27%)
Education
<
0.0001
Less than high school
217 (16%)
458 (34%)
32 (48%)
197 (42%)
64 (26%)
67 (35%)
98 (27%)
High school/vocational/tech
490 (36%)
492 (37%)
18 (27%)
173 (37%)
89 (36%)
73 (38%) 139 (39%)
At least some college
671 (49%)
390 (29%)
17 (25%)
103 (22%)
94 (38%)
52 (27%) 124 (34%)
Ever had frequent heartburn
0.8
No
1,007 (76%)
989 (77%)
43 (69%)
344 (75%) 194 (81%) 145 (81%) 263 (74%)
Yes
315 (24%)
303 (23%)
19 (31%)
112 (25%)
47 (20%)
34 (19%)
91 (26%)
Ever diagnosed with GERD
0.1
No
994 (77%) 1,008 (79%)
53 (84%)
329 (73%) 200 (84%) 147 (83%) 279 (80%)
Yes
303 (23%)
266 (21%)
10 (16%)
120 (27%)
37 (16%)
31 (17%)
68 (20%)
*Chi-square comparisons between controls and overall cases.
NOS
5
Not otherwise specified, GERD
5
gastroesophageal reflux disease
Laryngoscope 126: May 2016
Busch et al.: GERD and Head and Neck Cancer
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