Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study

Tatiana MacFarlane, G. J. Macfarlane, N. S. Thakker, S. Benhamou, C. Bouchardy, W. Ahrens, H. Pohlabeln, P. Lagiou, A. Lagiou, X. Castellsague, A. Agudo, A. Slamova, J. Plzak, F. Merletti, L. Richiardi, R. Talamini, L. Barzan, K. Kjaerheim, C. Canova, L. SimonatoD. I. Conway, P. A. McKinney, P. Thomson, P. Sloan, A. Znaor, C. M. Healy, B. E. McCartan, M. Marron, P. Brennan

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Background: The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.
Methods: A multicentre (10 European countries) case–control study [Alcohol-Related CAncers and GEnetic susceptibility (ARCAGE) project].
Results: There were 1779 cases of UADT cancer and 1993 controls. History of warts or C. albicans infection was associated with a reduced risk [odds ratio (OR) 0.80, 95% confidence interval (CI) 0.68–0.94 and OR 0.73, 95% CI 0.60–0.89, respectively] but there was no association with herpetic lesions, heartburn, regurgitation or medication for related symptoms. Regurgitation was associated with an increased risk for cancer of the oesophagus (OR 1.47, 95% CI 0.98–2.21). Regular aspirin use was not associated with risk of UADT cancer overall but was associated with a reduced risk for cancer of oesophagus (OR 0.51, 95% CI 0.28–0.96), hypopharynx (OR 0.53, 95% CI 0.28–1.02) and larynx (OR 0.74, 95% CI 0.54–1.01).
Conclusions: A history of some infections appears to be a marker for decreased risk of UADT cancer. The role of medical history and medication use varied by UADT subsites with aspirin use associated with a decreased risk of oesophageal cancer and suggestive of a decreased risk of hypopharyngeal and laryngeal cancers.
Original languageEnglish
Pages (from-to)1053-1060
Number of pages8
JournalAnnals of Oncology
Issue number4
Early online date9 Aug 2011
Publication statusPublished - Apr 2012



  • aspirin use
  • epidemiology
  • gastroesophageal reflux
  • medical history
  • medication use
  • upper aerodigestive tract cancer

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