Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries
Open accessAbstract
Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 – 3.09). Overall one‐third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 – 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2‐fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.
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Lifetime prevalence of dental caries has declined in the last four decades, mainly in high-income countries, with the most significant decline seen in 12-year-old children.
“Epidemiological evidence indicates that lifetime prevalence of dental caries has declined in the last four decades, but this is mainly in high-income countries with the most significant decline seen in 12-year-old children.30,31”
From Oral diseases: a global public health challenge (2019) · cites this paper as [31]
The Abstract and Results (pages not provided) address socioeconomic factors and head and neck cancer risk, not dental caries. Searches for declining lifetime caries prevalence and for trends in high-income countries and 12-year-old children found no passage addressing the claim. (LLM, conf=0.76)
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Chu, K. P.-M., Habbous, S., Kuang, Q., Boyd, K., Mirshams, M., Liu, F., Espin‐Garcia, O., Xu, W., Goldstein, D. P., Waldron, J. N., et al. (2015) · Cancer Epidemiology · doi:10.1016/j.canep.2015.11.010 · Cited by 41 · see citing works
Mathur, S., Conway, D. I., Worlledge-Andrew, H., MacPherson, L. M. D., & Ross, A. J. (2015) · Systematic Reviews · doi:10.1186/s13643-015-0169-1 · Cited by 36 · see citing works
Self-citationThe Effectiveness of a Population-Based Skin Cancer Screening Program: Evidence from Germany
Kaiser, M., Schiller, J., & Schreckenberger, C. (2016) · The European Journal of Health Economics · doi:10.1007/s10198-017-0888-4 · Cited by 36 · see citing works
Freire, A. R., Freire, D. E. W. G., de Araújo, E. C. F., de Lucena, E. H. G., & Cavalcanti, Y. W. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010238 · Cited by 35 · see citing works
“In addition, socioeconomic factors are strongly associated with the risk of oral cancer [7,8].”
BackgroundSocioeconomic disparities in head and neck cancer patients’ access to cancer treatment centers
Walker, B. B., Schuurman, N., Auluck, A., Lear, S. A., & Rosin, M. P. (2017) · Rural and Remote Health · doi:10.22605/rrh4210 · Cited by 34 · see citing works
Oral Potentially Malignant Disorders and Oral Cavity Cancer
Ojeda, D., Huber, M. A., & Kerr, A. R. (2020) · Dermatologic Clinics · doi:10.1016/j.det.2020.05.011 · Cited by 34 · see citing works
Diagnosis and management of head and neck cancers in a high-incidence area in France
Guizard, A., Dejardin, O., Launay, L., Bara, S., Lapôtre‐Ledoux, B., Babin, E., Launoy, G. D., & Ligier, K. (2017) · Medicine · doi:10.1097/md.0000000000007285 · Cited by 34 · see citing works
“However, one-fifth of patients had not received panendoscopy, which is recommended for all HNC. Cervical CT scan was performed more systematically, particularly for hypopharyngeal and laryngeal cancers.”
BackgroundInfluentialRisk prediction models for head and neck cancer in the US population from the INHANCE consortium
Lee, Y.-C. A., Al-Temimi, M., Ying, J., Muscat, J., Olshan, A. F., Zevallos, J. P., Winn, D. M., Li, G., Sturgis, E. M., Morgenstern, H., et al. (2020) · American Journal of Epidemiology · doi:10.1093/aje/kwz259 · Cited by 32 · see citing works
Self-citationBaseline Cognition Assessment Among Patients With Oropharyngeal Cancer Using PROMIS and NIH Toolbox
Sinha, P., Wong, A., Kallogjeri, D., & Piccirillo, J. F. (2018) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2018.0283 · Cited by 31 · see citing works
Environmental and behavioural head and neck cancer risk factors
Boras, V. V., Fučić, A., Baranović, S., Blivajs, I., Milenović, M., Bišof, V., Rakušić, Z., Ceppi, M., & Bruzzone, M. (2019) · Central European Journal of Public Health · doi:10.21101/cejph.a5565 · Cited by 32 · see citing works
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Disparities in cancer incidence by area-level socioeconomic status in the French West Indies
Luce, D., Michel, S., Dugas, J., Bhakkan, B., Menvielle, G., Joachim, C., & Deloumeaux, J. (2017) · Cancer Causes & Control · doi:10.1007/s10552-017-0946-3 · Cited by 30 · see citing works
Self-citationDiabetes mellitus, metformin and head and neck cancer
Figueiredo, R. A. D. O., Weiderpass, E., Tajara, E. H., Ström, P., Carvalho, A. L., de Carvalho, M. B., Kanda, J. L., Moysés, R. A., & Wünsch‐Filho, V. (2016) · Oral Oncology · doi:10.1016/j.oraloncology.2016.08.006 · Cited by 29 · see citing works
Goyal, N., Hennessy, M., Lehman, E. B., Lin, W., Agudo, A., Ahrens, W., Boccia, S., Brennan, P., Brenner, H., Cadoni, G., et al. (2022) · Oral Diseases · doi:10.1111/odi.14196 · Cited by 28 · see citing works
“In a previous INHANCE pooled analysis, low education was associated with an increased risk which that was not completely attenuated after adjusting for smoking and alcohol 56 .”
Self-citationRefaey, M. S., Abosalem, E. F., El-Basyouni, R. Y., Elsheriri, S. E., Elbehary, S. H., & Fayed, M. A. A. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e37641 · Cited by 27 · see citing works
“Oral cancer is more common in men, the elderly, and people from low-income families, with socioeconomic disparities reported both between and within different countries [24].”
BackgroundArnold, M., Rentería, E., Conway, D. I., Bray, F., Ourti, T. V., & Soerjomataram, I. (2016) · Cancer Causes & Control · doi:10.1007/s10552-016-0777-7 · Cited by 27 · see citing works
“In addition, cancers of the head and neck (C00–14) and testis (C62) were included because of their known or suspected link with socioeconomic status [11, 12].”
Self-citationKfouri, S. A., Eluf‐Neto, J., Koifman, S., Curado, M. P., Menezes, A. M. B., Daudt, A. W., & Filho, V. W. (2018) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720180005 · Cited by 27 · see citing works
Self-citationTaib, B. G., Oakley, J., Dailey, Y., Hodge, I., Wright, P., du Plessis, R., Rylands, J., Taylor-Robinson, D. C., Povall, S., Schache, A. G., et al. (2018) · Clinical Otolaryngology · doi:10.1111/coa.13067 · Cited by 27 · see citing works
Mahmodi, Y., & Valiee, S. (2015) · Women and Birth · doi:10.1016/j.wombi.2015.08.001 · Cited by 26 · see citing works
Ligier, K., Dejardin, O., Launay, L., Benoît, E., Babin, E., Bara, S., Lapôtre‐Ledoux, B., Launoy, G. D., & Guizard, A. (2016) · BMC Cancer · doi:10.1186/s12885-016-2531-7 · Cited by 25 · see citing works
“These social differences persist even after adjustment for tobacco and alcohol consumption and for dietary factors [8].”
BackgroundConway, D. I., Hovanec, J., Ahrens, W., Ross, A. J., Holcátová, I., Lagiou, P., Serraino, D., Canova, C., Richiardi, L., Healy, C., et al. (2021) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2020-214913 · Cited by 25 · see citing works
“10 Alcohol consumption also compounds head and neck cancer risk, 6 7 and clustering of these risk factors is also observed in lower socioeconomic groups.”
Self-citationInterventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment
Worthington, H. V., Bulsara, V. M., Glenny, A., Clarkson, J., Conway, D. I., & Macluskey, M. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006205.pub5 · Cited by 25 · see citing works
Self-citationPodestá, O. P. G. D., Peres, S. V., Salaroli, L. B., Cattafesta, M., de Podestá, J. R. V., von Zeidler, S. V., de Oliveira, J. C., Kowalski, L. P., Ikeda, M. K., Brennan, P., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220067 · Cited by 24 · see citing works
Self-citationBody mass index and the risk of head and neck cancer in the Chinese population
Chen, Y., Lee, Y.-C. A., Li, S., Li, Q., Chen, C., Hsu, W.-L., Lou, P., Zhu, C., Pan, J. G., Shen, H., et al. (2019) · Cancer Epidemiology · doi:10.1016/j.canep.2019.04.008 · Cited by 21 · see citing works
Self-citationInequality in survival of people with head and neck cancer: Head and Neck 5000 cohort study
Ingarfield, K., McMahon, A. D., Hurley, K., Toms, S., Pring, M., Thomas, S. J., Waylen, A. E., Pawlita, M., Waterboer, T., Ness, A., et al. (2021) · Head & Neck · doi:10.1002/hed.26589 · Cited by 21 · see citing works
Self-citationCarvalho, R. S., Scapulatempo‐Neto, C., Curado, M. P., Capuzzo, R. D. C., Teixeira, F. M., Pires, R. C., Cirino, M. T., Martins, J. C. J., da Silva, I. A. O., de Oliveira, M. A., et al. (2021) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-21-0016 · Cited by 20 · see citing works
“Conway and colleagues, in a pooled analysis of 31 case–control studies from 27 countries included in the INHANCE (International Head and Neck Cancer Epidemiology) consortium, observed that lower levels of income and educationwere associatedwith an increased risk of HNC (40).”
BackgroundInfluentialSelf-citationTamayo, R. S., Fernández-Mateos, J., Klain, J. C. A., Mesı́a, R., Borgoñón, M. P., Pérez-Ruiz, E., Fernández, S. V., Coloma, C. S., Domínguez, A. R., Taberna, M., et al. (2016) · Clinical & Translational Oncology · doi:10.1007/s12094-016-1493-1 · Cited by 20 · see citing works
“Social factors such as low socioeconomic status and low levels of education also seem to be related to disease development [10] and they could be related to the exposures described above.”
Educational inequality in cancer mortality: a record linkage study of over 35 million Italians
Alicandro, G., Frova, L., Sebastiani, G., Sayed, I. E., Boffetta, P., & Vecchia, C. L. (2017) · Cancer Causes & Control · doi:10.1007/s10552-017-0930-y · Cited by 20 · see citing works
Self-citationFei‐Zhang, D. J., Park, A. C., Chelius, D. C., Smith, S. S., Samant, S., Patel, U. A., Sheyn, A. M., & Rastatter, J. C. (2024) · Otolaryngology · doi:10.1002/ohn.675 · Cited by 19 · see citing works
Raymundo, M., Freire, A., Gomes-Freire, D., Silva, R., Araújo, E., Ishigame, R., de Sousa, S., de Lucena, E. H. G., & Cavalcanti, Y. W. (2020) · Medicina oral, patología oral y cirugía bucal · doi:10.4317/medoral.24009 · Cited by 19 · see citing works
“The epidemiological characteristics of the affected patients are, in their majority, men over 40 years of age, of low socioeconomic status and low educational level (5,6).”
BackgroundBolsa Família Program and deaths from oral cancer in Brazil: an ecological study
Costa, E. M., da Silva, N. C., Rocha, T. A. H., Lima, H. L. D. O., Vissoci, J. R. N., Queiroz, R. C. D. S., & Thomaz, É. B. A. F. (2022) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2022.208 · Cited by 18 · see citing works
“are consistent with those of other studies in which better education (31), a higher human development index (32), and higher income per capita (8) have already been associated with lower”
ResultRisk factors associated with head and neck cancer in former smokers: A Brazilian multicentric study
Gislon, L. C., Curado, M. P., López, R. V. M., de Oliveira, J. C., de Podestá, J. R. V., von Zeidler, S. V., Brennan, P., & Kowalski, L. P. (2022) · Cancer Epidemiology · doi:10.1016/j.canep.2022.102143 · Cited by 18 · see citing works
Self-citationAl-Kaabi, R., Gambôa, A. B. O., Williams, D., & Marcenes, W. S. (2015) · Journal of Public Health · doi:10.1093/pubmed/fdv116 · Cited by 18 · see citing works
Measuring socioeconomic status and inequalities
Conway, D. I., McMahon, A. D., Brown, D. S., & Leyland, A. H. (2019) · ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) · Cited by 17 · see citing works
Self-citationAssociation between the FTOrs8050136 polymorphism and cancer risk: a meta-analysis
Zhao, J., Huang, X., Yang, M., Li, M., & Zheng, J. (2015) · Familial Cancer · doi:10.1007/s10689-015-9843-7 · Cited by 17 · see citing works
Crawford, M., Johnson, E. H., Liu, K. Y. P., Poh, C. F.-Y., & Tsai, R. Y. L. (2022) · Cells · doi:10.3390/cells11061033 · Cited by 17 · see citing works
Oral cancer characteristics in France: Descriptive epidemiology for early detection
Jéhannin‐Ligier, K., Dejardin, O., Lapôtre‐Ledoux, B., Bara, S., Coureau, G., Grosclaude, P., Marrer, É., Molinié, F., Trétarre, B., Velten, M., et al. (2017) · Journal of Stomatology Oral and Maxillofacial Surgery · doi:10.1016/j.jormas.2017.02.003 · Cited by 17 · see citing works
Eichler, M., Keszte, J., Meyer, A., Danker, H., Guntinas‐Lichius, O., Oeken, J., Pabst, F., & Singer, S. (2016) · Head & Neck · doi:10.1002/hed.24436 · Cited by 16 · see citing works
“There is also evidence that socioeconomic status (SES) plays a role in incidence beyond its influence on tobacco and alcohol consumption.(10,11) Survival studies after total laryngectomy are rare.”
BackgroundInfluentialda Cunha, A. R., Bigoni, A., Antunes, J. L. F., & Hugo, F. N. (2021) · Scientific Reports · doi:10.1038/s41598-021-92207-x · Cited by 15 · see citing works
Social determinants of health and treatment decisions in head and neck cancer
Shehan, J. N., Alwani, T., LeClair, J., Mahoney, T. F., Agarwal, P., Chaudhry, S. T., Wang, J. J., Noordzij, J. P., Tracy, L. F., Edwards, H., et al. (2021) · Head & Neck · doi:10.1002/hed.26931 · Cited by 15 · see citing works
“Health literacy is strongly associated with educational levels and serves to partially explain why those with lower educational levels have poor health outcomes,25 and lower health numeracy is associated with a more limited understanding of risk prevention and benefits associated with preventative screening.26 Althoug…”
BackgroundInfluentialde la Cour, C. D., Munk, C., Aalborg, G. L., & Kjær, S. K. (2022) · Oral Oncology · doi:10.1016/j.oraloncology.2022.105832 · Cited by 15 · see citing works
Lin, J., Wang, C., Jiang, R., Wang, W.-Y., & Liu, S. (2016) · Scientific Reports · doi:10.1038/srep22614 · Cited by 15 · see citing works
Midgley, A. W., Levy, A. R., Price, R., da Cunha, F. A., & Rogers, S. N. (2020) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.bjoms.2020.03.021 · Cited by 14 · see citing works
Gui, C., Xie, J., Liu, D., Zhang, X., & Tang, A. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1132035 · Cited by 14 · see citing works
“A previous meta-analysis showed that higher education level was protective against OCPC (25, 26).”
MethodHealth-Related Internet Use Among Otolaryngology Patients
Pagedar, N. A., Schularick, N. M., Lee, P. C., & Karnell, L. H. (2018) · Annals of Otology Rhinology & Laryngology · doi:10.1177/0003489418779414 · Cited by 14 · see citing works
Emerson, M. A., Farquhar, D. R., Lenze, N. R., Sheth, S. H., Mazul, A. L., Zanation, A. M., Hackman, T., Weissler, M. C., Zevallos, J. P., Yarbrough, W. G., et al. (2022) · Head & Neck · doi:10.1002/hed.26977 · Cited by 14 · see citing works
Self-citationMass Spectrometric Comparison of HPV-Positive and HPV-Negative Oropharyngeal Cancer
Wurlitzer, M., Möckelmann, N., Kriegs, M., Vens, M., Omidi, M., Hoffer, K., von Bargen, C. M., Möller‐Koop, C., Witt, M., Droste, C., et al. (2020) · Cancers · doi:10.3390/cancers12061531 · Cited by 14 · see citing works
Health insurance status and survival among patients with head and neck cancer in Japan
Takenaka, Y., Yasui, T., Enomoto, K., Miyabe, H., Morizane, N., Ashida, N., Shimizu, K., Hirose, M., Yamamoto, Y., & Uno, A. (2015) · International Journal of Clinical Oncology · doi:10.1007/s10147-015-0921-5 · Cited by 13 · see citing works
Managing oral potentially malignant disorders:A question of risk
Thomson, P. J. (2015) · Faculty Dental Journal · doi:10.1308/rcsfdj.2015.186 · Cited by 12 · see citing works
Self-citationGrigolato, R., Accorona, R., Lombardo, G., Corrocher, G., Garagiola, U. M., Massari, F., Nicoli, S. F., Rossi, S., & Calabrese, L. S. (2021) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2021.103458 · Cited by 11 · see citing works
The Burden of Head and Neck Cancer in the United States, 1990 - 2017
Ludwig, D. C., Morrison, S. D., & Dillon, J. K. (2021) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2021.04.031 · Cited by 11 · see citing works
Individual and joint effect of socioeconomic status and lifestyle factors on cancer in Korea
Tran, C. L., Choi, K. S., Kim, S., & Oh, J. (2023) · Cancer Medicine · doi:10.1002/cam4.6359 · Cited by 9 · see citing works
Ramadan, S., Lee, J. J., Wang, R., Jackson, R. S., Pipkorn, P. J., Rich, J. T., Harbison, R. A., Zolkind, P., Kang, S. Y., Puram, S. V., et al. (2023) · Oral Oncology · doi:10.1016/j.oraloncology.2023.106607 · Cited by 10 · see citing works
Vanthomme, K., Vandenheede, H., Hagedoorn, P., & Gadeyne, S. (2017) · BMC Cancer · doi:10.1186/s12885-017-3461-8 · Cited by 10 · see citing works
“Earlier research reported that these lifestyle habits are causing 70% of head and neck cancers [48, 61], with alcohol being the most important contributor [50].”
BackgroundInfluentialVargas, D. G. D. M., Probst, L. F., da Cunha, A. R., Tagliaferro, E. P. D. S., Zafalon, E. J., Pereira, P. Z., & De‐Carli, A. D. (2021) · BMC Oral Health · doi:10.1186/s12903-021-01664-3 · Cited by 10 · see citing works
Raymundo, M. L. B., Ferreira, L., Gomes-Freire, D., Freire, A., Silva, R., Araújo, E., de Lucena, E. H. G., & Cavalcanti, Y. (2022) · Medicina oral, patología oral y cirugía bucal · doi:10.4317/medoral.25478 · Cited by 9 · see citing works
“A lower level of education is strongly associated with the risk of developing oral cancer, and is associated with worse clinical outcomes, including death (4,15).”
BackgroundEbrahimi, R., Masouri, M. M., Razeghian, I., Azad, G., & Nejadghaderi, S. A. (2025) · Health Science Reports · doi:10.1002/hsr2.71289 · Cited by 9 · see citing works
Geographic Barriers Affect Follow‐Up Care in Head and Neck Cancer
Alwani, T., Shehan, J. N., LeClair, J., Mahoney, T. F., Agarwal, P., Chaudhry, S. T., Wang, J. J., Noordzij, J. P., Tracy, L. F., Edwards, H., et al. (2021) · The Laryngoscope · doi:10.1002/lary.29934 · Cited by 9 · see citing works
“SDOH includes demographic and social contributors to illness, including socioeconomic status (SES), education, and access to food.6 Patients of lower SES have greater mortality rates, lower self-reported health, and poorer followup care overall.7–9 Within the HNC patient population lower income, lower education, and r…”
BackgroundInfluentialHealth effects associated with alcohol consumption: a Burden of Proof study
Dai, X., Nicholson, S. I., Lawlor, H. R., Carr, S., Steinmetz, J. D., Chen, N. M., McLaughlin, S. A., Hay, S. I., Ong, S. K., Aravkin, A. Y., et al. (2026) · Nature Health · doi:10.1038/s44360-026-00139-5 · Cited by 10 · see citing works
Estêvão, R., Santos, T., Ferreira, A. E. F., Machado, A., Fernandes, J., & Monteiro, E. F. (2016) · Acta Médica Portuguesa · doi:10.20344/amp.7003 · Cited by 8 · see citing works
“Características dos doentes portadores de tumores da cabeça e pescoço no norte de Portugal, Acta Med Port 2016 Oct;29(10):597-604”
BackgroundRisk factors associated with competing mortality among patients with head and neck cancer in Japan
Takenaka, Y., Yasui, T., Enomoto, K., Miyabe, H., Morizane, N., Ashida, N., Shimizu, K., Hirose, M., Yamamoto, Y., & Uno, A. (2015) · Acta Oto-Laryngologica · doi:10.3109/00016489.2015.1117653 · Cited by 8 · see citing works
“Regarding head and neck cancer, the incidence at each head and neck subsite was reported to be influenced by race, gender, socioeconomic status, and country [18].”
BackgroundDeneuve, S., Charbotel, B., Massardier-Pilonchery, A., Fort, E., Milliet-Baude, C., Pérol, O., Fayette, J., Zrounba, P., & Fervers, B. (2019) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-018-05275-7 · Cited by 8 · see citing works
Hsiao, J., Huang, C., Ou, C., Chang, C., Lee, W., Tsai, S., Huang, J., Chen, K., Lai, Y., Wu, Y.-H., et al. (2020) · Cancer Science · doi:10.1111/cas.14530 · Cited by 8 · see citing works
Social inequalities in cancer within countries
Vaccarella, S., de Vries, E., Sierra, M. S., Conway, D. I., & Mackenbach, J. P. (2019) · Europe PMC (PubMed Central) · Cited by 8 · see citing works
Self-citationJana, B. K., Singh, M., Dutta, R. S., & Mazumder, B. (2022) · Current Drug Delivery · doi:10.2174/1567201820666221128152010 · Cited by 7 · see citing works
Use of a Patient Information Leaflet on Oro-Dental Care During Radiotherapy
Bacher, H., Schweyen, R., Kuhnt, T., Leplow, B., & Hey, J. (2020) · Patient Preference and Adherence · doi:10.2147/ppa.s262471 · Cited by 7 · see citing works
Freije, S., Holmes, J. A., Rachidi, S., Ellsworth, S. G., Zellars, R. C., & Lautenschlaeger, T. (2020) · Future Oncology · doi:10.2217/fon-2020-0425 · Cited by 6 · see citing works
Taib, B. G., Rylands, J., Povall, S., Jones, T. M., & Taylor-Robinson, D. C. (2017) · Systematic Reviews · doi:10.1186/s13643-017-0545-0 · Cited by 6 · see citing works
“Socioeconomic inequalities have been demonstrated in head and neck cancer incidence (HANC) [2].”
BackgroundInfluentialIt's not just about the teeth: The importance of screening for oral cancer and raising awareness
Hook, H. (2021) · BDJ Student · doi:10.1038/s41406-021-0224-4 · Cited by 6 · see citing works
Survival inequalities in head and neck cancers: A hospital‐based cohort study
Menezes, F. D. S., Peres, S. V., de Castro, G., Antunes, J. L. F., Latorre, M. D. R. D. D. O., & Toporcov, T. N. (2023) · Head & Neck · doi:10.1002/hed.27433 · Cited by 5 · see citing works
“Low education level increases cancer risk due to alcohol use, smoking, and lowin-fruit-and-vegetable diets.(4) Accordingly, it contributes to health illiteracy,(26) which allied to low-income conditions commonly observed in public healthcare users,(11) reduces the access to healthcare assistance(7,8) and the likelihoo…”
BackgroundEpidemiology and types of oral cancer
Al-sharif, R. M., Batwa, D. Y., Alotaibi, T. N., Alwadai, N. M., Alsharif, A. H., Azhar, N. A., Moulana, A. A., Alahmadi, S. M., Althobaiti, M. Y., Bayyumi, D. F., et al. (2022) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20220032 · Cited by 5 · see citing works
“In this context, it has been shown that low income and low educational levels are the most significant risk factors associated with developing the disorder.(20) Moreover, studies also indicate that dietary contents and oral health are also other significant risk factors.”
Background[Advances in risk factors and genetic risk of head and neck squamous cell carcinoma].
Tu, X., Ren, J., & Zhao, Y. (2022) · PubMed Central · doi:10.13201/j.issn.2096-7993.2022.05.015 · Cited by 5 · see citing works
Horvath, D., Fekete, A., Martineková, P., Kiss‐Dala, S., Ábrám, E., Kivovics, M., Zsembery, Á., Hegyi, P., & Bródy, A. (2026) · JDR Clinical & Translational Research · doi:10.1177/23800844251403962 · Cited by 4 · see citing works
“Lower SES is also correlated with a higher risk of oral cancer (Conway et al 2015).”
Oral Medicine Considerations for Older Patients
Patterson, J., & Willis, A. (2020) · Primary Dental Journal · doi:10.1177/2050168420943975 · Cited by 3 · see citing works
- Authors
- Conway, D. I., Brenner, D. R., McMahon, A. D., Macpherson, L. M. D., Agudo, A., Ahrens, W., Bosetti, C., Brenner, H., Castellsague, X., Chen, C., Curado, M. P., Curioni, O. A., Dal Maso, L., Daudt, A. W., de Gois Filho, J. F., D'Souza, G., Edefonti, V., Fabianova, E., Fernandez, L., Franceschi, S., Gillison, M., Hayes, R. B., Healy, C. M., Herrero, R., Holcatova, I., Jayaprakash, V., Kelsey, K., Kjaerheim, K., Koifman, S., La Vecchia, C., Lagiou, P., Lazarus, P., Levi, F., Lissowska, J., Luce, D., Macfarlane, T. V., Mates, D., Matos, E., McClean, M., Menezes, A. M., Menvielle, G., Merletti, F., Morgenstern, H., Moysich, K., Müller, H., Muscat, J., Olshan, A. F., Purdue, M. P., Ramroth, H., Richiardi, L., Rudnai, P., Schantz, S., Schwartz, S. M., Shangina, O., Simonato, L., Smith, E., Stucker, I., Sturgis, E. M., Szeszenia‐Dabrowska, N., Talamini, R., Thomson, P., Vaughan, T. L., Wei, Q., Winn, D. M., Wunsch‐Filho, V., Yu, G., Zhang, Z., Zheng, T., Znaor, A., Boffetta, P., Chuang, S., Ghodrat, M., Amy Lee, Y., Hashibe, M., & Brennan, P.
- Affiliations
- University of Glasgow (GB)
- Centre international de recherche sur le cancer (FR)
- Institut Català d'Oncologia (ES)
- University of Bremen (DE)
- Mario Negri Institute for Pharmacological Research (IT)
- German Cancer Research Center (DE)
- Institut Catala d'Oncologia (ICO), IDIBELL, CIBER‐ESP, L'Hospitalet de Llobregat Barcelona Catalonia Spain
- Fred Hutch Cancer Center (US)
- International Prevention Research Institute Lyon France
- Hospital Heliópolis (BR)
- Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico IRCCS Aviano Italy
- Hospital de Clínicas de Porto Alegre (BR)
- Instituto do Cancer Arnaldo Viera de Carvalho Sao Paulo Brazil
- Johns Hopkins Bloomberg School of Public Health Baltimore MD
- University of Milan (IT)
- Regional Authority of Public Health Banska Bystrica Slovakia
- Instituto de Oncología y Radiobiología (CU)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- New York University (US)
- Trinity College Dublin (IE)
- First Faculty of Medicine, Institute of Hygiene and Epidemiology Charles University Prague Czech Republic
- Roswell Park Comprehensive Cancer Center (US)
- Brown University (US)
- Cancer Registry of Norway Oslo Norway
- Escola Nacional de Saúde Pública Sergio Arouca (BR)
- Department of Epidemiology IRCCS‐Istituto di Ricerche Farmacologiche “Mario Negri,” Milan Italy
- National and Kapodistrian University of Athens (GR)
- Washington State University Spokane (US)
- Centre Hospitalier Universitaire Vaudois (CH)
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Occupational and Environmental Determinants of Health Villejuif France
- University of Aberdeen (GB)
- National Institute of Public Health Bucharest Romania
- Universidad de Buenos Aires (AR)
- Boston University (US)
- Universidade Federal de Pelotas (BR)
- Inserm (FR)
- University of Turin (IT)
- University of Michigan (US)
- Pennsylvania State University (US)
- University of North Carolina at Chapel Hill (US)
- National Institutes of Health (US)
- Heidelberg University (DE)
- Orszagos Kornyezetegeszsegugyi Intezet (HU)
- New York Eye and Ear Infirmary (US)
- Russian Cancer Research Center NN Blokhin (RU)
- University of Padua (IT)
- University of Iowa (US)
- The University of Texas MD Anderson Cancer Center (US)
- Institute of Occupational Medicine Lodz Poland
- Centro di Riferimento Oncologico (IT)
- Newcastle University (GB)
- Department of Epidemiology, Faculdade de Saude Publica Universidade de Sao Paulo Brazil
- New York Medical College (US)
- University of California, Los Angeles (US)
- Yale University (US)
- Hrvatski zavod za javno zdravstvo (HR)
- International Prevention Research Institute (FR)
- National Health Research Institutes (TW)
- University of Utah (US)
- University of Utah School of Medicine Salt Lake City UT
- Corresponding author
- Conway, David I.
- ORCID
- Conway, David I.
- Brenner, Darren R.
- McMahon, Alex D.
- Agudo, Antonio
- Ahrens, Wolfgang
- Bosetti, Cristina
- Brenner, Hermann
- Curioni, Otávio A.
- Edefonti, Valeria
- Franceschi, Silvia
- Gillison, Maura
- Hayes, Richard B.
- Healy, Claire M.
- Jayaprakash, Vijayvel
- Kelsey, Karl
- Lissowska, Jolanta
- Macfarlane, Tatiana V.
- McClean, Michael
- Menezes, Ana M
- Menvielle, Gwenn
- Moysich, Kirsten
- Muscat, Joshua
- Olshan, Andrew F.
- Purdue, Mark P.
- Ramroth, Heribert
- Richiardi, Lorenzo
- Shangina, Oxana
- Simonato, Lorenzo
- Sturgis, Erich M.
- Thomson, Peter
- Wei, Qingyi
- Winn, Deborah M.
- Yu, Guo‐Pei
- Zhang, Zuo‐Feng
- Zheng, Tongzhang
- Chuang, Shu‐Chun
- Hashibe, Mia
- Brennan, Paul
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2014-08-23
- Volume
- 136
- Issue
- 5
- Pages
- 1125-1139
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- PMC
- PMC4531373
- OpenAlex
- W1503488050
- Cited by
- 167
- References
- 48
- Citations by year
- 2026: 12 · 2025: 8 · 2024: 12 · 2023: 9 · 2022: 19 · 2021: 28 · 2020: 16 · 2019: 11 · 2018: 10 · 2017: 16 · 2016: 13 · 2015: 13
- FWCI
- 12.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- PubMed Central (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- IRIS (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- HAL (submittedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Touro Scholar (Touro College) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- UNC Libraries
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Cancer Institute (R03CA113157)
- National Institute of Dental and Craniofacial Research (R03DE016611)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- head and neck cancer, educational attainment, household income, socioeconomic status, income inequality, cancer risk factors, cigarette smoking, alcohol consumption, oropharyngeal cancer, cancer subsite, sex differences, age differences, international variation
- MeSH terms
- Alcohol Drinking, Education, Female, Follow-Up Studies, Head and Neck Neoplasms, Humans, Income, Male, Middle Aged, Prognosis, Risk Factors, Smoking, Socioeconomic Factors, Global Health, Meta-Analysis as Topic, Case-Control Studies
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