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Epidemiology of cancers of the upper aero-digestive tract in the French West Indies : behavioral, viral and environmental risk factors

Abstract : The objective was to assess the potential influence of a large spectrum of risk factors on head and neck cancer (HNC) development in the French West Indies (FWI). As a first step, we used data from a cross-sectional health survey to describe the prevalence of tobacco smoking, alcohol drinking and obesity. This work highlighted significant social disparities in these risk factors in the population. We then analysed data from a population-based case-control study conducted in Martinique and Guadeloupe between 2013 and 2016, including 145 cases of HNC and 405 controls. The study revealed a high prevalence of oral infection with human papillomavirus (HPV) in the population, and a specific distribution of HPV genotypes. HPV52 was the most prevalent type and HPV16 was found in only 4% of cases. Tobacco smoking and alcohol drinking increased the risk of HNC, with a synergetic combined effect. High risk HPV (Hr-HPV) was associated with a significant increase in HNC risk, particularly in non-smokers and non-drinkers. Elevated risks of HNC were found in several occupations. A low body mass index (BMI) and family history of HNC were also associated with an increased risk of HNC. Condom use was found to decrease the risk of HNC, independently of oral HPV. In women, exposure to hormones, notably having menarche before 13, was associated with a decrease in HNC risk. Consumptions of tea, coffee, fruits and vegetables were not associated with HNC. In the population, the majority of HNC cases were attributable to tobacco smoking (62.5%) and alcohol (55.4%). About 14% of the cases were attributable to Hr-HPV, 11% to low BMI, 27% to occupation and 7% to family history of HNC. Given the predominant role of modifiable factors in HNC aetiology, there are many opportunities for prevention in this population.
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Aviane Auguste. Epidemiology of cancers of the upper aero-digestive tract in the French West Indies : behavioral, viral and environmental risk factors. Human health and pathology. Université Rennes 1, 2019. English. ⟨NNT : 2019REN1B048⟩. ⟨tel-02520472v2⟩

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