Genetic, clinical, lifestyle and sociodemographic risk factors for head and neck cancer:

1. The highest-ranking phenotypic predictors of head and neck cancer included past tobacco smoking, job code at baseline, pain experienced during the last month, qualifications, FVC (Z score), and blood pressure.

2. Single nucleotide polymorphisms were less important in predicting the risk of head and neck cancer than phenotypic variables. 

Evidence Rating Level: 2 (Good) 

Head and neck cancer (HNC) refers to malignant tumors in the nasal cavity, oral cavity, pharynx, and larynx and accounts for over 300,000 deaths worldwide. 50-75% of these cases are diagnosed at the “advanced” stage, creating the need for risk prediction models. This retrospective biobank study looked at 502,367 participants from the UK Biobank between 2006 and 2021 to identify the relative importance of known risk factors and to identify novel risk factors. Data on potential risk factor exposure was collected through questionnaires/interviews, phenotype screening, and genetic testing. At baseline, men were more likely to get HNC (p < 0.001). Additionally, HNC was associated with poor or fair overall health rating, lower BMI with lower body fat percentage, engaged in less physical activity, had long standing illness/disability, more medications taken, high blood pressure, greater hand grip strength, pain during the past month, lower household income, lower educational attainment, and used tobacco. Incident cases were more likely to drink alcohol, smoke, have wheezing in the chest, experience shortness of breath with walking, and consume processed meat 2-4 times/week. There is also a significant difference in single-nucleotide polymorphisms (SNPs) between HNC incident cases and controls (p < 0.001), including rs259919-G (ZNRD1ASP gene) SNPs being more common in HNC incidences whereas rs1131769-T (STING1 gene) and rs28419191-T (ECSCR – SMIM33 gene) SNPs were more prevalent in controls. The highest-ranking phenotypic predictors of head and neck cancer included past tobacco smoking, job code at baseline, pain experienced during the last month, qualifications, FVC (Z score), and blood pressure. Single nucleotide polymorphisms were less important in predicting risk of head and neck cancer than phenotypic variables as none of the studied 25 genes were in the top 50 predictors of HNC. 

Click to read the study in PLOSONE

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