Head & Neck 5000: Key findings
Risk factors and survival in head and neck cancer
Several projects have investigated the links between different risk factors and survival including smoking, alcohol consumption, co-morbidity (other illnesses that affect health), diet, and feeling low in mood. The findings are:
- Both former smokers and current smokers have a higher risk of mortality when compared with people who have never smoked.
- Alcohol is a known risk factor for getting head and neck cancer but we have found no link between alcohol consumption and survival.
- Co-morbidity (having other illnesses as well as the head and neck cancer) is a strong indicator for survival; this means that people with fewer medical illnesses are more likely to survive for longer after a diagnosis of head and neck cancer.
- The link between eating fruit and vegetables and head and neck cancer survival is not clear. It is difficult to work out how much of the effect is due to diet and how much is due to other factors such as tobacco and alcohol intake.
There is some evidence of higher mortality for participants who had symptoms of depression before their treatment started.
Several projects have looked at genetic data and we have joined other studies so that there would be large enough numbers to show any genetic differences. The findings are:
- Seven new genetic loci have been found for oral cavity and pharynx cancers.
- There is no link between vitamin D and the risk of oral and oropharyngeal cancer so supplements of vitamin D are unlikely to be of benefit in preventing head and neck cancers.
- The link between telomere length (a telomere is a genetic structure) and cancer survival in head and neck and lung cancer was investigated. The research supported a link in a type of lung cancer but not in head and neck cancers.
- Indicators of chronic inflammation were associated with head and neck cancer and survivalffect is due to diet and how much is due to other factors such as tobacco and alcohol intake.
Several projects have described tumour type and tumour behaviour:
- Cancer in the nasal cavity is rare compared to other head and neck cancers. The study described patterns of disease and survival outcomes. Further studies are needed to explore whether the type of treatment given alters survival.
- Changing trends in head and neck cancer have been described in particular looking at cancer in the larynx, oropharynx and oral cavity.
- Changes in tobacco and alcohol consumption after a diagnosis of head and neck cancer vary. Those who smoked at diagnosis were more likely to smoke less a year later; however those who didn’t smoke at diagnosis were more likely to smoke a year later.
Head and Neck 5000 is part of ongoing collaborations with several large international research teams that are sharing data and blood and tissue samples. Putting together data from several studies can increase the chance of finding factors that affect outcome.
- HEADSpAcE is a group of 15 centres from across Europe and South America and is investigating factors affecting the late diagnosis and the poor outcomes of head and neck cancer.
- The Voyager study brings together several large international research studies in oral and oropharyngeal cancer and is looking at the role of genetic changes in cancer development.
- The INHANCE group focuses on genetic and environmental risk factors in head and neck cancer.