Familial risks of squamous cell carcinoma of the head and neck: retrospective case-control study

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Abstract
Objective: To determine the contribution of inheritance to the incidence of squamous cell carcinoma of the head and neck. Design: Historical cohort study. First degree relatives of cases with squamous cell carcinoma of the head and neck made up the exposed cohort and first degree relatives of spouses of cases made up the comparison unexposed cohort. Setting: Ear, nose, and throat clinic in a large metropolitan teaching hospital. Subjects: 1429 first degree relatives of 242 index cases of squamous cell carcinoma of the head and neck; as controls, 934 first degree relatives of the spouses of 156 index cases. Main outcome measures: Relative risk of developing squamous cell carcinoma in first degree relatives of cases compared with risk in first degree relatives of spouses. Results: The adjusted relative risk for developing head and neck cancer if the index case had squamous cell carcinoma of the head and neck was 3.79 (95% confidence interval 1.11 to 13.0). There were no significantly increased risks associated with a family history of cancer at other sites. The adjusted relative risk for squamous cell carcinoma of the head and neck was 7.89 (1.50 to 41.6) in first degree relatives of patients with multiple primary head and neck tumours. Conclusions: These data suggest that genetic factors are important in the aetiology of head and neck cancer, in particular for patients with multiple primary cancers. Given the prolonged exposure of these subjects to carcinogens, these genetic factors may have a role in modifying carcinogen activity or in host resistance to carcinogens. Inherited factors may be important in persons with environmentally induced cancers. Tobacco and alcohol are established risk factors, but some affected persons are non-smokers and non-drinkers Genetic makeup may determine how individuals respond to carcinogens This study found a significantly increased relative risk of 3.79 for developing head and neck cancer if a first degree relative had squamous cell carcinoma of the head and neck As with other cancers, people with multiple primary cancers of the head and neck may represent a susceptibility group as the familial risks are higher