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No association between moist oral snuff (snus) use and oral cancer : pooled analysis of nine prospective observational studies

Araghi, Marzieh ; Galanti, Maria Rosaria ; Lundberg, Michael ; Liu, Zhiwei ; Ye, Weimin ; Lager, Anton ; Engström, Gunnar LU ; Alfredsson, Lars ; Knutsson, Anders and Norberg, Margareta , et al. (2021) In Scandinavian Journal of Public Health 49(8). p.833-840
Abstract

Aims: Worldwide, smokeless-tobacco use is a major risk factor for oral cancer. Evidence regarding the particular association between Swedish snus use and oral cancer is, however, less clear. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between snus use and oral cancer. Methods: A total of 418,369 male participants from nine cohort studies were followed up for oral cancer incidence through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. Results: During 9,201,647 person-years of observation, 628 men developed oral... (More)

Aims: Worldwide, smokeless-tobacco use is a major risk factor for oral cancer. Evidence regarding the particular association between Swedish snus use and oral cancer is, however, less clear. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between snus use and oral cancer. Methods: A total of 418,369 male participants from nine cohort studies were followed up for oral cancer incidence through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. Results: During 9,201,647 person-years of observation, 628 men developed oral cancer. Compared to never-snus use, ever-snus use was not associated with oral cancer (adjusted HR 0.90, 95% CI: 0.74, 1.09). There were no clear trends in risk with duration or intensity of snus use, although lower intensity use (⩽ 4 cans/week) was associated with a reduced risk (HR 0.65, 95% CI: 0.45, 0.94). Snus use was not associated with oral cancer among never smokers (HR 0.87, 95% CI: 0.57, 1.32). Conclusions: Swedish snus use does not appear to be implicated in the development of oral cancer in men.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
incidence, Oral cancer, smokeless tobacco, snus
in
Scandinavian Journal of Public Health
volume
49
issue
8
pages
833 - 840
publisher
SAGE Publications
external identifiers
  • pmid:32466721
  • scopus:85085628224
ISSN
1403-4948
DOI
10.1177/1403494820919572
language
English
LU publication?
yes
id
9f79dae6-60cc-4d63-8926-0c09ad9609a5
date added to LUP
2020-06-17 13:44:23
date last changed
2024-05-01 11:39:35
@article{9f79dae6-60cc-4d63-8926-0c09ad9609a5,
  abstract     = {{<p>Aims: Worldwide, smokeless-tobacco use is a major risk factor for oral cancer. Evidence regarding the particular association between Swedish snus use and oral cancer is, however, less clear. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between snus use and oral cancer. Methods: A total of 418,369 male participants from nine cohort studies were followed up for oral cancer incidence through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. Results: During 9,201,647 person-years of observation, 628 men developed oral cancer. Compared to never-snus use, ever-snus use was not associated with oral cancer (adjusted HR 0.90, 95% CI: 0.74, 1.09). There were no clear trends in risk with duration or intensity of snus use, although lower intensity use (⩽ 4 cans/week) was associated with a reduced risk (HR 0.65, 95% CI: 0.45, 0.94). Snus use was not associated with oral cancer among never smokers (HR 0.87, 95% CI: 0.57, 1.32). Conclusions: Swedish snus use does not appear to be implicated in the development of oral cancer in men.</p>}},
  author       = {{Araghi, Marzieh and Galanti, Maria Rosaria and Lundberg, Michael and Liu, Zhiwei and Ye, Weimin and Lager, Anton and Engström, Gunnar and Alfredsson, Lars and Knutsson, Anders and Norberg, Margareta and Wennberg, Patrik and Lagerros, Ylva Trolle and Bellocco, Rino and Pedersen, Nancy L. and Östergren, Per Olof and Magnusson, Cecilia}},
  issn         = {{1403-4948}},
  keywords     = {{incidence; Oral cancer; smokeless tobacco; snus}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{833--840}},
  publisher    = {{SAGE Publications}},
  series       = {{Scandinavian Journal of Public Health}},
  title        = {{No association between moist oral snuff (snus) use and oral cancer : pooled analysis of nine prospective observational studies}},
  url          = {{http://dx.doi.org/10.1177/1403494820919572}},
  doi          = {{10.1177/1403494820919572}},
  volume       = {{49}},
  year         = {{2021}},
}