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Visualization and Analysis of Pharyngeal Arch Arteries using Whole-mount Immunohistochemistry and 3D Reconstruction
Published on: March 31, 2020
Smoking and oral and pharyngeal cancer: a meta-analysis
Irene Possenti1, Stefano Miotti1, Silvano Gallus1
1Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Introduction:
Oral cavity and pharyngeal cancer (OPC) affects over 580,000 people globally each year, with tobacco and alcohol being key risk factors. This meta-analysis quantifies the excess risk of OPC associated with cigarette smoking and its patterns.
Methods:
We carried out a systematic review and meta-analysis of case-control and cohort studies assessing the association between cigarette smoking and OPC risk, including articles published up to February 2025. Using a combined umbrella and traditional review approach, we estimated pooled relative risks (RR) by smoking status, intensity, duration, and time since quitting.
Results:
Out of 137 eligible articles, 115 original studies were included in this meta-analysis. Relative to never smokers, the pooled risk of OPC was 3.58 (95% CI: 3.03-4.24; n = 54) among current smokers, 1.61 (95% CI: 1.44-1.81; n = 53) among former smokers, and 2.45 (95% CI: 2.19-2.75; n = 80) among ever smokers. Subsite-specific analyses showed RRs of 3.39 (95% CI: 2.64-4.35; n = 25) for oral cancer and 4.24 (95% CI: 2.96-6.09; n = 18) for pharyngeal cancer in current versus never smokers. Risk rose steeply with both smoking intensity and duration, doubling after 6 cigarettes per day or 7 years of smoking, before reaching a plateau around an RR of 5 at 20 cigarettes per day or 20 years. The risk declined linearly with longer time since quitting, with a 50% reduction observed within 10 years of cessation.
Conclusion:
Our findings reaffirm the substantial impact of smoking on OPC risk and stress the need for efforts to avoid smoking initiation and support cessation.
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