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

Araghi, M; Galanti, MR; Lundberg, M; Liu, Z; Ye, W; Lager, A; Engström, G; ... Magnusson, C; + view all (2020) No association between moist oral snuff (snus) use and oral cancer: pooled analysis of nine prospective observational studies. Scandinavian Journal of Public Health 10.1177/1403494820919572. (In press). Green open access

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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 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.

Type: Article
Title: No association between moist oral snuff (snus) use and oral cancer: pooled analysis of nine prospective observational studies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/1403494820919572
Publisher version: https://doi.org/10.1177/1403494820919572
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Oral cancer, incidence, smokeless tobacco, snus
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10099144
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