Abstract
BackgroundEpidemiological studies show that cigarette smoking increase the risk of nasopharyngeal carcinoma (NPC), however, whether other common, potentially adverse household inhalants increase NPC risk remains uncertain.MethodsWe conducted a large case-control study to explore the effects of household inhalants, such as incense, mosquito coil, cooking fumes, and wood combustion, on NPC risk. We recruited 1,845 cases and 2,275 controls from Guangdong province, a high-risk area for NPC in China, to obtain the demographic data and relevant exposure information through face-to-face interviews.ResultsWe found that incense burning was associated with NPC risk by comparing frequent incense use with never using incense [OR and 95 % confidence interval (CI) = 1.73, (1.43, 2.09)]. Wood fuel use was also associated with NPC risk compared with non-wood fire use [OR and 95 % CI = 1.95, (1.65, 2.31)]. More intriguingly, we observed a significant addictive interaction between frequent incense burning and heavy cigarette smoking on NPC risk [synergistic index (SI) = 1.67; 95 % CI: 1.01, 2.76]. We also found a significant joint effect between wood fuel use and NPC family history for NPC risk (SI = 1.77; 95 % CI: 1.06, 2.96). However, neither mosquito oil nor cooking fumes were associated with NPC risk.ConclusionsOur study shows that incense smoke is not only the potential independent risk factor but also co-contributes with cigarette smoking to NPC risk. Moreover, wood combustion is another potential environmental risk factor and exerts a joint effect with NPC family history on NPC.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-2035-x) contains supplementary material, which is available to authorized users.
Highlights
Epidemiological studies show that cigarette smoking increase the risk of nasopharyngeal carcinoma (NPC), whether other common, potentially adverse household inhalants increase NPC risk remains uncertain
Several case-referent studies performed in Hong Kong found a positive effect of incense burning on NPC risk [10,11,12], while the only population-based cohort study to date, conducted by Friborg et al found a null association between incense burning and NPC risk among Singapore Chinese [13]
Significant differences between cases and controls were observed for cigarette smoking, with cases being more likely to be heavy smokers of more than 20 packyears (31.25 % vs. 21.51 %)
Summary
Epidemiological studies show that cigarette smoking increase the risk of nasopharyngeal carcinoma (NPC), whether other common, potentially adverse household inhalants increase NPC risk remains uncertain. According to the latest WHO report, there were 4.3 million deaths in 2012 due to household air pollution globally, which reflects a large increase over the estimated 2 million deaths in 2004 (http://www.who.int/ phe/health_topics/outdoorair/databases/FINAL_HAP_ AAP_BoD_24March2014.pdf?ua=1). This is especially an issue for Southeast Asia, where environmental issues have become increasingly prominent and which bears. He et al BMC Cancer (2015) 15:1022 differences indicate that genetic traits play a large role in the pathogenesis of NPC. Researchers have conducted studies to assess the association between incense burning and NPC risk in Hong Kong and Singapore with inconsistent results. Several case-referent studies performed in Hong Kong found a positive effect of incense burning on NPC risk [10,11,12], while the only population-based cohort study to date, conducted by Friborg et al found a null association between incense burning and NPC risk among Singapore Chinese [13]
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