Carcinogenic effect of tobacco smoking and alcohol drinking on anatomic sites of the oral cavity and oropharynx

✍ Scribed by Paolo Boffetta; Arthur Mashberg; Regina Winkelmann; Lawrence Garfinkel

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: French
• Weight: 436 KB
• Volume: 52
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.2910520405

✦ Synopsis

A series of 359 male patients with 424 cancer lesions of the oral cavity and oropharynx identified at a US Department of Veterans Affairs Medical Center were divided according to site of origin of the lesion and compared with 2,280 controls from the same hospital with respect to exposure to tobacco smoking and alcohol drinking. Sites of origin were: floor of the mouth (I 53), oral tongue (50), anterior tonsillar pillar (49), soft palate (44), lingual aspect of retromolar trigone ( I I), alveolar ridge (5), buccal mucosa (4), and hard palate (2). Forty-one patients had cancers in multiple sites. Tobacco smoking was more strongly associated with soft-palate lesions than with lesions in more anterior sites. Patients with cancer of floor of the mouth and oral tongue had higher odds ratios for alcohol drinking than subjects with cancers of other sites. This study supports the hypothesis of the carcinogenic effect of tobacco smoke and alcoholic beverages on the oral mucosa through direct contact.

o 1992 Wiley-Liss. Inc.

Tobacco smoking and alcohol drinking are established risk factors of cancer of the oral cavity and oropharynx (hereafter designated "oral cancer") (IARC, 1986(IARC, , 1988)). It is not clear if they act as contact carcinogens on the squamous mucosa. If this is the case, the different pattern of exposure may reflect different carcinogenic effects among anatomic sites within the oral cavity and oropharynx.

Since 1972. oral cancer cases among US Veterans attending the Department of Veterans Affairs Medical Center in East Orange, NJ, have been the subject of clinical and etiological studies (Mashberg et al., 1973, 1981). In the present study, regression models were applied in order to analyze the carcinogenic effect of alcohol and tobacco on different sites in the oral cavity and to test the hypothesis of a contact effcct of these risk factors.