Comparison of the effect of smoking and alcohol drinking between oral and pharyngeal cancer

✍ Scribed by Silvia Franceschi; Fabio Levi; Carlo La Vecchia; Ettore Conti; Luigino Dal Maso; Luigi Barzan; Renato Talamini

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: French
• Weight: 50 KB
• Volume: 83
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/(sici)1097-0215(19990924)83:1<1::aid-ijc1>3.0.co;2-8

✦ Synopsis

To compare the separate and combined effects of alcohol drinking and smoking between the 2 sites, we evaluated 274 men with oral cancer, 364 with pharyngeal cancer and 1,254 controls, frequency-matched for age and area of residence, from Italy and Switzerland. Extremely elevated risk increases for oral cancer (odds ratio, OR ‫؍‬ 228) and pharyngeal cancer (OR ‫؍‬ 100) were found for the highest joint level of drinking (H77 drinks/week) and smoking (H25 cigarettes/day). Ratios of ORs between oral cancer and pharyngeal cancer vs. controls, obtained by polytomous logistic regression, suggested that the risk increase for oral cancer was about 2-fold greater than that for pharyngeal cancer at each combined level of smoking and drinking, except at low levels of drinking in smokers. A clear departure from risk difference additivity was present for both oral and pharyngeal cancer in individuals heavily exposed to both factors versus non-smoking abstainers/ light drinkers. Our findings thus help explain observations from descriptive epidemiology that, if smoking level in a population does not change substantially, but alcohol consumption increases, increase in oral cancer would be greater than at any other site in the upper aero-digestive tract, including cancer of the pharynx.