Alcohol and tobacco, and the risk of cancers of the upper aerodigestive tract in Latin America: a case-control study

Background: Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are...

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Bibliographic Details
Published in:Cancer causes & control 2011-07, Vol.22 (7), p.1037-1046
Main Authors: Szymańska, K., Hung, R. J., Wünsch-Filho, V., Eluf-Neto, J., Curado, M. P., Koifman, S., Matos, E., Menezes, A., Fernandez, L., Daudt, A. W., Boffetta, P., Brennan, P.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alcohol drinking
Alcohol Drinking - adverse effects
Alcohol Drinking - epidemiology
Alcohol use
Alcohols
Biomedical and Life Sciences
Biomedicine
Cancer Research
Carcinoma - epidemiology
Carcinoma - etiology
Case-Control Studies
Cigarette smoking
Developing countries
Disease
Epidemiology
Ethanol - adverse effects
Female
Head
Head & neck cancer
Head and Neck Neoplasms - epidemiology
Head and Neck Neoplasms - etiology
Hematology
Hospitals
Humans
Hypopharynx
Larynx
Latin America - epidemiology
LDCs
Male
Middle Aged
Mouth
Nicotiana - adverse effects
Oncology
Original Paper
Oropharynx
Public Health
Risk Factors
Smoking
Smoking - adverse effects
Smoking - epidemiology
Smoking cessation
Tobacco
Tobacco smoking
Tumors
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Summary:Background: Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited. Methods: We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba. Results: We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37-30.32) for oesophagus.Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72-16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use. Conclusions: In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.
ISSN:0957-5243
1573-7225
DOI:10.1007/s10552-011-9779-7