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

• Published in: Cancer causes & control Vol. 22; no. 7; pp. 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: Journal Article
• Language: English
• Published: Dordrecht Springer 01.07.2011; Springer Netherlands; Springer Nature B.V
• 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; Latin America; South America; Cuba; Argentina; Rio de Janeiro Brazil; Brazil; France; ASW, Caribbean Sea, Greater Antilles, Cuba; South America; Alcohol; Tobacco; Upper aerodigestive tract; Cancer
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-011-9779-7

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.