Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case—control study

• Published in: European journal of epidemiology Vol. 27; no. 7; pp. 499 - 517
• Main Authors: Marron, Manuela, Boffetta, Paolo, Møller, Henrik, Ahrens, Wolfgang, Pohlabeln, Hermann, Benhamou, Simone, Bouchardy, Christine, Lagiou, Pagona, Lagiou, Areti, Slámová, Alena, Schejbalová, Miriam, Merletti, Franco, Richiardi, Lorenzo, Kjaerheim, Kristina, Agudo, Antonio, Castellsague, Xavier, Macfarlane, Tatiana Victorovna, Macfarlane, Gary John, Talamini, Renato, Barzan, Luigi, Canova, Cristina, Simonato, Lorenzo, Biggs, Anne-Marie, Thomson, Peter, Conway, David Ian, McKinney, Patricia Ann, Znaor, Ariana, Healy, Claire Marie, McCartan, Bernard Eugene, Brennan, Paul, Hashibe, Mia
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.07.2012; Springer Netherlands; Springer Nature B.V
• Subjects: Adult; Age; Age Distribution; Aged; Alcohol; Alcohol drinking; Alcohol Drinking - epidemiology; Alcohol use; Alcoholic beverages; Alcoholic Beverages - classification; Alcoholic Beverages - statistics & numerical data; Beer - statistics & numerical data; Beer industry; Beers; Biological and medical sciences; CANCER; Carcinogenicity; Carcinoma, Squamous Cell - epidemiology; Cardiology; Case-Control Studies; Causality; Cigar smoking; Cigarette smoking; Education; Epidemiology; Ethanol; Europe - epidemiology; Female; Fruits; Gastrointestinal Neoplasms - epidemiology; General aspects; Head & neck cancer; Health risks; Heterogeneity; Humans; Infectious Diseases; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Odds Ratio; Oncology; Organs; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Sex Distribution; Smoking - epidemiology; Smoking cessation; Tobacco; Tobacco smoking; Tumors; Vegetables; Vitaceae; Wine - statistics & numerical data; Wines; Europe; Wine; Upper aerodigestive tract cancer; Alcohol; Liquor; Head and neck cancer; Epidemiology; Cancer; Beer; Human; Ethanol; Multicenter study; Risk; Case control study; Malignant tumor; European; Alcoholic beverage; Risk factor; ENT disease; Public health
• ISSN: 0393-2990; 1573-7284
• DOI: 10.1007/s10654-012-9699-1

The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among 'pure drinker' who consumed one beverage type exclusively, among 'predominant drinkers' who consumed one beverage type to more than 66 % and among 'mixed drinkers' who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among 'pure drinkers' (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among 'predominant drinkers' (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among 'mixed drinkers' (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.