Risk factors for cancer of the oral cavity and oro-pharynx in Cuba

• Published in: British journal of cancer Vol. 85; no. 1; pp. 46 - 54
• Main Authors: FERNANDEZ GARROTE, L, HERRERO, R, REYES, R. M, VACCARELLA, S, ANTA, J. Lence, FERBEYE, L, MUNOZ, N, FRANCESCHI, S
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 06.07.2001
• Subjects: Adult; Age; Aged; Aged, 80 and over; Alcohol Drinking - adverse effects; Alcohol use; Biological and medical sciences; Cancer research; Cancer therapies; Case-Control Studies; Cigars; Cuba - epidemiology; Diet; Female; Humans; Male; Medical research; Medical sciences; Middle Aged; Mouth Neoplasms - epidemiology; Mouth Neoplasms - etiology; Oral cancer; Oral Hygiene; Oropharyngeal Neoplasms - epidemiology; Oropharyngeal Neoplasms - etiology; Otorhinolaryngology. Stomatology; Population; Questionnaires; Regular; Risk Factors; Sexual Behavior; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Smoking; Smoking - adverse effects; STD; Tobacco; Tropical medicine; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Zea mays; Central America; Cuba; America; West Indies; Italy; United States > US; Europe; Costa Rica; ASW, Caribbean Sea, Greater Antilles, Cuba; Human; Ethanol; Stomatology; Food habit; Sexual behavior; Tobacco smoking; Oropharynx; Malignant tumor; Epidemiology; Oral cavity; Dentition; Risk factor; ENT disease; Oral cavity disease; Pharynx disease; Public health; Hygiene
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1054/bjoc.2000.1825

In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking > or =30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9-48.3), similar to smoking > or =4 cigars daily (OR = 20.5). Drinking > or = 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8-18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba.