Combined effect of tobacco and alcohol on laryngeal cancer risk: a case-control study |
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Authors: | Talamini R Bosetti C La Vecchia C Dal Maso L Levi F Bidoli E Negri E Pasche C Vaccarella S Barzan L Franceschi S |
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Affiliation: | (1) Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy;(2) Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Via Pedemontana Occ., 33081 Aviano (PN), Italy;(3) Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;(4) Università degli Studi di Milano, Milan, Italy;(5) Registre Vaudois des Tumeurs, Institut Universitarie de Médicine Sociale et Préventive, Lausanne, Switzerland;(6) Unità Operativa di Otorinolaringoiatria, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy;(7) International Agency for Research on Cancer, Lyon, France |
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Abstract: | Objective: To provide information on the effects of alcohol and tobacco on laryngeal cancer and its subsites. Methods: This was a case–control study conducted between 1992 and 2000 in northern Italy and Switzerland. A total of 527 cases of incident squamous-cell carcinoma of the larynx and 1297 hospital controls frequency-matched with cases on age, sex, and area of residence were included. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression. Results: In comparison with never smokers, ORs were 19.8 for current smokers and 7.0 for ex-smokers. The risk increased in relation to the number of cigarettes (OR = 42.9 for 25 cigarettes/day) and for duration of smoking (OR = 37.2 for 40 years). For alcohol, the risk increased in relation to number of drinks (OR = 5.9 for 56 drinks per week). Combined alcohol and tobacco consumption showed a multiplicative (OR = 177) rather than an additive risk. For current smokers and current drinkers the risk was higher for supraglottis (ORs 54.9 and 2.6, respectively) than for glottis (ORs 7.4 and 1.8) and others subsites (ORs 10.9 and 1.9). Conclusions: Our study shows that both cigarette smoking and alcohol drinking are independent risk factors for laryngeal cancer. Heavy consumption of alcohol and cigarettes determined a multiplicative risk increase, possibly suggesting biological synergy. |
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Keywords: | alcohol drinking laryngeal cancer smoking and drinking interaction tobacco smoking years since quit smoking |
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