TY - JOUR
T1 - Interaction between tobacco and alcohol consumption and the risk of cancers of the upper aero-digestive tract in Brazil
AU - Schlecht, Nicolas F.
AU - Franco, Eduardo L.
AU - Pintos, Javier
AU - Negassa, Abdissa
AU - Kowalski, Luiz P.
AU - Oliveira, Benedito V.
AU - Curado, Maria P.
PY - 1999/12/1
Y1 - 1999/12/1
N2 - The authors investigated the joint effects of tobacco and alcohol consumption on the risk of squamous cell carcinomas of the upper aero- digestive tract (UADT) using data from a hospital-based case-control study conducted in southern Brazil, 1986-1989. A total of 784 cases of cancers of the mouth, pharynx, and larynx and 1,578 non-cancer controls matched on age, sex, hospital catchment area, and period of admission were interviewed about their smoking and drinking habits and other characteristics. Using logistic regression, evidence was found for interaction between the cumulative exposures for smoking and alcohol on UADT cancer risk. The joint effects for pharyngeal cancers exceeded the levels expected under a multiplicative model for moderate smokers (p = 0.007). There was little statistical evidence, however, for interaction on cancers of the mouth (p = 0.28) or larynx (p = 0.95). Among never smokers, heavy drinkers had 9.2 times (95% confidence interval 1.7, 48.5) greater risk of cancers of mouth, pharynx, and supraglottis than never drinkers, with a dose-response trend (p = 0.013) with cumulative consumption. The authors conclude that the interaction occurring in the pharynx between smoking and alcohol on UADT cancers is not uniform, with varying effects depending on the level of smoking exposure. Alcohol may act as both a promoter for tobacco and as an independent risk factor.
AB - The authors investigated the joint effects of tobacco and alcohol consumption on the risk of squamous cell carcinomas of the upper aero- digestive tract (UADT) using data from a hospital-based case-control study conducted in southern Brazil, 1986-1989. A total of 784 cases of cancers of the mouth, pharynx, and larynx and 1,578 non-cancer controls matched on age, sex, hospital catchment area, and period of admission were interviewed about their smoking and drinking habits and other characteristics. Using logistic regression, evidence was found for interaction between the cumulative exposures for smoking and alcohol on UADT cancer risk. The joint effects for pharyngeal cancers exceeded the levels expected under a multiplicative model for moderate smokers (p = 0.007). There was little statistical evidence, however, for interaction on cancers of the mouth (p = 0.28) or larynx (p = 0.95). Among never smokers, heavy drinkers had 9.2 times (95% confidence interval 1.7, 48.5) greater risk of cancers of mouth, pharynx, and supraglottis than never drinkers, with a dose-response trend (p = 0.013) with cumulative consumption. The authors conclude that the interaction occurring in the pharynx between smoking and alcohol on UADT cancers is not uniform, with varying effects depending on the level of smoking exposure. Alcohol may act as both a promoter for tobacco and as an independent risk factor.
KW - Alcohol drinking
KW - Case-control studies
KW - Epidemiologic methods
KW - Head and neck neoplasms
KW - Larynx
KW - Mouth
KW - Pharynx
KW - Smoking
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U2 - 10.1093/oxfordjournals.aje.a009938
DO - 10.1093/oxfordjournals.aje.a009938
M3 - Article
C2 - 10588073
AN - SCOPUS:0033485388
SN - 0002-9262
VL - 150
SP - 1129
EP - 1137
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 11
ER -