Franceschi S, Levi F, Dal Maso L, Talamini R, Conti E, Negri E, La Vecchia C
Centro di Riferimento Oncologico, Servizio di Epidemiologia, Aviano, Italy.
Int J Cancer. 2000 Mar 15;85(6):787-90. doi: 10.1002/(sici)1097-0215(20000315)85:6<787::aid-ijc8>3.0.co;2-6.
A strong, dose-dependent association exists between alcohol consumption and risk of cancer of the oral cavity and pharynx. The impact on risk of temporal aspects of drinking habits has been inadequately evaluated. Our case-control study included 754 individuals with incident cancer of the oral cavity and pharynx (median age 57) and 1,775 controls (median age 57) in the hospital for acute, non-neoplastic diseases who were interviewed in 2 Italian areas and in the Swiss Canton of Vaud between 1992 and 1997. The questionnaire included lifetime drinking and smoking habits. No influence of age at starting or duration of alcohol drinking was found. Risk increased substantially with the increase of weekly alcoholic drinks [Odds Ratios (OR) for >/= 91 drinks/week vs. never drinkers = 11.6]. Risk in former compared with current drinkers was 1.9-fold elevated. However, among individuals who had also stopped smoking, former drinkers showed lower ORs than current drinkers. The persistence of risk elevation several years after drinking cessation suggests that the role of alcohol is complex and it probably affects more than one stage of oral carcinogenesis. It remains to be clarified which impact prevention-driven drinking cessation may have on the excess of cancer of the oral cavity and pharynx due to elevated alcohol intake.
饮酒与口腔癌和咽癌风险之间存在强烈的剂量依赖性关联。饮酒习惯的时间因素对风险的影响尚未得到充分评估。我们的病例对照研究纳入了754例口腔癌和咽癌患者（中位年龄57岁）以及1775例对照（中位年龄57岁），这些对照为在意大利两个地区以及瑞士沃州因急性非肿瘤性疾病住院的患者，于1992年至1997年间接受访谈。问卷包括终生饮酒和吸烟习惯。未发现开始饮酒的年龄或饮酒持续时间有影响。随着每周酒精饮料摄入量的增加，风险大幅上升[每周≥91杯饮料者与从不饮酒者的比值比（OR）=11.6]。既往饮酒者与当前饮酒者相比，风险升高了1.9倍。然而，在同时也戒烟的个体中，既往饮酒者的OR低于当前饮酒者。戒酒数年之后风险升高仍持续存在，这表明酒精的作用很复杂，可能影响口腔致癌过程的不止一个阶段。预防驱动的戒酒对因酒精摄入量增加导致的口腔癌和咽癌过量风险可能有何种影响，仍有待阐明。
