Muscat J E, Wynder E L
Division of Epidemiology, American Health Foundation, New York, New York 10017.
Cancer. 1992 May 1;69(9):2244-51. doi: 10.1002/1097-0142(19920501)69:9<2244::aid-cncr2820690906>3.0.co;2-o.
Data from a hospital-based case-control study between 1985-1990 were used to examine the effects of tobacco, alcohol, asbestos, and other occupational exposures on laryngeal cancer risk in 194 white men with primary cancer of the larynx and 184 age-matched control subjects. A dose-dependent effect for current cigarette smoking was observed, with higher relative risks (RR) for supraglottic cancer (RR, 21.6 to 68) than for cancer of the glottis (RR, 5.5 to 20.7). Elevated RR for ex-smokers (RR, 4.8) and pipe and cigar smokers (RR, 4.3) did not vary by subsite. The effects of alcohol also showed dose-dependent effects, with higher RR for cancer of the supraglottis than glottis for heavy drinkers (207 ml or more/daily; RR, 9.6 versus 2.5) and binge drinkers (RR, 28.4 versus 8.3). A slightly elevated but not significant association was seen for asbestos exposure and glottic cancer (RR, 1.3). The RR did not increase linearly with the number of years employed in asbestos-related occupations. No relationship was observed between asbestos and cancer of the supraglottis. When examining the data for a synergistic effect of cigarette smoking and asbestos exposure, no excess risk was found. A significantly elevated risk was found for men exposed to diesel fumes (RR, 5.2). Elevated but not significant RR were seen for men chronically exposed to rubber (RR, 6.4) and wood dust or employed as construction laborers, auto mechanics, and other jobs. A significant inverse trend with body mass was observed for cancer of the supraglottis.
1985年至1990年间一项基于医院的病例对照研究数据，被用于检验烟草、酒精、石棉及其他职业暴露因素对194例原发性喉癌白人男性患者及184例年龄匹配的对照对象患喉癌风险的影响。观察到当前吸烟存在剂量依赖效应，声门上癌的相对风险（RR）较高（RR为21.6至68），高于声门癌（RR为5.5至20.7）。既往吸烟者（RR为4.8）以及吸烟斗和雪茄者（RR为4.3）的RR升高情况在不同亚部位并无差异。酒精的影响也呈现剂量依赖效应，对于重度饮酒者（每日207毫升或更多；RR为9.6对2.5）和暴饮者（RR为28.4对8.3），声门上癌的RR高于声门癌。石棉暴露与声门癌之间存在轻度升高但不显著的关联（RR为1.3）。RR并未随从事石棉相关职业的年限呈线性增加。未观察到石棉与声门上癌之间存在关联。在检验吸烟与石棉暴露的协同效应数据时，未发现额外风险。发现接触柴油烟雾的男性风险显著升高（RR为5.2）。长期接触橡胶（RR为6.4）以及接触木尘或从事建筑工人、汽车修理工及其他工作的男性，RR升高但不显著。观察到声门上癌与体重呈显著的反向趋势。
