Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Oral Pathol Med. 2011 Oct;40(9):684-92. doi: 10.1111/j.1600-0714.2011.01022.x. Epub 2011 Mar 8.
Recognition of how risk factors affect the age when cancers are first diagnosed may help to establish more appropriate cancer screening and preventive strategies.
To investigate the independent and synergistic effects of alcohol, tobacco-free betel-quid (TF-BQ), and cigarette use on diagnosis age and dissemination of upper aerodigestive tract squamous cell carcinoma (UADT-SCC), we recruited pathology-proven 1522 patients with UADT-SCC for study.
A 49-, 53-, 57-, and 62-year-old stepwise older median age at carcinoma diagnosis was, respectively, found among patients with oral, pharyngeal, esophageal, and laryngeal cancer. Oral cavity (53.2%) and larynx (11.6%) were separately the dominant and recessive sites where the UADT-SCC occurred. Although alcohol and tobacco bestowed increased risks of earlier tumor occurrence only for oral/pharyngeal and oral cancers, respectively, TF-BQ was consistently observed to confer elevated age-associated risks for each UADT-SCC [adjusted hazard ratio (aHR) = 1.6-2.3]. Alcohol and TF-BQ joint consumers experienced a stepwise increased cumulative risk (CR) of contracting carcinomas of the larynx (46.2%), esophagus (47.5%), pharynx (53.5%), and oral cavity (60.5-71.0%), with >68% of CRs found among drinkers who started chewing before age 20. Alcohol + Betel + Cigarette and Alcohol + Betel users exhibited earlier diagnosis ages than non-users: 10 years ahead for oral cancer, 7, 17, and 12 years earlier for pharyngeal, esophageal, and laryngeal cancers. Noticeably, higher cumulative cancer risks regarding earlier tumor occurrence were correspondingly identified for these users aged 43, 49, 43, and 44 upward.
Tobacco-free betel-quid, in conjunction with alcohol and/or tobacco consumption, impacts early cancer occurrence for specific UADT-SCC and influences tumor site incidence pattern of these neoplasms.
认识到危险因素如何影响癌症首次诊断的年龄，可能有助于制定更合适的癌症筛查和预防策略。
为了研究酒精、无烟草槟榔（TF-BQ）和香烟使用对诊断年龄和上呼吸道鳞状细胞癌（UADT-SCC）传播的独立和协同作用，我们招募了经病理证实的 1522 名 UADT-SCC 患者进行研究。
口腔癌、咽癌、食管癌和喉癌患者的癌症诊断中位年龄分别为 49、53、57 和 62 岁，呈递增趋势。口腔（53.2%）和喉（11.6%）分别是 UADT-SCC 最常见和罕见的发生部位。尽管酒精和烟草仅分别增加了口腔/咽癌和口腔癌的早期肿瘤发生风险，但 TF-BQ 始终被观察到与 UADT-SCC 的每个部位的年龄相关风险增加有关[校正风险比（aHR）=1.6-2.3]。酒精和 TF-BQ 联合消费者经历了喉癌（46.2%）、食管癌（47.5%）、咽癌（53.5%）和口腔癌（60.5-71.0%）的累积风险（CR）的逐步增加，其中 68%以上的 CR 发生在 20 岁之前开始咀嚼的饮酒者中。与非使用者相比，酒精+槟榔+香烟和酒精+槟榔使用者的诊断年龄更早：口腔癌提前 10 年，咽癌、食管癌和喉癌提前 7、17 和 12 年。值得注意的是，年龄在 43、49、43 和 44 岁及以上的这些使用者的累积癌症风险更高，更早发生肿瘤的风险也相应增加。
无烟草槟榔与酒精和/或烟草消费一起影响特定 UADT-SCC 的早期癌症发生，并影响这些肿瘤的肿瘤部位发病模式。
