International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008, Lyon Cedex, France.
Cancer Causes Control. 2011 Jul;22(7):1037-46. doi: 10.1007/s10552-011-9779-7. Epub 2011 May 24.
Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited.
We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba.
We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37-30.32) for oesophagus. Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72-16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use.
In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.
上呼吸消化道（UADT；包括口腔、咽、喉和食管）癌症在全球的发病率很高，在拉丁美洲的一些地区尤为常见。然而，这些地区主要危险因素作用的数据仍然有限。
我们评估了酒精和烟草消费的作用，研究对象为来自巴西、阿根廷和古巴 7 个中心的 2252 例上呼吸消化道鳞状细胞癌病例和 1707 例对照。
我们表明，饮酒者患 UADT 癌症的风险比从不饮酒者高五倍。与其他类型的酒精相比，开胃酒和烈酒的作用非常明显，食管的 OR 达到 12.76（95%CI 5.37-30.32）。与从不吸烟者相比，吸烟者患上呼吸消化道癌症的可能性高达 6 倍，下咽和喉癌的 OR 达到 11.14（95%CI 7.72-16.08）。所有部位的风险在停止饮酒或吸烟后都有下降的趋势。酒精和烟草的交互作用大于相乘作用。在这项研究中，65%的所有 UADT 病例归因于酒精和烟草使用的综合效应。
在这项拉丁美洲最大的 UADT 癌症研究中，我们首次表明，大多数 UADT 癌症病例是由于酒精和烟草使用的共同作用，如果停止使用这两种物质中的任何一种，都可以预防。
