INSERM U1018, Epidemiology of Occupational and Social Determinants of Health, Grenoble, France.
Eur J Cancer Prev. 2013 May;22(3):268-76. doi: 10.1097/CEJ.0b013e3283592cce.
The objective was to examine the role of tobacco smoking and alcohol drinking in the incidence of oral cavity cancer by subsite in France, a high-incidence area. We analysed detailed data on lifelong tobacco smoking and alcohol drinking from 772 oral cavity cancer cases and 3555 controls included in a population-based case-control study, the ICARE study. Tobacco smoking increased the risk of oral cavity cancer even for the smaller quantities and durations, whereas alcohol drinking increased this risk only in heavy drinkers who were also ever smokers. The combined effect of smoking and drinking was greater than multiplicative. The floor of the mouth was the subsite that was the most affected by the harmful effects of tobacco and alcohol, whereas the gums were less susceptible. The risk associated with tobacco and alcohol consumption did not differ between intraoral cavity and subsites usually included in the oropharynx (soft palate and base of the tongue). Population-attributable risks for oral cavity cancer were 78.6% for tobacco smoking, 7.3% for alcohol drinking and 80.7% for tobacco and/or alcohol consumption. These results indicate that regular oral check-ups should be targeted at smokers and heavy drinkers, and that prevention efforts should be focused on smoking cessation.
目的是研究法国（一个高发地区）口腔癌各亚部位与吸烟和饮酒的关系。我们分析了一项基于人群的病例对照研究（ICARE 研究）中纳入的 772 例口腔癌病例和 3555 例对照者终生吸烟和饮酒的详细数据。吸烟即使是少量和短时间的吸烟也会增加口腔癌的风险，而饮酒仅会增加那些曾经吸烟的重度饮酒者的风险。吸烟和饮酒的联合效应大于相乘效应。吸烟和饮酒对口腔底部的危害最大，而对牙龈的影响较小。口腔内与通常包括在口咽（软腭和舌根部）的亚部位的癌症风险与烟草和酒精消费无关。口腔癌的人群归因风险分别为吸烟 78.6%、饮酒 7.3%以及吸烟和/或饮酒 80.7%。这些结果表明，应针对吸烟者和重度饮酒者进行常规口腔检查，并且应将预防工作重点放在戒烟上。
