Gupta Bhawna, Kumar Narinder, Johnson Newell W
School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia. Email:
Asian Pac J Cancer Prev. 2017 Feb 1;18(2):347-356. doi: 10.22034/APJCP.2017.18.2.347.
Background: Squamous cell carcinomas of the upper aero-digestive tract (UADTSCC) are a multifaceted public health problem. Effects of lifestyle risk factors, including tobacco (chewing and smoking), alcohol drinking and exposure to second hand tobacco smoke (SHS) at home and their association with UADT cancers was assessed in a case-control study with a life-course perspective. The study was conducted at two different hospitals in Pune, India. Material and methods: The total sample size (N=480) included 240 histopathologically confirmed cases of UADT cancers and an equal number of controls frequency matched with cases by gender and age distribution (+5 years). All the patients were interviewed face-face using structured questionnaires. Self-reported information on socio-demographic and lifestyle risk factors from childhood to the date of diagnosis of disease/cancer was obtained. Frequency, duration and age of initiation of habits were also recorded to study dose-response relationships. Odds ratios and their 95% confidence intervals were calculated through unconditional logistic regression, adjusting for relevant potential confounders. Results: Chewing tobacco emerged as the strongest predictor for UADT cancers (OR=7.61; 95% CI 4.65-12.45) in comparison to smoking and drinking alcohol. Exposure to SHS during childhood (<16 years) rather than ≥16 years increased the risk (OR=4.05; 95% CI 2.06-7.95). Combined effects of tobacco and alcohol consumption habits elevated the risk by twelve fold (OR=12.05; 95% 4.61-31.49) in comparison to never users of these habits. Furthermore, the combination of these lifestyle risk factors accounted for 86.8% of population attributable risk. Conclusions: Early exposure to various modifiable lifestyle risk factors has a strong positive association with UADT cancer incidence. Effective future public health interventions with focus on vital time points in life targeting these risk factors could possibly be a major step in primary prevention and control of this cancer at the population level.
上呼吸道消化道鳞状细胞癌（UADTSCC）是一个多方面的公共卫生问题。在一项具有生命历程视角的病例对照研究中，评估了包括烟草（咀嚼和吸烟）、饮酒以及在家中接触二手烟（SHS）等生活方式风险因素的影响及其与上呼吸道消化道癌症的关联。该研究在印度浦那的两家不同医院进行。材料与方法：总样本量（N = 480）包括240例经组织病理学确诊的上呼吸道消化道癌症病例以及数量相等的对照，对照按性别和年龄分布（±5岁）与病例进行频率匹配。所有患者均通过结构化问卷进行面对面访谈。获取了从童年到疾病/癌症诊断日期的社会人口统计学和生活方式风险因素的自我报告信息。还记录了习惯开始的频率、持续时间和年龄，以研究剂量反应关系。通过无条件逻辑回归计算比值比及其95%置信区间，并对相关潜在混杂因素进行调整。结果：与吸烟和饮酒相比，咀嚼烟草是上呼吸道消化道癌症最强的预测因素（OR = 7.61；95%CI 4.65 - 12.45）。童年时期（<16岁）而非≥16岁接触二手烟会增加风险（OR = 4.05；95%CI 2.06 - 7.95）。与从不有这些习惯的人相比，烟草和饮酒消费习惯的综合影响使风险增加了12倍（OR = 12.05；95% 4.61 - 31.49）。此外，这些生活方式风险因素的组合占人群归因风险的86.8%。结论：早期接触各种可改变的生活方式风险因素与上呼吸道消化道癌症发病率有很强的正相关。未来聚焦于生命中关键时间点针对这些风险因素的有效公共卫生干预措施可能是在人群层面一级预防和控制这种癌症的重要一步。
