Differential effects of tobacco and alcohol in cancer of the larynx, pharynx, and mouth.

Two thousand five hundred forty male patients with cancer of larynx, pharynx, and mouth were examined in the same hospital between 1975 and 1982. Different sites were compared according to alcohol and tobacco consumption: oropharynx, hypopharynx, larynx supraglottis, larynxglottis, epilarynx, lip, tongue-tip, and tongue lateral border, other tongue sites, gum, floor of the mouth, and buccal mucosa. For tobacco, the mean daily consumption of smokers and exsmokers did not differ according to location (except in patients with cancer of the lip, in whom the consumption was lowest). Cancer locations differed significantly according to the daily alcohol consumption. The consumption was the lowest for patients with cancer of the lips and the glottis, the highest for patients with cancer of the epilarynx, hypopharynx, and the floor of the mouth. Significant differences were observed in the percentage of nonsmokers or nondrinkers, even between adjacent locations: supraglottis versus glottis; tongue, tip, and lateral border versus tongue, other sites; floor of the mouth versus buccal mucosa. Some of the results might be particular to elements of the French life-style (e.g., consumption of brown tobacco, high consumption of wine).