Tuyns A J
International Agency for Research on Cancer, Lyon, France.
Cancer Surv. 1994;19-20:159-73.
By and large, the incidence of laryngeal cancer is tending to increase over time in much of the world, often in parallel with changes in tobacco and/or alcohol consumption. There are encouraging examples of declining trends that can be attributed to decreasing use of either tobacco or alcohol. These observations are in line with what is known about the multiplicative effects of both exposures. Since it is now well known that the epidemiology of cancer of the epilarynx differs from that of the endolarynx, it is highly desirable that in the future, this should be better reflected in the way laryngeal tumours are classified. There is good reason to believe that a change in alcohol consumption would have an effect on neoplasms of the epilarynx, whereas a change in tobacco consumption would affect incidence of neoplasms of the lower larynx. To examine this hypothesis, combined analyses of both lung and laryngeal cancer trends may have to be carried out together and compared, as in a recent Italian study (Capocaccia et al, in press). Research along these lines should provide a better understanding of how time trends in laryngeal cancer incidence can be related to changes in either tobacco and/or alcohol consumption. We know enough to believe that continuous efforts to reduce the consumption of either factor would result in a decrease in laryngeal cancer and that the biggest effect could be expected from a simultaneous reduction in alcohol and tobacco consumption (Tuyns, 1991).
总体而言，在世界上许多地区，喉癌的发病率呈上升趋势，且往往与烟草和/或酒精消费的变化同步。也有一些令人鼓舞的下降趋势的例子，这可归因于烟草或酒精使用量的减少。这些观察结果与已知的两种暴露因素的相乘效应相符。由于现在已经清楚地知道喉上癌的流行病学与喉内癌不同，因此非常希望在未来，喉肿瘤的分类方式能更好地反映这一点。有充分的理由相信，酒精消费的变化会对喉上肿瘤产生影响，而烟草消费的变化会影响下喉部肿瘤的发病率。为了检验这一假设，可能必须像最近一项意大利研究（卡波卡恰等人，即将发表）那样，对肺癌和喉癌趋势进行联合分析并加以比较。沿着这些思路进行的研究应能更好地理解喉癌发病率的时间趋势如何与烟草和/或酒精消费的变化相关。我们有足够的认识相信，持续努力减少任何一种因素的消费都会导致喉癌发病率下降，而且同时减少酒精和烟草消费有望产生最大的效果（图恩斯，1991年）。
