Alcoholism and cancer of the larynx: a case-control study in western Washington (United States).

Alcohol consumption is a well-known risk factor for laryngeal cancer. To determine whether alcoholism, as measured by responses to the Michigan alcoholism screening test (MAST), is a risk factor for laryngeal cancer independent of alcohol consumption, we analyzed data from a population-based case-control study. Personal interviews were conducted with 235 patients (81 percent response rate) with laryngeal cancer diagnosed from September 1983 through February 1987, who were residents of the Seattle metropolitan area. A total of 547 controls frequency-matched by age and gender, selected by random-digit dialing, were interviewed (75 percent response rate). When considered in a multivariate model, independent risk factors for laryngeal cancer included: alcohol consumption (42 or more drinks/wk compared with seven or less drinks/wk: odds ratio [OR] = 3.1, 95 percent confidence interval [CI] = 1.2-7.9); cigarette use (40 or more cigarettes/day compared with never-smoked: OR = 23.1, CI = 9.4-52.6); and weighted positive responses to the MAST (score of five or more compared with score of zero: OR = 1.9, CI = 1.1-3.4). Possible explanations for the association between alcoholism and laryngeal cancer are that a measure of alcoholism improves the accuracy of assessment of alcohol consumption, that alcoholism is associated with a pattern of alcohol consumption that increases the risk of laryngeal cancer, or that alcoholism may be a marker for host susceptibility to the carcinogenic effects of alcohol.