Muscat J E, Richie J P, Thompson S, Wynder E L
Division of Epidemiology, American Health Foundation, New York, New York 10017, USA.
Cancer Res. 1996 Nov 15;56(22):5192-7.
Based on studies that show gender differences in cigarette smoking and lung cancer risk, we hypothesized that sex differences also exist in the risk for cancer of the oral cavity and pharynx. A hospital-based study of 1009 patients with oral neoplasia and 923 age-matched controls was conducted from 1981-1990. All subjects were interviewed directly with an extensive questionnaire containing items on tobacco smoking, alcohol consumption, and occupational exposures. Using a cumulative lifetime measure of exposure to cigarette tar, the adjusted odds ratio for men, according to increasing quartile of tar consumption and relative to never smokers, was 1.0 [95% confidence interval (CI), 0.6-1.6) for the lowest category, 0.9 (95% CI, 0.6-1.6) for the second category, 1.6 (95% CI, 1.0-2.5) for the third category, and 2.1 (95p5 CI, 1.4-3.2) for the highest category. Among women, the corresponding odds ratios were 1.8 (95% CI, 1.1-3.0), 2.8 (95% CI, 1.6-4.9), 3.2 (95% CI, 1.9-5.6), and 4.6 (95% CI, 2.5-8.7). The linear increase in risk was significantly higher for women than for men. Among nonsmoking cases, there was a significantly higher proportion of women than men over the age of 50 years. This was consistent for all subsites within the oral cavity. These findings support the hypothesis that there are gender differences in the smoking-related risks for oral cancer and in the risk for nonsmoking-related oral cancer as well. The role of nutrition in relation to these findings is discussed.
基于显示吸烟与肺癌风险存在性别差异的研究，我们推测口腔和咽癌风险也存在性别差异。1981年至1990年进行了一项基于医院的研究，研究对象为1009例口腔肿瘤患者和923例年龄匹配的对照者。所有受试者都直接接受了一份详尽的问卷访谈，问卷内容包括吸烟、饮酒和职业暴露情况。采用累积终生香烟焦油暴露量指标，按照焦油消费量的四分位数增加且相对于从不吸烟者，男性的调整优势比在最低类别为1.0 [95%置信区间(CI)，0.6 - 1.6]，第二类为0.9 (95% CI，0.6 - 1.6)，第三类为1.6 (95% CI，1.0 - 2.5)，最高类别为2.1 (95% CI，1.4 - 3.2)。在女性中，相应的优势比分别为1.8 (95% CI，1.1 - 3.0)、2.8 (95% CI，1.6 - 4.9)、3.2 (95% CI，1.9 - 5.6)和4.6 (95% CI，2.5 - 8.7)。女性风险的线性增加显著高于男性。在不吸烟病例中，50岁以上女性的比例显著高于男性。口腔内所有亚部位均如此。这些发现支持了这样的假设，即吸烟相关的口腔癌风险以及非吸烟相关的口腔癌风险都存在性别差异。本文还讨论了营养与这些发现的关系。
