Lifetime risk of distinct upper aerodigestive tract cancers and consumption of alcohol, betel and cigarette

• Published in: International journal of cancer Vol. 135; no. 6; pp. 1480 - 1486
• Main Authors: Hsu, Wan‐Lun, Chien, Yin‐Chu, Chiang, Chun‐Ju, Yang, Hwai‐I, Lou, Pei‐Jen, Wang, Cheng‐Ping, Yu, Kelly J., You, San‐Lin, Wang, Li‐Yu, Chen, Shu‐Yuan, Yang, Czau‐Siung, Chen, Chien‐Jen
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 15-09-2014; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol; alcohol drinking; Alcohol Drinking - epidemiology; Areca; betel quid chewing; Biological and medical sciences; Biomarkers; Cancer; Cigarette smoking; Cigarettes; Cohort Studies; Colorectal cancer; cumulative lifetime incidence; Esophageal cancer; Gastric cancer; Head & neck cancer; Head and Neck Neoplasms - epidemiology; Health risk assessment; Health risks; Humans; Larynx; Male; Medical diagnosis; Medical research; Medical sciences; Men; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Oral cancer; Oral carcinoma; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Pharynx; Questionnaires; Smoking - epidemiology; Taiwan - epidemiology; Throat cancer; Tumors; UADT cancers; Taiwan; Consumption; betel quid chewing; Ethanol; cumulative lifetime incidence; Tobacco smoking; Betel; Risk; Chewing; Malignant tumor; Epidemiology; alcohol drinking; Incidence; Cigarette; cigarette smoking; Alcoholic beverage; Carcinogen; Lifetime; Cancerology; Risk factor; ENT disease; Head and neck cancer; UADT cancers; Cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.28791

The cancer of upper aerodigestive tract (UADT) is a common cancers in the world. However, its lifetime risk by consumption of alcohol, betel and cigarettes remain to be elucidated. This study aimed to estimate lifetime risk of distinct UADT cancers and assess their associations with alcohol, betel and cigarette consumption. Three cohorts of 25,611 men were enrolled in 1982–1992 in Taiwan. The history of alcohol, betel and cigarette consumption was enquired through questionnaire interview. Newly developed UADT cancers were ascertained through computerized linkage with national cancer registry profile. Lifetime (30–80 years old) risk and multivariate‐adjusted hazard ratio (HRadj) of distinct UADT cancers by alcohol, betel and cigarette consumption were estimated. A total of 269 pathologically confirmed cases of UADT cancers were newly‐diagnosed during 472,096 person‐years of follow‐up. The lifetime risk of UADT cancer was 9.42 and 1.65% for betel chewers and nonchewers, 3.22 and 1.21% for cigarette smokers and nonsmokers and 4.77 and 1.85% for alcohol drinkers and nondrinkers. The HRadj (95% confidence interval) of developing UADT cancer was 3.36 (2.51–4.49), 2.02 (1.43–2.84), 1.90 (1.46–2.49), respectively, for the consumption of betel, cigarette and alcohol. Alcohol, betel and cigarette had different effect on cancers at various anatomical sites of UADT. The cancer risk from the mouth, pharynx, esophagus to larynx increased for alcohol and cigarette consumption, but decreased for betel consumption. Alcohol, betel and cigarette consumption are independent risk predictors for distinct UADT cancers.
What's new?
Betel quid chewing, alcohol consumption, and cigarette smoking are associated with an increased risk of upper aerodigestive tract (UADT) cancers, though lifetime risk associations have not been fully elucidated. The present study estimated lifetime risk of distinct UADT cancers in three male cohorts in Taiwan over a twenty‐year period. The findings show that for alcohol and cigarette consumption the risk of cancer was higher at sites in the throat compared to the mouth, while an opposite pattern was observed for betel quid chewing. Cumulative UADT risk reached 17.2% for men who chewed more than 20 betel quids per day.