Page last updated: Wednesday, November 19, 2008
Alcohol and Laryngeal Cancer
It is rare to find laryngeal cancer in individuals who do not smoke and drink, with limited information on risk factors for such individuals. In the USA a hospital based case-control study found an association between smoking in teetotallers and moderate drinkers, but did not provide any data on non-smokers. Other case-control studies have reported an increased risk of laryngeal cancer for non-smoking drinkers and non-drinking smokers, however the data was based on small sample sizes. This paper by Bosetti C et al, is an analysis of the separate effect of alcohol and tobacco on laryngeal cancer risk. Pooled data of 2 case-control studies (one conducted between 1986-1992 in northern Italy and one conducted between 1992-2000 in northern Italy and the Swiss canton of Vaud) were used to analyses the separate effects of smoking and alcohol use on laryngeal cancer risk and included large numbers of non-drinking, non-smoking subjects.

Subjects were 40 non-smoking and 68 non-drinking cases of incident, histologically confirmed laryngeal cancer and 160 non-smoking and 161 non-drinking controls admitted to the same network of hospitals for acute, non-neoplastic conditions. A questionnaire was used to ascertain demographics, anthropometric variables and various life-style characteristics including smoking and alcohol. The multivariate odds ratio (OR) for laryngeal cancer was 2.46 (95% CI 0.98 — 6.20) for non-smoking heavy drinkers (> 8 drinks/day compared to < 8 drinks/day). There was no evidence for an elevated risk at lower drinking levels; when the reference category was set at <3 drinks/day, the OR was below unity until 7 drinks/day, and the trend in the risk was significant. In non-drinkers, the OR was 9.38 (95% CI 3.35-26.26) for current smokers and 4.23 (95% CI 1.41 — 12.73) for ex-smokers, as compared to never smokers. The OR increased with increasing number of cigarettes smoked per day (P= 0.004 for trend) and was 13.56 (95% CI 3.90-47.19) for >25 cigarettes/day. Even in non-smokers the uniquely large data set confirms a strong role of tobacco in the risk for laryngeal cancer. Alcohol abuse also appears to increase the risk, even in non-smokers. In contrast with cancers of the oral cavity and oesophagus, no excessive risk was found for moderate drinking.

Source. Bosetti C, Gallus S, Franceschi S et al. Cancer of the larynx in non-smoking alcohol drinkers and in non-drinking tobacco smokers. BR J Cancer 87 (2002) 516-518.

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