A case-control investigation of alcohol, tobacco, and diet in head and neck cancer

A case-control study of head and neck cancer in the Republic of Ireland

“…In his 1956 study of cancer of the larynx Wynder and his colleagues found that consumption of spirits was greater among cases than controls, but in a later study (1976) no significant differences in the type of alcohol consumed were found. Feldman & Hazan (1975) found no difference between cases and controls except for "mixed" drinkers, who predominated among the cases. It seems likely that it is the total quantity of alcohol consumed which is important in the development of cancers of the upper respiratory and alimentary tracts, but the possibility that "mixed" drinking increases the risk cannot be ruled out.…”

“…The findings of Feldman & Hazan (1975) were similar, but a significant synergistic effect between tobacco and alcohol was not demonstrated. In this series heavy drinking in the presence of non-and light smoking produced only a small increase in risk, but when combined with heavy smoking the risk rose sharply.…”

“…It is likely that other aetiological factors are important in the development of head and neck cancer in women, particularly in the cases of cancer of the pharynx, which is relatively more common in women than in men. Assessment of nutritional status was not undertaken in this study, since many researchers have shown (Wynder et al, 1957;Martinez, 1970;Feldman & Hazan 1975) that retrospective dietary histories do not usually detect differences between cases and controls. However, it seems clear (Wynder & Chan, 1970;Wynder et al, 1976) that the whole question of dietary deficiencies and of their effect on the metabolism of epithelial cells is one which should be further investigated.…”

“…Many studies (Wynder et al, 1956;Feldman & Hazan, 1975;Jayant et al, 1977;Simarak et al, 1977;McMichael, 1978;Ward Hinds et al, 1979) Wynder et al (1976) showed that at each measure of cigarette consumption heavy alcohol consumption increased the risk of laryngeal cancer, but no such increased risk was seen in non-smoking heavy drinkers. The findings of Feldman & Hazan (1975) were similar, but a significant synergistic effect between tobacco and alcohol was not demonstrated.…”

“…MANY STUDIES (Wynder et al, 1956;1976;Vincent & Marchetta, 1963;Rothman & Keller, 1972;Feldman & -Hazan, 1975;McMichael, 1978;Ward Hinds et al, 1979) have demonstrated a positive association between the consumption of tobacco and alcohol and the development of head and neck tumours. The 1979 Surgeon General's Report included references to studies in many parts of the world which show that the use of tobacco in all its forms is a risk factor in oral and laryngeal cancers.…”