Pipe smoking and cancers of the upper digestive tract

Abstract

Pipe smoking has been related to the risk of cancers of the upper digestive and respiratory tract, but quantification of the risk for exclusive pipe smokers is still limited. To analyse the association between exclusive pipe smoking and cancers of the upper digestive tract, we used data from a series of case-control studies conducted in Italy and Switzerland between 1984 and 1999. After excluding cigarette and cigar smokers, 41 male oral and pharyngeal cancer cases, 52 male oesophageal cancer cases and 1,032 male controls were included in the present analysis. Odds ratios (OR) of cancers were estimated by the mean of unconditional multivariate logistic regression, including terms for age, study centre, education, body mass index, and alcohol drinking. Compared to never smokers, exclusive pipe smokers had an OR of 8.7 [95% confidence intervals (CI): 4.0-18.9] of all upper digestive tract cancers. The OR was 12.6 for oral and pharyngeal and 7.2 for oesophageal cancer. Pipe smokers who were also heavy alcohol drinkers had an OR of 38.8 (95% CI: 13.6-110.9) as compared to never smokers and light drinkers. Thus, pipe smoking and heavy alcohol drinking appears to interact at least on a multiplicative model. ' 2007 Wiley-Liss, Inc.Key words: digestive cancer; pipe smoking; case-control study; risk factors Pipe smoking has been related to the risk of cancers of the upper digestive and respiratory tracts, 1,2 but quantification of the risk for exclusive pipe smokers is still limited. The American Cancer Society Cancer Prevention Study II (ACS-CPS II) 2 reported relative risk (RR) of oral and pharyngeal cancers of 3.9, based on 15 deaths, and of oesophageal cancer of 2.4, based on 20 deaths, for current pipe smokers. Another cohort of 25,129 Swedish men enrolled in 1963 and followed-up to 1979 gave RRs of 1.4 for cancers of the oral cavity, pharynx and larynx (based on 3 deaths) and of 3.6 for cancer of the oesophagus (based on 6 deaths). 3Other cohort studies from the USA 4,5 reported similar RR for oral, pharyngeal and oesophageal cancers, again based on small numbers. Finally, in a study including 104 case/control pairs from Beijing, China, the multivariate odds ratio (OR) of oral cancer among exclusive pipe smoking was 5.7 in males and 4.9 in females. 6 To provide further quantification of the risk of upper digestive tract neoplasms for exclusive pipe smokers, we analysed data from a network of case-control studies conducted in Italy and Switzerland. Material and methodsThe present analysis is based on data from 3 hospital-based case-control studies of cancers of the oral cavity and pharynx, and 3 case-control studies of the cancer of the oesophagus, whose methods have already been described. [7][8][9][10][11] Only male subjects were included in the present analysis, since female cancers of the upper digestive tract are rare, and the proportion of female pipe smokers is negligible.Two Italian case-control studies on oral and pharyngeal cancers were conducted between 1984 and 1997 in the greater Milan area and the pro...

Molecular and health effects in the upper respiratory tract associated with tobacco smoking other than cigarettes

“…It was also established that pipe smokers who were also heavy alcohol drinkers had OR equaled to 38.8, which strongly indicates the multiplicative interaction of pipe smoking and heavy alcohol drinking. 104 The findings concerning pipe smoking are in agreement with the study on cancer risk in exclusive cigar smokers (137,243 male participants). Current cigar smoking increased a risk of death from lung cancer (RR = 5.1), oral cavity/pharynx (4.0), larynx (10.3) and esophagus (1.8).…”

“…Odd ratios compared to never smokers were as follows: 8.7 for all upper digestive tract cancers, 12.6 for oral and pharyngeal cancers, and 7.2 for esophageal cancer. It was also established that pipe smokers who were also heavy alcohol drinkers had OR equaled to 38.8, which strongly indicates the multiplicative interaction of pipe smoking and heavy alcohol drinking . The findings concerning pipe smoking are in agreement with the study on cancer risk in exclusive cigar smokers (137,243 male participants).…”

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