Quantification of the role of smoking and chewing tobacco in oral, pharyngeal, and oesophageal cancers

Summary.-A retrospective case-control study of 200 patients with head and neck cancer, and 200 controls matched for age and sex, confirmed the importance of tobacco and alcohol consumption in the aetiology of malignant tumours of the upper gastrointestinal and upper respiratory tracts. A male-female ratio of 3:1 was found, and the association of smoking with laryngeal cancer and of alcohol with cancer of the tongue was particularly strong. A significant excess of alcohol-related occupations was found among the cases. These findings are discussed.

Section: Combined Effect Of Tobacco and Alcohcmentioning

confidence: 99%

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

Herity¹,

Moriarty²,

Bourke³

et al. 1981

“…The epidemiology of gingival carcinoma has been studied previously as part of a case spectrum consisting of other intra oral and head and neck cancers (Sanghvi et al, 1955;Shanta & Krishnamoorthy, 1959, 1963Wahi et al, 1965;Jussawalla & Deshpande, 1971;Jayant et al, 1977: Notani, 1988 Pan chewing, pan-tobacco chewing, bidi smoking, cigarette smoking, alcohol and nasal snuff inhalation were the habits ascertained for the cases and controls. Pan chewing is defined as chewing of a quid containing fresh betel leaves (Piper betle), arecanut (Areca catechu) and aqueous lime (calcium hydroxide).…”

mentioning

confidence: 99%

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confidence: 99%

Tobacco chewing, alcohol and nasal snuff in cancer of the gingiva in Kerala, India

Sankaranarayanan

Duffy²,

Padmakumary³

et al. 1989

Summary A case-control study of cancer of the gingiva was carried out in Kerala, Southern India, using 187 cases and 895 hospital-based controls. We investigated the effects on risk in males of pan (betel)-tobacco chewing, bidi and cigarette smoking, drinking alcohol and taking snuff. In females only pan-tobacco chewing was investigated as very few females indulged in the other habits. Among males, significant positive associations with risk were observed for pan-tobacco chewing (P<0.001), bidi smoking (P<0.001), alcohol drinking (P<0.001) and snuff use (P<0.05). In females, pan-tobacco chewing had a similar predisposing effect (P<0.001). Daily frequency of pan-tobacco chewing was the strongest predictor of risk in males, with a relative risk of 15.07 associated with chewing ten or more quids per day. The corresponding relative risk among females was 13.69. In males a relative risk of 3.20 was associated with smoking more than 20 bidis per day, and relative risks of 2.62 and 3.90 were associated with regular use of alcohol and snuff respectively. Surprisingly high relative risks were observed in association with occasional use of pan-tobacco, bidi, cigarettes, alcohol and snuff. A stepwise logistic regression analysis yielded four predictors: pan-tobacco daily frequency, duration of bidi use, and alcohol and snuff use (regular versus never). There were also significantly elevated risks associated with occasional indulgence in these four habits. Total lifetime exposure was no better at predicting risk than daily frequency or duration of habits.Cancer of the gingiva is an uncommon malignancy in many parts of the world. The highest incidence rates which are of the order of 2.3 per 100,000 population per year are reported from the Indian subcontinent (Muir et al., 1987). In many parts of India it constitutes 10-15% of all intra oral cancers and 2-3% of all incident cancers (National Cancer Registry Project, India, 1982-1985Krishnan Nair et al., 1988).The epidemiology of gingival carcinoma has been studied previously as part of a case spectrum consisting of other intra oral and head and neck cancers (Sanghvi et al., 1955;Shanta & Krishnamoorthy, 1959, 1963Wahi et al., 1965;Jussawalla & Deshpande, 1971;Jayant et al., 1977: Notani, 1988 Pan chewing, pan-tobacco chewing, bidi smoking, cigarette smoking, alcohol and nasal snuff inhalation were the habits ascertained for the cases and controls. Pan chewing is defined as chewing of a quid containing fresh betel leaves (Piper betle), arecanut (Areca catechu) and aqueous lime (calcium hydroxide). Locally cured tobacco leaves and/or stem are added to the quid in pan-tobacco. Bidi is a local cigarette containing 0.5 g of coarse tobacco dust rolled in a dried temburni leaf. The alcohol predominantly consumed is either 'toddy' (a locally fermented distilled sap from palm trees) or another locally brewed liquor called 'arrack' (approximately 40% ethanol) or both. Consumption of wine, beer, brandy, whiskey, gin and rum, collectively known as 'foreign liquors' is uncommon. The snu...

“…As seen earlier, bidi smokers with or without the additional habit -of tobacco chewing have a much higher risk of cancer of the oropharynx including base of the tongue and larynx compared to cigarette smokers. Consequently, one could (Jayant et al, 1977). Even so, the change in cumulative incidence rate in successive cohorts is similar to the pattern observed for hypopharyngeal cancer.…”

Section: Methodsmentioning

confidence: 52%

Cancers of the upper alimentary and respiratory tracts in Bombay, India: A study of incidence over two decades

Jayant

Bb²

1987

Self Cite

Summary Cancers of tongue, oropharynx and larynx in males have registered a decline in incidence over the last two decades in Bombay. This decline has been shown to be a cohort effect. A synoptic measure of risk in each birth cohort, obtained by estimating site-specific cumulative incidence rate over an appropriate age range, was found useful in assessing the risk differential in successive birth cohorts.The changing pattern in incidence of cancers at several sites viz., tongue, oropharynx, and larynx, where bidi smoking is the predominant risk factor, were in conformity with the pattern expected on the basis of changing tobacco habits in the birth cohorts. However, for other sites, viz., hypopharynx, oesophagus and lung, more detailed information on relevant tobacco habits in the birth cohorts is necessary for interpreting the absence of a consistent trend in successive birth cohorts.The recent trends in per capita consumption by type of tobacco (viz., chewing /bidi/cigarette) suggest an emerging cancer pattern in the country at variance with the pattern expected from the current cancer trends in Bombay. Consequently, it is desirable to direct primary cancer prevention programmes especially to cigarette smokers in urban centres and to both bidi and cigarette smokers in the rest of the country.Cancers of the upper alimentary and respiratory tracts constitute almost 50% of all cancers in males in Bombay. These cancers are known to be aetiologically associated with the habit of chewing and smoking tobacco. It is relevant to examine the available data for time trends in incidence of these cancers and to attempt an explanation in the light of the changing pattern of tobacco habits in the population. Subjects and methodsThe Bombay Cancer Registry which was set up in 1964, provides data on chronological trends in incidence of various cancers in the city over a 20 year period (Table I). With a little care in adjusting for differences in classification in the 7th to the 9th revision, of International Classification of Diseases (ICD), the age adjusted rates for various systemic groups could be compared. For specific sites, trends in incidence rates could also be studied in some detail. Furthermore, if the average annual incidences reported for the various periods 1964-66, 1968-72, 1973-77, 1978-82 are considered to represent the incidence at the respective mid points of the given periods, we would have age-specific incidence rates for successive fifth years, viz., 1965, 1970, 1975 and 1980 enabling us to compare the age-specific incidence curves for successive 5 year birth cohorts. For instance, the age-specific rates for 30-34 years in 1964-66, 35-39 in 1968-72, 40-44 years in 1973-77, 45-49 years in 1978-82 could be taken to represent the age-specific incidence rates for 32.5, 37.5, 42.5, and 47.5 years respectively, for those born in 1933, for the purposes of drawing the corresponding age-specific curve.Although the age-specific incidence curves for cohorts indicate the differences between cohorts, the risk dif...