Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer
Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer
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DOI：
10.1016/j.oraloncology.2011.05.004
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发表时间：
2011-08-01
期刊：
影响因子：
4.8
通讯作者：
Macfarlane, Gary J.
中科院分区：
文献类型：
--
作者：
Anantharaman, Devasena;Marron, Manuela;Macfarlane, Gary J.
烟草和酒精是上呼吸道(UADT)癌症的主要危险因素，整个欧洲的UADT癌症发病率存在显著差异。我们已经估计了由烟草和酒精解释的UADT癌症负担的比例，以及这种比例如何随着整个欧洲的发病率、癌症亚群、性别和年龄的变化而变化。这应该有助于估计包括人类乳头瘤病毒在内的其他危险因素对UADT癌症的最小残余负担。我们分析了来自ARCAGE多中心研究的1981例UADT癌症病例和1993例对照病例。我们估计了单独吸烟、单独饮酒及其联合作用的人群归因风险(PAR)。烟草和酒精共同解释了UADT癌症负担的73%，其中近29%是由吸烟单独造成的，不到1%是由酒精本身造成的，44%是由烟草和酒精共同作用造成的。烟草和酒精共同导致下咽/喉癌(PAR=85%)的比例高于口咽癌(PAR=74%)、食道癌(PAR=67%)和口腔癌(PAR=61%)。烟草和酒精加在一起只解释了女性UADT癌症总负担的一半左右。从地理上看，烟草和酒精导致UADT癌症的比例在中部(PAR=84%)高于南部(PAR=72%)和西欧(PAR=67%)。虽然欧洲大多数UADT癌症是由烟草或烟草和酒精的共同作用引起的，但我们的结果支持了其他危险因素的重要作用，特别是对口腔和口咽癌以及南欧和西欧的UADT癌症。(C)2011爱思唯尔有限公司。保留所有权利。
Tobacco and alcohol are major risk factors for upper aerodigestive tract (UADT) cancer and significant variation is observed in UADT cancer rates across Europe. We have estimated the proportion of UADT cancer burden explained by tobacco and alcohol and how this varies with the incidence rates across Europe, cancer sub-site, gender and age. This should help estimate the minimum residual burden of other risk factors to UADT cancer, including human papillomavirus. We analysed 1981 UADT cancer cases and 1993 controls from the ARCAGE multi-centre study. We estimated the population attributable risk (PAR) of tobacco alone, alcohol alone and their joint effect. Tobacco and alcohol together explained 73% of UADT cancer burden of which nearly 29% was explained by smoking alone, less than 1% due to alcohol on its own and 44% by the joint effect of tobacco and alcohol. Tobacco and alcohol together explained a larger proportion of hypopharyngeal/laryngeal cancer (PAR = 85%) than oropharyngeal (PAR = 74%), esophageal (PAR = 67%) and oral cancer (PAR = 61%). Tobacco and alcohol together explain only about half of the total UADT cancer burden among women. Geographically, tobacco and alcohol explained a larger proportion of UADT cancer in central (PAR = 84%) than southern (PAR = 72%) and western Europe (PAR = 67%). While the majority of the UADT cancers in Europe are due to tobacco or the joint effect of tobacco and alcohol, our results support a significant role for other risk factors in particular, for oral and oropharyngeal cancers and also for UADT cancers in southern and western Europe. (C) 2011 Elsevier Ltd. All rights reserved.