Tobacco and alcohol use and oral cancer in Puerto Rico
Tobacco and alcohol use and oral cancer in Puerto Rico
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DOI：
10.1023/a:1008876115797
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发表时间：
1999-02-01
影响因子：
2.3
通讯作者：
Winn, DM
中科院分区：
文献类型：
--
作者：
Hayes, RB;Bravo-Otero, E;Winn, DM
目的：确定波多黎各与使用酒精和烟草相关的口腔癌风险。方法：在波多黎各，比较了口腔和咽非唾液腺癌（n = 342）、大唾液腺癌和小唾液腺癌（n = 25）和521例以人群为基础的对照组的酒精和烟草使用情况。结果：酒精（通常使用，男性的p趋势< 0.0001，女性的p趋势= 0.02）和烟草（通常使用，男性和女性的p趋势< 0.0001）是波多黎各口腔癌的强大独立危险因素，并具有综合暴露的倍增效应。使用过滤嘴香烟和不使用过滤嘴香烟的风险没有系统差异。在男性和女性中，使用其他形式吸烟的风险约为7倍。在停止使用烟草和酒精后，风险才逐渐降低。吸烟与唾液腺癌有关，但与酒精无关。波多黎各因饮酒和吸烟导致的口腔癌负担（男性76%，女性52%）与早先对美国大陆人口的估计非常吻合，而约72%的唾液腺癌（男性和女性加起来）是由吸烟造成的。结论：波多黎各口腔癌的过度风险在很大程度上可以用酒精和烟草使用模式来解释。吸过滤嘴香烟和不吸过滤嘴香烟不会改变风险，而停止烟酒使用似乎只能逐渐降低风险。
Objectives: To determine risk for oral cancer in Puerto Rico associated with use of alcohol and tobacco.Methods: In Puerto Rico, alcohol and tobacco use were compared among nonsalivary gland cancers of the mouth and pharynx (n = 342), cancers of major and minor salivary glands (n = 25) and 521 population-based controls.Results: Alcohol (usual use, P-trend < 0.0001 for men and P-trend = 0.02 for women) and tobacco (usual use, Ptrend < 0.0001, for both men and women) were strong independent risk factors for oral cancer in Puerto Rico, with a multiplicative effect from combined exposures. Risks did not vary systematically by use of filter vs. nonfilter cigarettes. Risks with use of other forms of smoked tobacco were about sevenfold among both men and women. Risks decreased only gradually after cessation of tobacco and alcohol use. Tobacco use, but not alcohol, was linked to cancers of the salivary glands. The burden of oral cancer due to alcohol and tobacco use in Puerto Rico (76% for men, 52% for women) agreed closely with earlier estimates for the mainland US population, while about 72% of salivary gland cancer (men and women, combined) was due to tobacco use.Conclusions: Excess risks for oral cancer in Puerto Rico are largely explained by patterns of alcohol and tobacco use. Smoking filter vs. nonfilter cigarettes does not alter risk, while cessation of alcohol and tobacco use appears to reduce risk only gradually.